Published in Myopia

The Orthokeratology Practice Management Crash Course Webinar

This post is sponsored by Euclid Vision Corporation
6 min read

Join host Craig W. Norman, FCLSA, Azinda Morrow, OD, FAAO, and David L. Kading, OD, FAAO, FCLSA for a crash course on orthokeratology practice management.

  • Introduction (0:00-3:38)
  • Why myopia management? How does this benefit your practice? (3:39-9:30)
  • Why doctors should consider Ortho-K for myopia management (9:31-17:19)
  • How do you determine product positioning and fee structures for Ortho-K? (17:20-41:38)
  • How do you choose a specialty lens partner? (41:39–48:01)
  • Q&A (48:02–1:04:16)
If you’re serious about adding a leading myopia management program to your practice, then adding Ortho-K lenses to your arsenal is a wise decision—especially if you follow this roadmap to success: Myopia Management Success.

The Roadmap to Myopia Management Success

If you’re serious about adding a leading myopia management program to your practice, then adding orthokeratology lenses to your arsenal is a wise decision—especially if you follow this roadmap to success.

Why myopia management? How does this benefit your practice? (3:39-9:30)

Myopia management has become more prevalent over the past several years due to advances in technology and an increased awareness of its benefits. More importantly, doctors are realizing how closely linked myopia is to other diseases that can impact vision and ocular health. Successful and early myopia management can potentially prevent these serious conditions.
“As a full-scope optometrist, I was seeing patients with glaucoma, macular degeneration, or retina disease and it just hit me one day, ‘What is the refractive error of all of these patients with all this disease?'” Dr. Kading said. “I thought, ‘We're working so hard to manage these patients at the end, what are we doing at the beginning?’”
“It's a great way to make sure we're setting our kids up for success in the future and avoiding all of those long-term complications,” Dr. Morrow added. “It’s also a unique way to set your practice apart in terms of offering the best care possible for your patients with the newest types of lens offerings.”
Additionally, Drs. Kading and Morrow pointed out that myopia management:
  • Provides clinical and lifestyle benefits to patients—as well as financial benefits to the practices that provide it
  • Helps providers expand their patient base to include more children
  • Allows providers to adopt a more holistic approach by including preventative medicine
  • Enables the early detection of other issues related to the child’s eye health
  • Helps the entire practice team feel good about the positive results achieved

Why doctors should consider Ortho-K for myopia management (9:31-17:19)

In addition to orthokeratology (Ortho-K), other modalities used to address myopia include soft multifocal contact lenses, atropine drops, and spectacles—or some combination of those.
In that context, when should a provider decide to use Ortho-K?
Dr. Morrow said she encourages parents to consider the various options for myopia management and to “pick the one they’re most excited about, which will set us both up for success.”
Additionally, Dr. Morrow:
  • Works with patients across a wide age range; some as young as 5 years old
  • Believes Ortho-K is a good fit for patients with very active lifestyles
  • Emphasizes that a benefit of Ortho-K is that all maintenance can be performed at home
In Dr. Kading’s practice:
  • The focus is on prescriptions under 4 diopters of myopia (but he sometimes expands beyond 5 diopters of myopia)
  • If a patient has astigmatism, he wants it to be under 2 cylinders before transitioning to a toric Ortho-K lens
  • Myopia management is being provided for patients as young as 3 years old, with Ortho-K being offered to children as young as 4
“Orthokeratology has really changed over the last couple of years and it's far easier than it used to be,” Dr. Kading said.

