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Myopia

Myopia Awareness Week: May 24 – 28

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You may have noticed that children’s vision and myopia have been in the news a lot. The New York Times. CNBC. So many others. This is in part due to the concerns over changes in behavior during the pandemic. Not only have many children been E-learning, but even children who are at brick-and-mortar schools are using devices more and been outside less. Research shows this puts them at higher risk for developing myopia.

Just to be clear. “Nearsightedness” is the description we give where people can see up close but not far away. “Myopia” is the condition where the eye grows too long, causing nearsightedness and risk for eye diseases.

The Brien Holden Vision Institute, the preeminent organization for myopia research and education based in Australia, has established the Myopia Awareness Week from May 24 to 28. This global initiative will to bring attention to the growing epidemic of myopia in children across the world. This is an important topic because myopia is worsening around the world. It is estimated that by 2050, half of the population will be myopic.

MAW21 Image 7Fortunately, there is good news. Evidence has shown that increased outdoor time decreases the risk for myopia. Recently the FDA approved MiSight 1-Day contact lenses for controlling myopia progression. Johnson & Johnson has very recently announced their FDA Abiliti orthokeratology brand. Essilor announced that the FDA has granted “Breakthrough Device” designation to its Essilor Stellest™ spectacle lens which are developed to correct myopia and slow down the progression of myopia in children. Additionally, off-label of multifocal contacts, orthokeratology, and atropine are all considerations for myopia control.

Summer is the best time to get students ready for the next school year. I see many children whose myopia has progressed a lot this year, and they are unaware of it. An eye exam is necessary to determine this. If you have questions about myopia management, simply call us at (813) 792-0637 or request an appointment.

One positive note: During the COVID-19 pandemic, I was honored to complete my Fellowship in the International Academy of Orthokeratology and Myopia Control. This makes me one of the few optometrists in the world with Fellowship in American Academy of Optometry, Academy, Orthokeratology and Myopia Control, and the College of Optometrists in Vision Development.

 

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Myopia Control Showcase!

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Some of the most notable images in the office are the Success Trees. These are handprints from the graduates of the Vision Therapy program. Patients are so proud to add their hands to the trees when they complete the program. And they should be! They’ve worked hard.

We want to do something similar for all of our hundreds of Myopia Control Patients. What we envision is a wall with pictures of children and adults who are successfully using ortho-k, atropine, or daily contact lenses. The goal is to both recognize you or your child, but also so other families can see that there is something that something CAN BE DONE about children’s vision and glasses free-vision.

Here are two ways you can help:

1) Help us decide what to call it?

  • Wall of Fame?
  • Myopia Superstars?
  • Bright Eyes Myopia Spectacle! ( get it? )
  • Something else?

2) Submit a picture of you or your child! They can be doing anything, but it is more fun if they are doing something that they love. We’ll frame it and post on the wall with all the others.

With your picture, let us know:

  • if we can use their first name, a nickname, or “A happy Bright Eyes patient” for a caption.
  • A quote about what they like about their myopia/orthok treatment.
  • if we have permission to share on social media as well.

Thank you!!!

I am very excited about this project. Let me know your questions or concerns!

-Dr. Nate and the Bright Eyes Team

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Dr. Nate and Cristina’s kids are both myopia control patients!

Dr. Nate Earns Fellowship in the International Academy of Orthokeratology and Myopia Control

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I am excited to share that I am now a full-fledged Fellow of The International Academy of Orthokeratology and Myopia Control (IAOMC), a non-profit organization of practitioners and academics devoted to the science and education of Orthokeratology and Myopia Control. Since I have offered myopia management options for over a decade, becoming a Fellow has long been a goal of mine.

  • Ortho-K (short for Orthokeratology) is a non-surgical procedure using specially designed contact lenses to gently reshape the curvature of the eye to improve vision.
  • Myopia is a progressive visual disorder that results in poor distance vision. If the myopia is severe, it will impair near vision as well. Myopia is also known as “near-sighted” or “Short-sighted”.” Options exist to help limit the progression of myopia as a child grows.

