From business, to healthcare, to personal growth, pivots from the status quo can reconfigure and streamline a clearer path for success. But when should an ECP consider a pivot in myopia management?
Dr. Adam Peiffer, a pediatric optometrist at University Hospitals Rainbow Babies & Children’s in Cleveland, Ohio, describes 3 strategic myopia management pivots that can improve a practice’s approach to initial prescribing, parent communication, and more.
1. Pivot #1: Prescribe MiSight® 1 day* First vs. Single Vision CLs
Single vision contact lenses are designed to correct vision.1 Full stop. They temporarily address the symptom of distance blur but do nothing to slow myopia progression.1 Further, they may give a false sense of “good enough” while a child’s underlying myopia worsens. Just consider: Investigators from the BLINK study found children who wore single vision CLs progressed the most over three years. During the same time period, those children wearing single vision CLs also experienced more eye growth compared to kids who wore contact lenses designed to help curb myopia progression.1
Early on, Dr. Peiffer personally learned a lesson about prescribing MiSight® 1 day first and foremost vs. starting with a single vision, daily disposable contact lens for a child with myopia.
“Initially for families uncertain about their child's ability to adapt to contact lens wear—particularly given the associated costs—I offered a trial fitting with single vision daily disposable lenses as a lower-risk introduction to contact lens wear. This approach proved counterproductive,” he says.
Why? Pediatric patients adapt well to contact lens wear regardless of lens design, he explains.2
“I’ve since modified my fitting protocol to exclusively trial MiSight® 1 day lenses during the initial evaluation period,” Dr. Peiffer continues. “This approach has resulted in excellent subjective acceptance of vision quality, as patients have no alternative contact lens experience for comparison.”†3
Today, Dr. Peiffer reserves single vision daily disposable contact lenses only in the cases where patients or parents indicate they may not commit to the recommended wearing schedule or when treatment cost is a concern.
“This revised protocol has substantially increased the conversion rate from trial fitting to long-term MiSight® 1 day prescription compared to outcomes observed when single vision lenses were used during the trial period,” Dr. Peiffer says.
Pivot #1 Takeaway: For children with myopia, prescribing myopia control treatment from the start is vital to help ensure they are on the best path when it comes to their future vision and ocular health.1,4,5
Pivot #2: Embrace a Collaborative Care Model
Maybe you’ve drilled down your myopia communication talk to a succinct script that hits on all the key points. But is your well-tuned consult connecting with parents, and are you engaging them in the process?
If not, Dr. Peiffer suggests a communication pivot that adds a personal touch and invites collaboration.
“Given the expanding array of myopia management options now available, parents often ask which approach would be most appropriate for their specific situation,” Dr. Peiffer says. “This provides an excellent opportunity for collaborative decision-making. I emphasize that the selection process is a team effort rather than a unilateral clinical directive. The discussion encompasses not only clinical efficacy data, but also practical considerations including the family’s lifestyle, the child’s capabilities and preferences, and financial feasibility.”
Additionally, every touch point of an exam offers the chance to connect with families on a personal level, even at the end of the visit.
“Perhaps the most memorable—and most frequent—question I receive at the conclusion of many examinations is simply, ‘Would you do this for your own child?’” Dr. Peiffer says. “My response is nearly instinctive: ‘Yes, absolutely!’ This is particularly true when MiSight® 1 day lenses are among the options being considered. This question underscores the trust families place in their eye care provider and highlights the importance of recommending treatments we genuinely believe in and would confidently choose for our own families.”
Dr. Peiffer also encourages his colleagues to view these exam room discussions as educational opportunities and not an avenue to use fear-based tactics as part of an end-goal to get a yes to treatment. “Parents should be provided with evidence-based information about myopic progression and the associated risk factors for ocular complications in adulthood. The goal is informed decision-making, not coercion,” he adds. That buy-in from both parent and child makes a world of difference.
Pivot #2 Takeaway: Successful myopia treatment takes a team approach between an ECP and a family. As a provider: educate, but also collaborate, connect, and listen.
Pivot 3: Advocate for Referrals
Whether you’re new to myopia management or have a long-term program in place, it’s important to create a network of myopia management care with fellow providers and advocate for referrals to make sure children don’t fall through the cracks.
“My primary advice to fellow optometrists is to engage in open, informative conversations with families about myopia management options, regardless of whether you ultimately provide these services in your practice or choose to refer patients elsewhere,” he says.
For colleagues who may feel less comfortable providing myopia management services or prefer to focus their care in other areas, Dr. Peiffer strongly encourages them to refer. “What matters most is that families are made aware of available options. Simply put, we should strive to ensure that no parent looks back years later wishing they had been informed about myopia management strategies when their child was younger and intervention could have made a difference,” he says.
He adds, “By normalizing these conversations within our profession, we empower families with knowledge and uphold our responsibility as primary eye care providers, regardless of whether the ultimate management occurs within our own practices or through collaborative care with colleagues.”
Pivot #3 Takeaway: Connect with other ECPs and healthcare providers in your community and make sure they are referring children with myopia if they aren’t providing this vital care.
Want more? Discover the ease of MiSight® 1 day prescribing here. And click this link to find more reasons why myopia control contact lenses are better than single vision CLs for children with myopia.1 Finally, access other myopia resources and learnings at CooperVision’s Online Success Center.
Adam J. Peiffer, OD, MS, is a Pediatric Optometrist and Assistant Professor in the Division of Pediatric Ophthalmology at University Hospitals Rainbow Babies & Children’s and Case Western Reserve University School of Medicine. He also serves as Residency Coordinator for The Ohio State University College of Optometry affiliated pediatric optometry residency at UH Rainbow Babies & Children's. Dr. Peiffer obtained his OD and Master's degrees from The Ohio State University and completed an Advanced Practice Fellowship in Binocular Vision and Pediatrics. His practice focuses on routine and medical ocular examinations with special interest in pediatric ocular disease, special needs children, sports vision, and myopia management. Dr. Peiffer also serves as the optometrist for the Cleveland Browns providing routine and acute eye care for players, coaches, staff and their families.