How do you determine product positioning and fee structures for Ortho-K? (17:20-41:38)

Compared to other modalities, positioning Ortho-K in a practice requires additional considerations — such as determining fees.
Dr. Morrow said that since the refractive error for Ortho-K lenses is much more limited, it is the “pickiest” of the myopia management modalities and has a higher price tag. actors contributing to price include the need for custom-made lenses and increased visit frequency for patients and their families. In that light, it is important to clearly communicate the value that’s being provided.
Dr. Kading underscored the fact that providing Ortho-K is specialty care and thus carries a premium rate.
“We're giving these patients an incredible quality of life,” he explained. “And that involves more time and expertise on our part, as well as the use of a product that is a bit more costly than other options.”
Dr. Kading said that in his practice:
  • A one-cost myopia management “umbrella” is provided that includes various treatment modalities
  • Participation in Treehouse Eyes has been very helpful for staff training and support
  • He uses a spreadsheet calculator (Myopia Management Business Model) he created to assess the financial impact of myopia management on the practice and to help determine fees (32:12)

How do you choose a specialty lens partner? (41:39-48:01)

“Consultation is one of the key things I look for when choosing a specialty lab,” Dr. Morrow said. “It’s important to ensure there are people on the manufacturing side who are very knowledgeable about their lenses and can offer helpful tips.”
Tips for choosing a speciality lens partner
  • It can take time to build a relationship with a specialty manufacturer
  • Most companies are eager to help new practitioners who are “learning their lens inside and out”
  • It is important to assess warranty details and the number of lens exchanges permitted
  • The more simple and seamless the process can be, the better it is for everyone
  • Euclid’s online portal allows ECPs to send topographies to their consultants for easily collaboration when needed
“If you do not hang up the phone and feel like a hero, then you need to find a different laboratory,” Dr. Kading added. “Their job is to help you be successful. If you don't feel they're doing that, then you need to find someone else.”
David L. Kading, OD, FAAO, FCLSA
About David L. Kading, OD, FAAO, FCLSA

Dave Kading, OD, FAAO, FCLSA, is an optometrist with three practices in and around Seattle, Washington. Along with being recognized as one of the top 50 optometry influencers of all time and having written thousands of scholarly papers and articles, he is also a consultant for optometry practices and host of The Myopia Podcast.

David L. Kading, OD, FAAO, FCLSA
Azinda Morrow, OD, FAAO
About Azinda Morrow, OD, FAAO

Dr. Azinda Morrow is currently an Associate Optometrist at Silicon Valley Eyecare Optometry & Contact Lenses in Santa Clara, CA. She earned her Doctor of Optometry degree from SUNY College of Optometry in 2017 and completed her residency in Cornea and Contact Lenses at the Illinois College of Optometry in Chicago, IL in 2018.

After completion of her residency, she was an Assistant Clinical Professor at the SUNY College of Optometry / University Eye Center and responsible for clinical supervision of students and residents in both the Cornea / Contact Lens and Myopia Management clinics. In addition, she taught in pre-clinical laboratories and was involved in clinical research.

Now in private practice, Dr. Morrow continues to provide full-scope care to patients of all ages, as well as continuing her passion of caring for patients with specialty contact lens and myopia management needs. Dr. Morrow is also a fellow of the American Academy of Optometry, and a member of the American Optometric Association.

Azinda Morrow, OD, FAAO
Craig W. Norman, FCLSA
About Craig W. Norman, FCLSA

A clinician for over 40 years, he has been involved in the development and evaluation of numerous products and technologies in the soft, GP and scleral lens category. Recently, he was the founding Director of Research at the Michigan College of Optometry, Ferris State University where he remains as adjunct faculty.

From its inception in 2002 through 2018 he was Education Committee Chairman of the Global Specialty Lens Symposium. Mr. Norman has been a Consulting Editor to the Contact Lens Spectrum authoring a column on Prescribing for Presbyopia for 15 years. He is a Member of the Advisory Panel of the GP Lens Institute, Advisory Board Member of the International Keratoconus Academy and has been an Advisory Panel Member to numerous SCL and GP lens companies.

He has published over 160 articles, posters, videos and book chapters on GP and Soft Lens Design, Presbyopic Contact Lenses, Specialty Contact Lens Uses and Eye Care Practice Management and traveled extensively throughout the world lecturing on a variety of contact lens and eyecare related topics.

Mr. Norman is presently the Co-curator of the Contact Lens Museum, President of Professional Optical Resources, Inc., a contact lens industry consultancy group, and CTO (Chief Thinking Officer) of Wink Productions, Inc., an eyecare training and professional development company.

Craig W. Norman, FCLSA
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