 

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According to the Academy, these are qualities of a Fellow:

  • Fellows have undergone advanced training and rigorous testing to demonstrate their level of expertise in myopia control and orthokeratology
  • A Fellow is the gold standard and represents the highest level of knowledge, ethics and patient care in the myopia control.
  • Fellows serve as mentors and role models for other practitioners as well as the general public.

This was a year-long process which included presenting multiple complex case reports, passing both written and oral exams. The exams were supposed to take place at the annual meeting in Seattle in April, but the meeting was canceled due to COVID -19 and the testing process had to be completed remotely.

There are approximately 150 Fellows of the The International Academy of Orthokeratology and Myopia Control around the world. And I am one of only a handful that have earned 3 fellowships in the International Academy of Orthokeratology, the College of Optometrists in Vision Development, and the American Academy of Optometry.

I have learned a great deal in the process of becoming a fellow and I look forward to using this knowledge to better help my patients.

-Nathan Bonilla-Warford, OD, FAAO, FCOVD, FIAOMC

Dr. Nate Talks about Screen Size on Bay News 9

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The end of the year is gift-giving time and for many children, that means digital devices and video games. Roy de Jesus of Bay News 9 reached out to Dr. Nate to talk about how the size of the screen matters.

Many people are have learned that more screen time at younger ages is not best. Man parents are familiar with the recent World Health Organization’s screen time recommendations for chidlren. Here are WHO’s screen time recommendations by age:

  • Infant (less than 1 year of age): Screen time is not recommended.
  • 1-2 years of age: No screen time for a 1-year-old. No more than an hour for 2-year-olds, with less time preferred.
  • 3 to 4 years old: No more than one hour.

But not everyone realizes that the size of the screen matters, too. It is not just whether kids can see the device but how harder their eyes have to work to be able to see it. Basically, the smaller the screen the more the eyes have to work.

Here is what happens:

  • Kids want to see more detail on the small screen.
  • They hold the device closer than they would normally hold a book or a larger screen.
  • The closer the eyes have to focus, the harder the eyes have to work to make the screen clear
  • The eyes have to turn inward to keep the screen from becoming double.
  • This extra effort can cause eyestrain.
  • In the short team, this discomfort may lead to unwanted behavior or frustration.
  • Long term, this can contribute to myopia or other vision problems.

Fortunately, you do not need to throw out the new devices. Here are some things you can do:

  • As parents, role model proper device use yourself
  • Participate in screen time with your children and observer their behavior.
  • Enforce regular screen breaks with outside time.
  • Educate kids on Harmon Distance AKA Elbow Distance and enforce it.

If children complain of persistent symptoms such a burning eyes, blurry vision, double vision, and symptoms such as headaches, it is important that a thorough eye exam is done to look for underlying eye and vision problems. Both Dr. Nate and Dr. Beth are residency-trained in children’s vision. You can request an appointment or call (813)-792-0637.

 

 

 

 

 

 

 

 

Perfect Vision is The Perfect Gift: Ortho-K

girl holiday giftsAs the holidays approach, most of us have one thing at the top of our to-do lists: gift shopping! This holiday season, give the gift of perfect vision that will have your loved one thanking you every morning. If you or anyone in your family has myopia (nearsightedness), there is no better gift than Ortho-K lenses.

What is Ortho-K?

Orthokeratology (commonly referred to as Ortho-K, corneal reshaping contact lenses or corneal refractive treatment) is a process that uses specialized gas-permeable lenses to safely and gently reshape the cornea (the clear front surface of the eye), by having them worn overnight and removed in the morning. Doing so provides clear vision all day long without the need to wear lenses or glasses. This FDA-approved method of vision correction is suitable for children and adults, is a safer alternative to LASIK, and can be used for myopia, astigmatism, hyperopia (farsightedness), and occasionally presbyopia (farsightedness due to aging).

Give the Gift of Ortho-K

Children and adults with mild to moderate myopia or those who cannot undergo LASIK or other refractive surgeries (for a variety of reasons) are excellent candidates for Ortho-K. Believe us — they’ll be grateful for this gift!

