Build on these three foundational steps

With the broader recognition of the global impact of myopia and a deeper understanding of the meaningful role we optometrists play in changing the trajectory of this disease, orthokeratology (ortho-k) is more coveted than ever before.

What’s more, having no age restrictions, it offers both children and adults freedom from visual correction throughout the day; successful, happy patients become loyal to the practice offering the correction “for life” and provide referrals; it is free from the influence and restrictions of third-party payment; and ortho-k is virtually invulnerable to online “disruptors.”

To launch a successful ortho-k practice, I recommend optometrists build on these three foundational steps, which, incidentally, have enabled ortho-k to flourish at my practice.

1 EQUIPPING

In addition to the standard equipment needed for a comprehensive optometric visual and ocular health exam, topography and biometry are required in an ortho-k practice.

Topography provides essential clinical data for both the initial contact lens design, as well as for troubleshooting. Key analytics include corneal astigmatism, horizontal visible iris diameter, and eccentricity. There are a variety of options in topographers, which provide software-based lens design modules for empirical lens fitting. Additionally, several topographers offer built-in biometry for measuring axial length.

Because ortho-k eliminates refractive error, measuring axial length via biometry is essential for monitoring myopia progression. For ODs who already own a topographer, biometry upgrades may be available. If not, I suggest purchasing a stand-alone optical biometry device. The rewards (both professional and monetary) will multiply many times over as your ortho-k practice grows.

2 MARKETING

My practice employs marketing pieces, such as the example on the left, to educate child and adult patients. I also have found that a good, “old-fashioned” personal discussion with all patients has been the most successful form of promotion. It takes very little time, and serves to highlight the optometrist’s dedication to being on the forefront of managing myopia: providing freedom from visual correction, and offering state-of-the art alternatives to refractive surgery. Remember that every patient either knows or is related to a myopic child or adult who may benefit from the OD’s expertise.

3 IMPLEMENTING

Once optometrists have the necessary technology, they’ll need to train staff, set up related administrative components, and provide patient assets to implement ortho-k in practice.

Regarding staff training, I have found that most of the ortho-k manufactures offer staff education by laboratory representatives online, or who come to the office. The basics of ortho-k are the same, despite design, so the education should center on what ortho-k is, why the practice is offering it, and how to handle parent and patient inquiries, such as the safety of wear. To reinforce this education, I suggest ODs conduct additional dedicated training sessions with their staff, reviewing the exam components, instrument operation, testing flow, and care and handling of ortho-k contact lenses.

When it comes to the related administrative components, optometrists should ensure that their administrative team is proficient in fielding new patient inquiries regarding the basic purpose and procedures, follow-up care, and pricing. I find providing a basic script is a valuable tool in promoting consistent and accurate patient education.

An example script:

“Orthokeratology is a process during which overnight contact lenses (also referred to as retainers) are custom designed by our doctors to gently and temporarily alter the curvature of the cornea to provide corrected vision upon waking and throughout the day, without the use of traditional contact lenses or glasses. When treating children, additional design alterations are employed to focus the light in a specific manner on the retina to control the progression of myopia (nearsightedness). The initial fitting process, including lens design, and follow-up care will take about three months. After that, the patient is monitored on a semi-annual basis. The cost for the initial fitting, lenses, and three-month follow-up care is_____.”

Patient assets may be in the form of printed handouts, electronic documents, and/or QR codes or links to web-based videos or tutorials. The topics for these materials can include information for parents on myopia progression and risk, lens insertion and removal training, and the OD’s informed consent/patient responsibility “contract.” Many resources, such as the American Academy of Orthokeratology & Myopia Control (aaomc.site-ym.com ), are available for accessing ready-to-use assets, and can be further edited and customized with your clinic logo. OM

DR. RESNICK is president and managing partner at Drs. Farkas, Kassalow, Resnick, and Associates, a contact lens and anterior segment specialty practice in New York. She is a diplomate in the Cornea, Contact Lens, and Refractive Technology section of the AAO, a diplomate of the ABO, and a fellow of the Scleral Lens Education Society.