Dr. Eiden discussed the following advanced technologies and how they can both be incorporated and applied in optometric practice:

1.  Placido-based Corneal Topography

2.  Anterior Segment Tomography

     a.  Scheimpflug Tomography

     b.  AS-OCT

3.  Corneo-Scleral Profilometry

     a.  NaFl-based

     b.  Scheimpflug-based

     c.   Impression-based

4.  Specular Microscopy

5.  Aberrometry

     a.  Diagnostic technologies

     b.  Therapeutic approaches

6.  Ocular Surface Diagnostics

     a.  Meibography/Osmolarity/MMP9s/Others

7.  Genetic Testing of Corneal Diseases

8.  Ocular Biometry

Some clinical pearls from this presentation included:

★ Outstanding graphics for all of the technologies presented

★ Technology allows us to individualize/personalize our contact lens management strategies

★ New technologies allow you to customize scleral lens design to match the scleral lens and therefore optimize first-fit success

★ Advanced in aberrometry and contact lens manufacturing allows for the correction of high order aberrations

★ New techniques and instrumentation allow for diagnosis and management of ocular surface and dry eye disease

★ With the advancements made in myopia management, the ability to monitor axial length becomes increasingly important

SPOTLIGHT ON EDUCATION PART II:

The Nuts and Bolts of Orthokeratology

Ariel Cerenzie, OD, FAAO, FSLS

Why Orthokeratology?

1. Myopia – notably high myopia – is a growing concern with resulting increased incidence of retinal pathology – including myopic macular degeneration and retinal detachment – as well as glaucoma.

2. You can change people’s lives – not only as a result of significantly reducing their myopia progression and risk of disease – but also by allowing the freedom provided by not having to wear a correction during the day. It has been found in a study of 100 orthokeratology-wearing children, that this modality increased their self-confidence, increased their willingness to try new things, and increased their activity in sports and entertainment.(1)

3. Practice Builder. Myopia management is rapidly becoming standard of care as traditional spectacles and contact lenses do not impact eye growth or amount of myopia progression. In fact the World Council of Optometry passed a resolution in 2021 for myopia management standard of care. Offering orthokeratology as a service in your practice will allow you to offer an exceptional benefit not provided by most other practices.

Dr. Cerenzie then provided a very good overview of the role of base curve, reverse curve, alignment curve, and peripheral curve in an optimum orthokeratology lens-to-cornea fitting relationship. This also included associated corneal topography changes. She also discussed the benefits and challenges of the three methods of fitting orthokeratology including empirical. diagnostic, and software-designed.

She completed the webinar with a very applicable case example. This was initiated by following the recommendations provided by the fabricating laboratory. The associated parameter determination guide as well as consultation services are invaluable when fitting these patients. This patient was a 7 year-old who progressed from a 1 D myope to a 3 D myope in one year. This patient was put on a combination of low dose atropine and orthokeratology. The orthokeratology design was provided after input of refractive parameters and horizontal visible iris diameter into a calculator. The evaluation of the fit as well as results of the 1 day and 1 week follow-up visits – and what to evaluate on these and future follow-up visits – were discussed.

(1)Zhao F, Zhao G, Zhao Z. Investigation of the effect of orthokeratology lenses on quality of life and behaviors of children. Eye Cont Lens 2018;44(5):335-338

May 17th at 8PM Central

Specialty Contact Lens Coding and Billing Update by Clarke Newman, OD, FAAO, FBCLA, FSLS, FNAP

Sponsored by: Acuity Polymers, Art Optical, Contamac, and TruForm Optics