Ortho-k is not only effective for correcting refractive errors but is also great for slowing the progression of myopia in children — rendering it a particularly meaningful gift for a child. By slowing the progression of myopia, you can greatly reduce your child’s risk of developing serious eye conditions and diseases later in life, such as cataracts, glaucoma, or retinal detachment.

While you can’t wrap this gift up in a box, with Ortho-K, your loved ones will truly SEE the difference!

The myopia management program at Bright Eyes Family Vision Care's Myopia Control Center is dedicated to improving your child’s eye health. Call us with any questions you may have – we’re here for you.

Dr. Knighton and Dr. Bonilla-Warford provides myopia management and other services for patients in Tampa, Westchase, Town 'N' Country, and University, and throughout Florida.

Why a New Pair of Glasses Is NOT the Best Holiday Gift for Your Child

girl hugging her present 3154363If your child is nearsighted (myopic), it may seem like a great idea to get him or her a new pair of glasses. They will surely improve how well your child sees but, unfortunately, will do nothing to slow myopia progression. You can offer your child MUCH more than a pair of specs — something that will ensure long term vision health care and quality of life: Myopia Management.

Myopia Management is made up of several treatments designed to slow down how quickly myopia, or shortsightedness, progresses. In other words, their prescription will remain the same as they grow older. The treatments include uniquely designed multifocal contact lenses, atropine eye drops, and orthokeratology (“ortho-k”). Evidence suggests that myopia management can reduce the progression of myopia by up to 60% after two years of treatment.

What Makes Myopia Management An Excellent Gift?

Currently, myopia is among the leading causes of permanent vision loss and legal blindness.

As a child quickly develops and their nearsighted vision worsens, the child is at a higher risk of developing dangerous eye diseases later in life, such as retinal detachment, macular degeneration, glaucoma, and cataracts.

To thwart any of these sight-robbing conditions, Bright Eyes Family Vision Care's Myopia Control Center offers evidence-based treatment to prevent the onset or reduce the progression of myopia in our pediatric patients.

Myopia management enables your child to experience a more mild form of myopia than he or she would have otherwise had without treatment. Having mild-degree myopia means that your child’s likelihood of developing retinal detachment or macular degeneration is dramatically reduced.

So why don’t you make this holiday gift a particularly special one by protecting your child’s precious gift of sight. And the best part? It will pay off well after the holidays are over.

On behalf of Dr. Knighton and Dr. Bonilla-Warford and the staff at Bright Eyes Family Vision Care's Myopia Control Center in Tampa, we’d like to wish you all the best for the holiday season and the New Year!

Dr. Nate Featured on Local TV News Discussing Children’s Vision

Because it is back to school season, people want to know what they need to do get their kids ready to learn. And one of the most important things they can do is make sure that children can see well. Jenny Dean from WTSP 10 News reached out to Dr. Nate to find out what people need to know. Lucky enough, two amazing Bright Eyes patients shared their experience with orthokeratology, night time contacts that allow them to see the board without glasses or contacts.

 

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A few other pointers:

For kids, eye exams are recommended:

  • at around 6-12 months of age
  • at least once between the ages of 3-5
  • right before first grade
  • every year from ages 6-18.

Signs to look for in kids with:

  • frequent eye rubbing or blinking
  • headaches, especially while reading or using devices
  • covering one eye

 

Read the full article here:

https://www.wtsp.com/article/entertainment/television/brightside/good-to-know/eye-exams-for-kids-are-more-important-than-ever-eye-doctor-says/67-346e9186-8263-461b-8c74-d569b9314e61

Podcast Episode #15: Myopia Management With Esther Rodas

Welcome to The Bright Eyes Podcast: Advice for Healthy Vision for All Ages. Your hosts are Dr. Nate Bonilla-Warford & Dr. Beth Knighton, residency-trained optometrist that provide eye exams for glasses and contacts, and specialty services including vision therapy, myopia control, orthokeratology, and sports vision training. Their mission to empower patients by providing the best in friendly, professional, and individualized eye care.

In this episode, Dr. Nate talks with Optician Esther Rodas about Myopia and the treatment options to control it.

