In a perfect world, all young myopes who are good candidates for orthokeratology would have access to the treatment. In reality, there are barriers that may deter providers and patients from initiating myopia management. Navigating these obstacles with tools for parents and your team can ensure patients get the appropriate education and care.
Hesitation From Parents
Orthokeratology requires commitment from parents, so it is important they understand the purpose of the treatment and trust the recommendation of their provider. The parent needs to be aware of the time commitment and the importance of lens care and handling at home. As providers, we can support parents by providing strategies to improve the at-home experience. After the consultation, consider sending some artificial tears home with the patient so the child and parent can practice placing drops in the eyes to start decreasing the lid sensitivity and blink reflexes. Reference materials with application and removal techniques as well as information on care systems and where to purchase them are helpful.
Child Readiness
Children can be ready for orthokeratology at a range of ages. We can support child readiness by asking the patient about their hobbies and how they feel about wearing glasses. Kids love the thought of playing sports, swimming, and playing without glasses on, which usually supports motivation to continue wearing their new orthokeratology lenses in the early weeks. It is also helpful to teach the patient how to properly gain lid control and start application and removal training with proper setup rather than starting with the lens right away. By the time the child returns to the clinic reading 20/20 uncorrected, they are comfortable with the process and so proud to demonstrate to their parents how well they can see.
Team Support
Team support during the growth of a myopia control clinic is invaluable. Team members answering patient calls should have a familiarity with the orthokeratology process, costs, and access to answers to FAQs. A script explaining orthokeratology and its benefits can ensure the message to patients is consistence. Technicians need to be comfortable working with young patients as well as communicating with parents. Building forms with important points the technician can review with the parent can provide a base of knowledge for the parent to support a productive conversation with the provider. Our best technicians have full belief in the process and convey their passion to be part of the care for young myopes.
Financial Investment
Without education on the effects of progressing myopia, the investment into orthokeratology can be an initial hurdle for parents, especially if the parent is not a myope themselves. When building a myopia management program, being upfront with families on what’s included, including initial and recurring costs year-over-year. Be sure to also discuss if your program includes comprehensive eye examinations and visits to evaluate a red eye as well as what happens in the event of a broken or lost lens. The program explanation should also include how financials are handled in case the family decides to discontinue their orthokeratology lens wear. Given the customized design of an orthokeratology lens and the technology needed to properly care for these patients, the cost of a program can create “sticker shock” for some parents. However, with patience, education, and a confident recommendation, the buy-in from the parent can be achieved.
These uncomfortable barriers to building an orthokeratology program can become prepared and confident conversations with your patients and their parents. Despite initial apprehensions, it won’t be long before parents and patients are sharing their positive experiences with other families.
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