An Interview with Pacific Rims Optometry
As part of PECAA’s Q3 Myopia Management Education Series, we reached out to Selena Chan, OD of Pacific Rims Optometry to find out how she implemented and runs two successful myopia management practice locations in San Francisco, CA.
What Sparked Your Interest in Starting a Myopia Management Practice?
I first became interested in treating and preventing myopia progression because my children are myopic. Both my husband and my brother suffered from the negative effects of high myopia: cataracts and retinal detachment. When my older daughter first became myopic 8 years ago, I didn’t want her to have similar eye issues as my husband and brother. So I decided that I had to find ways to slow her myopia.
What Keeps You Going?
When patients come back year after year with no or minimal change in their myopia, I know that I am making a difference in their lives. One recent success story that I remember vividly was from a 19 year old Chinese man. Seven years ago, his mom came to me, asking if there was any way possible to manage or slow down his myopia.
Throughout the five years that he was on ortho k, he told me he wore the ortho k lenses because his mother told him to. Upon his high school graduation two years ago, he decided that he wanted to discontinue ortho k wear. After we washed him out of his ortho k lenses, his prescription was exactly the same as before his ortho k treatment. He was able to wear his glasses from five years ago! The myopia management program we had for him for the past five years clearly helped halt his myopia progression. It has been two years since he was off of ortho k, and his myopia is still the same as when he was twelve. Another success story is my own daughter. Her myopia has remained the same since she started ortho k eight years ago. I asked her what she would do when she goes to college next year. She said she’d continue to wear her ortho k lenses. She is one of my many patients who were successfully treated with ortho k lenses until adulthood within no to minimal change in their prescription and were happy with my treatment.
What Would You Say Are the Top 3 Things to Consider When Launching a Myopia Management Practice?
1. Willingness to invest in the tools and time to manage myopia: corneal topographer, axial length measurements, retinal camera, different ortho k lens designs and access/knowledge to atropine and soft lens designs.
2. Enthusiastic and supportive staff to help educate and promote myopia management in your practice. All of your staff need to be on board to treat kids with myopia. There are a lot of details involved so you’d need at least one staff who is good at communicating with parents with all their questions and keep track of the frequent follow ups, lens and prescription orders. You will need at least one staff who is experienced with training kids on contact lens insertion and removal as well as using eye drops.
3. Knowledge to put forth a game plan on how to treat myopic kids.
Before a child comes in for their appointment, create a short list of questions to determine if they are at risk. During the exam, have a system of incorporating the test results with the best treatment option for the child.
What is Your Best Advice to Share with New Practitioners?
Practice and Patience.
If initially the results are not what you expected, don’t give up or be afraid to reach out and ask for help. Be persistent in trying to find the best options for your patient. All the consultants for the different ortho k designs and soft multifocal designs are very knowledgeable and helpful and there are several atropine approaches available. If you’re not sure which modality or parameters to order for patient, consult with the manufacturer’s consultants.
Do You Have Preferred Methods that You Use in Your Practice?
Our practice primarily uses ortho k for myopia management but of course we have access, and use, all treatment modalities when appropriate. Patients like to be able to see without any correction during the day. Parents like to be sure that the kids won’t mess with contact lenses while they are in school or sports and of course, they both like that we are slowing down axial elongation. The uncorrected daytime vision is a bonus, but not the core reason for using an ortho k lens for myopia management. For example, one patient had her contact lenses pop out while at school. The teacher had to stop class and have everyone help look for the lenses… disrupting class.
How Do You Market Myopia Control Options to Patients?
When a child comes in with myopia, I plant the seed by informing the parent and the child of the risks of myopia and the options available to them. Our primary myopia management patient base used to be through internal referrals. Since joining Treehouse Eyes, we use their proven protocols to discuss with parents the kids’ myopia risks and management options. Treehouse Eyes have consumer tested content and tools that offices can use to market in their own communities as well as to other doctors.
What Else Would You Like to Share With Us About Your Myopia Control Specialty Practice?
Because myopia management is relatively new to many, I’m sure parents will be skeptical about the need to treat myopia. We need to be proactively learning and have at the ready, quality literature and resources that educate patients or parents of the risks of myopia. As well as the greater perils of myopia if not treated. Nearly all companies offer marketing materials for patient waiting rooms or your website at no-charge. As a Treehouse Eyes practice, we rely heavily on their systems, documentation, marketing and education.