You can listen in the player below or read the transcript. The show is available via Stitcher, Google Play, iTunes, and the webplayer below. You can find all previous episodes here. If you have any questions or suggestions for future episodes, please email office@BrightEyesTampa.com.

Previous relevant episodes:


Full Transcript:

Introduction [00:00:10] Welcome to the Bright Eyes podcast. Advice for healthy vision for all ages. Your hosts are doctor Nate Bonilla-Warford and Dr. Beth Knighton. Residency trained optometrist providing eye care to all ages with exams for glasses and contacts and specialty services including vision therapy, myopia control, Ortho-kertology and sports vision training. Their mission is to empower patients by providing the best in friendly, professional and individualized eyecare.

Dr. Nate [00:00:38] From rainy Tampa Bay. It’s the Bright Eyes podcast.This is episode number 15. I’m Dr. Nate Bonilla-Waford and today’s episode is all about myopia control. I’d like to introduce our special guest today this is Esther Rodas. Esther is an Optician. She works here at Bright Eyes and not only is she an optician, she’s our myopia control coordinator so Hi Esther.

Esther [00:01:05] Hello everyone. So Esther here just like Dr. Nate just mentioned and been here for about a couple of years and usually I will be the one that you talk to if you have any questions on myopia control and scheduling and all of that good stuff.

Dr. Nate [00:01:21] Absolutely. And when Esther joined us she was a student at the Hillsborough Community College in the opticianry program. And now that she’s got her license she works with us full time and we are so lucky to have her and patients just love her and all the staff does too.

Esther [00:01:37] Happy to be here.

Dr. Nate [00:01:38] Excellent. So Esther we introduced myopia in episode six as part of our refractive error episode. And here’s our vision therapist Miriam giving the definition of myopia.

Miriam [00:01:56] Myopia, aka nearsightedness is a condition where objects up close appear clearly while objects far away appear blurry. With myopia, light comes to focus in front of the retina instead of on the retina.

Dr. Nate [00:02:10] So myopia is all about nearsightedness. It’s all about not being able to see very far away without either contacts or glasses or lenses of some sort or for adults they can consider refractive surgery like LASIK. From your perspective Esther when a doctor diagnoses a child with myopia what are some of the most common questions that parents will ask you?

Esther [00:02:36] Definitely first thing they ask is if it’s permanent. If it’ll get better the older that they get?

Dr. Nate [00:02:43] Right. And that’s one of the questions that they ask us doctors are very first thing. They’re like, are they going to outgrow this? Are these glasses that they need? Or is this something that after a while they won’t need anymore? And one of the things about myopia that’s important to understand is while we see it as vision getting blurrier or glasses getting thicker or stronger, what’s really happening in myopia is the eye ball itself is stretching, it’s getting longer and getting bigger and it’s much easier for the eye tissue to stretch and elongate rather than it is to shrink and get smaller. And so for that reason when we’re talking about myopia I like to say it’s a one way street but it doesn’t really get better. And so after they kind of digest that what are the next questions that parents will ask you?

Esther [00:03:40] So once they know what can potentially happen and the inside of the eye they definitely know the options at that point what they can do to limit that progression.

Dr. Nate [00:03:51] Right. And so when I talked to parents, we always talk about myopia as a condition that needs to be managed. It’s not just in one point in time it’s a lifetime of change that we need to think about. We always talk about myopia in the short term and in the long term. So in the short term, kids need to be able to see, they need to be able to see the board at school, they need to be able to see for sports they need to be able to function in everyday life. There’s a variety of different ways that we can help them be able to see clearly and that’s the common things that people are familiar with glasses, contacts, the night time treatment contacts of ortho-K can help people see clearly. So there’s different options and we need to address that first because it’s very important that we make sure that kids have useful vision for living their lives. But, we also need to make sure that we are addressing the long term component. Because myopia tends to worsen and sometimes more dramatically in some patients rather than others- we need to make sure we’re addressing that and offering different kinds of treatments to hopefully reduce the risk of progression. So in our office Esther, what are the three main ways that we use to reduce the progression of myopia?

Esther [00:05:26] We offer here the Atropine medicated eyedrops as one solution. We offer Ortho-keratology which is the night time lenses and we also offer specialty designs soft multi-focal lenses to help with that progression.

