Management requires focus and education

“Are you crazy?” That was my first reaction when my now co-founder and partner, Dr. Gary Gerber, first approached me almost four years ago with the concept of a dedicated myopia management business. Despite my misgivings, I was intrigued by the idea, having spent more than 15 years in the industry at CIBA Vision/Alcon and knowing the growing incidence rate of myopia in children. I understood the massive need and business opportunity, but had concerns about the early stage of our knowledge of treatment options and the low public awareness of myopia as a real issue.

Gary and I spent the next few months assembling an advisory board of leading minds on the clinical and commercial side of myopia management and doing extensive (and expensive) consumer research to understand the true market potential and business model. More than two years later, with hundreds of children now in myopia treatment at our Treehouse Eyes centers, I took some time to reflect on lessons learned.

Example of the eye health risk chart.
Image courtesy of Treehouse Eyes


For those looking to add myopia management to their practices, or do more of it, my advice is to ensure you think about this as a different business, not a part of your primary care practice. This is because the main lesson learned doing only myopia management all day, every day is it requires intense focus to do it properly.

At various industry meetings, I talk with O.D.s and industry executives who are “dabbling” in myopia as part of a full-scope practice. This may be a source of difficulty if approached in the same way many other specialties are when added to a practice. As we have tested and learned, it has become evident that myopia management is closer in business model to an orthodontic practice or a refractive surgery practice than a typical optometry practice. Higher price points, more chair time, lack of insurance coverage and the need to educate parents are all similarities myopia management shares with these specialties.

In fact, one of our advisory board members is a renowned refractive surgeon. Lessons learned from his practice have helped us tremendously, as we’ve been able to triple the close rate to treatment since first opening. One of these lessons was to have a high-quality, branded folder made up for each parent to take home. This folder contains a customized treatment plan for the child, lifestyle recommendations and financing/payment options. This helps parents to have everything they need to commit to treatment in one place.


Another key lesson learned is how much education is required. “Why haven’t I heard about this before?” is a common question, and many parents are skeptical about myopia management or even angry when hearing about it because their pediatrician or primary care eye doctor never mentioned the eye health risks associated with progressing myopia. At Treehouse Eyes, we are on version 10 of what and how we educate parents, as well as when and what we give them to take home.

One simple, but amazingly effective, change we made after a few months was to have an eye health risk chart printed for each patient. This chart lists the risks of several eye diseases associated with progressive myopia and the increased risk at various levels of myopia. After the history and initial consultation, the doctor pulls out the chart and shows the parent the child’s current myopia, with associated risk levels and where they may progress to if not treated. (See image, p.34.) That sheet helps make the risks associated with non-treatment very real for the parent.

Quality materials for parents to share with their spouses are critical, as is relentless and scripted follow-up from a dedicated and well-educated staff. More manufacturers are creating templates for practices to use to educate parents. It is key for practices to take these and adapt them for their own practice brand and needs, so they can effectively educate parents on how they can help their myopic children.

Translating Lessons to Action Steps

KEY TAKEAWAYS from the article include:

→ Seek advice from managers of other businesses, such as orthodontia or refractive surgery, on how, specifically, they’ve been able to help a large pool of patients.

→ Send parents home with a high-quality folder that contains all the information about myopia treatment, as it pertains to research and their child.

→ Draft and refine continuously scripts educating parents on myopia.

→ Look for scripts and other resources from industry to adapt for your own needs.

→ Educate staff, so they are able to continue the conversation with parents about myopia control.

→ Illustrate to parents the risks of non-treatment.


Moving forward, it is exciting to see how the interest in myopia management is growing, but by most estimates, O.D.s are only scratching the surface of treating the millions of myopic children in the U.S. To have a real impact on the eye health of children, O.D.s must accelerate the offering of this service dramatically. There is a need in the market for a variety of models: Dedicated centers, like Treehouse Eyes, focused models within existing full-scope optometric practices and, potentially, even models within refractive surgery practices all make sense to help reach more children in need.

Underlying all this, public education is critical. It has been gratifying to see efforts, such as Essilor’s “Out of Focus” and the Global Myopia Awareness Coalition, created specifically to address this need. Through these education efforts, and focused business models that do myopia management the right way, there is an opportunity to have a profound impact on a generation of children growing up increasingly myopic. OM