Contact Lens Spectrum Supplements

Special Edition 2017

Contact Lens Spectrum

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49 c l s p e c t r u m . c o m C O N T A C T L E N S S P E C T R U M S P E C I A L E D I T I O N 2 0 1 7 highly structured service, you and your staff will build patients' confidence that your practice is the best place to receive their ortho-k treatment. Patient education is also key to a successful ortho- k practice. For patients who are moving forward with treatment, it needs to be absolutely clear what you are offering: the indications, benefits, limitations and risks, and the financial policy you have in place for the service and materials. The most effective way to deliver this in- formation to patients is through documented informed consent. This form should be explained to patients in person and signed in-office before proceeding with treatment. Having a solid informed consent will protect against any confusion between you and the patient. Educating yourself on how to become the best ortho- keratologist is by far the most challenging and important feat for building an ortho-k practice. Before immersing yourself in ortho-k design, you must have a fundamen- tal understanding of basic GP lens design and corneal topography. Consultants and educational programs of- fered by contact lens laboratories are excellent resources to help you learn about ortho-k. Patients will go out of their way to seek excellence, so commit yourself to be- ing the expert at ortho-k, and your practice will grow organically. MARKETING BASICS Your individual marketing and communication strategy will differ in the details from another's plan but should be built on your ortho-k expertise. That is because, without a doubt, word-of-mouth marketing will be key to your success. Word-of-mouth marketing is controllable, but without happy patients it cannot be tion for ortho-k, correction of other refractive errors is achievable with alternate lens designs and fitting philos- ophies. Ortho-k for hyperopia creates central steepening by gently reshaping the midperipheral cornea (Figure 4). Regular astigmatism is correctable through designs that offer back toric curves. 11,12 Ortho-k correction for patients who have undergone LASIK is also available. Other new fascinating applications for ortho-k include corneal crosslinking to prolong the effects of ortho-k and corneal reshaping using alternative lens designs such as corneal scleral lenses and soft contact lenses. 12 As with any contact lens modality, potential risks ex- ist with ortho-k. Symptomatic flare, glare, and reduced contrast sensitivity from higher-order aberrations, par- ticularly when treating high myopia, are common. For- tunately, these symptoms usually decrease with treat- ment progression, unless the lens is decentered. 17-20 Of greater importance is the risk of microbial keratitis (MK) in overnight ortho-k. Vision loss from MK has occurred in children while wearing overnight ortho-k lenses. 21,22 Nevertheless, one retrospective study showed the risk of MK in ortho-k was no higher than with any other lens modality. 23 Patient education regarding hygiene, proper cleaning techniques, handling, and wearing schedule is imperative for reducing the risk of infection. Regularly reinforcing good contact lens habits during follow-up visits is effective at mitigating the risk of MK. Staff education is essential for a successful ortho-k practice. To best represent the practice, all staff mem- bers, even those in reception, should be conversant in ortho-k. Ideally, key staff members are assigned special- ized tasks, such as performing the initial workup, obtain- ing informed consent, and teaching patients proper lens handling and care for ortho-k. This will ensure that data collection, such as corneal topography, is performed efficiently and accurately. By consistently delivering OR THOKERA TOLOGY Figure 3. Example of ortho-k software linked to corneal topography for customizable lens design. Figure 2. Corneal topography difference map pre- and post-orthokeratology. Corneal topography is essential for monitoring ortho-k treatment progress. Courtesy of Jaume Paune PhD, OD, MOVS, FIAO

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