Dr. Nate [00:05:46] Right. And we feel very strongly not just with myopia but with all of our patient care that every option needs to be tailored individually to the patient. So it’s not one size fits all. It’s not that every single patient who comes in needs any one particular treatment but it depends on their lifestyle,it depends on their goals,it depends on their genetics,it depends on if they’re more likely to progress. So very briefly we’ll just go over what these options are. The first one which is the most easy to administer are the Atropine eye drops. Now, atropine is a medication that dilate the pupils and it reduces the eyes ability to focus. And for that reason, it hasn’t been widely used in the United States. It’s used for many many conditions but not for myopia control. Until recently when it was discovered that you could use a very low concentration to minimize the side effects. So we have many patients who are on the low concentration atropine treatment to reduce the likelihood of progression. We don’t know exactly how the atropine works, what it’s doing in the eyes but it’s been shown in many many many studies to be effective. So that’s that’s one option. The other option like Esther said was the multifocal contacts.The multi-focal contacts are worn in the daytime just like any other soft contact that you’d be familiar with. But it has a special optical treatment which provides some stimulus to the eye that reduces its need or its inclination to to get worse. We can optically change how the light focus is on the back of the eye to reduce that stimulus to progress and get worse. And so that’s the daytime contacts. The nighttime contacts the Ortho-K does the same thing optically, but it actually reshapes the eyes so that you can see clearly without daytime contacts or glasses. So you get a little bit of a two for one with ortho-K which is great. So once we do the exam and we take lifestyle into account, we look at all of the the treatment options and I will recommend a particular treatment option for a patient. I’ll bring them out and then they will go over the details and the logistics of that treatment option with Esther at that point. What kind of questions do you get?

Esther [00:08:24] So definitely the top question which you kind of touched on right now is their parents are only super interested and intrigued of like the science behind each one and the how is it that the atropine, the multi focal and that the nighttime lends aid in hopefully limiting that progression of the nearsightedness for their child. So anything you can add to what you just said.

Dr. Nate [00:08:48] So the interesting thing about myopia control is even though there are many many scientific papers exploring how well these different options work and how they relate to each other- we don’t thoroughly understand exactly how they work. We have a pretty good idea of how the optical effects of the multi focal contacts on the ortho-K works to reduce that stimulus to progress. We really don’t know as much about how the atropine works. We know that atropine has been used for hundreds and hundreds of years and it’s been used for many many conditions and it’s extremely safe to use. We don’t know what’s exactly going on at the molecular level to help keep the eyes from progressing, but we do know it’s very effective. I know the parents don’t think that that’s a super satisfying answer but it is the honest answer at this point. So what other questions do parents ask you?

Esther [00:09:45] Definitely risks. They want to know what kind of risks are involved and short term risks and long term risk as well. So for example the night time contacts as they are more rigid than the soft lenses. And they always want to know what the risks are for abrasions and things like that. Almost the same for soft contact lenses for short term risks. Long time parents want to know if the ridgid of lenses will affect the kids eligibility to do maybe LASIK in the future. Parents also ask about any effects that that may have on things such as glaucoma and any long term risks in the medicated eye drops. So it’s kind of like a few questions and one.

Dr. Nate [00:10:34] Well I think that that’s really important topic because with any procedure or with any therapy we always need to weigh the benefits and the risks and that’s part of the discussion that always happens between me and the parents when we’re talking about undertaking one of these treatments. Fortunately in the big picture all of these have been proven to be very safe. And that’s why we can feel comfortable doing them. And that’s why I feel comfortable with both of my children using these different methods. My son uses the medicated eyedrops. And my daughter does the night time Ortho-K lenses. Obviously, if I didn’t feel they were very safe I’d be reluctant to use them with my own kids and I know that lots of doctors around the country and around the world have their own children and in myopia control programs similar to these as well. So let’s talk about the different risks with any contacts. There are certainly risks especially if you don’t use proper hygiene, if you don’t care for them properly. If you use them in a way that you shouldn’t be then you increase those risks. Fortunately all of the scientific studies that have shown that with the Ortho-k lenses for night time don’t have any additional risk compared to traditional contact lens wear. And so that that helps us educate patients properly now. The very first question that people ask me is often, well I was told that I shouldn’t sleep in my contacts because it’s not healthy. So why is it healthy to sleep in these contacts. That’s a great question because it’s true that you shouldn’t sleep in your daytime contacts because one- they’re often not intended for that two- if you’re sleeping in them in the nighttime and then wearing them in the daytime then you’re wearing them for a full 24 or multiple cycles. And that can create problems because the lenses never get cleaned with Ortho-k. One, they are super breathable materials. Two, they’re designed specifically to be worn at night and three they’re only worn for about eight hours at night and then they’re being cleaned and stored the rest of the time. Furthermore the Ortho-k lenses rarely or never leave the house. It’s not like the contact lenses that you wear where you get pollen in them you, get dust in them. If you are out and about your eyes can get sweaty you can get sunblock on them if they goes in your eyes etc. Whereas Ortho-k you put them in before you go to bed you take them out in the morning and they’re clean and so the lenses stay very, very clean and we’re very, very clear about the proper method for keeping the lenses clean. Once we have the proper care method established then the risks go way,way down. It is possible in the short term, if the patient doesn’t have good insertion technique for putting the lenses in to lightly scratch or abrade their eye but that’s very, very rare and when it does happen it’s mild and it resolves right away. Now fortunately, we’ve never had any infection for any of our patients and that is incredibly rare with proper care. That’s the same for our for our soft contact lens patients soft contact lenses are healthier than ever before and the risk of infection is is very, very low. I will add here and I always tell patients all the time, that you should never use tap water or you should never clean your lenses with anything other than solutions that have been provided. You shouldn’t shower or swim or go on lakes or hot tubs with your contact lenses on because that can introduce contaminants or bacteria or amoebas that can cause a severe infection. So I was always educating about that.

Dr. Nate [00:14:48] Regarding the atropine, there are known side effects like I mentioned about sensitivity to light and focusing, but by using the lower concentration those are dramatically reduced. Other than that, the only real side effect that can happen with patients sometimes is if the drops come with a certain preservative and the patients are sensitive to that preservative it can cause an allergic like reaction where the eyes get red and irritated. Many of our patients use non preserved drops and that’s not an issue we haven’t found that to be a common problem. But it’s theoretically possible and some patients you it’s hard to know whether they’re they respond to preservatives or not. In the long term, for long term use- atropine has been used for for many years without any problems or side effects.

Esther [00:15:49] We do go through a couple of compounding pharmacies.

Dr. Nate [00:15:53] Yeah, we do have some options and that’s actually an important point. So if you get the high concentration atropine which we don’t use very often except in the very most stubbornly progressive cases, you can get that at almost any pharmacy because that’s the standard formulation that is used to treat eye disease. The lower concentration is only available through compounding pharmacies and we have a variety of options that we can we can help patients acquire that.

Esther [00:16:25] Have you got at all questions about if it’ll affect someone’s eligibility for LASIK in their future or the glaucoma?

Dr. Nate [00:16:33] Yeah and that’s actually a very common question and it’s a great question because sometimes patients are concerned well maybe this reshaping with Ortho-k reshaping of the cornea will adversely affect them for their chances for Lasik and I say you know exactly the opposite. The goal of Ortho-k is to keep the eyes the prescription is stable enough over the long term so that they remain eligible for for LASIK or refractive surgery. What typically happens is people will do Ortho-k starting when they’re when they’re younger maybe you know 10 or 12 years old and they’ll keep doing it until they’re an adult they might stop at 18 or I had a patient just the other day was 12 and she’s now 30 and she’s been doing it continuously. But if she or other patients wanted to stop as an adult they could wait until their eyes go back to their natural shape and once that’s stable and it’s confirmed to be stable with repeated curvature measurements then they are eligible for LASIK just like any other patient will be.

Esther [00:17:44] How about the glaucoma question?

Dr. Nate [00:17:47] So the glaucoma question is interesting because people worry about glaucoma for this reason- they think the Ortho-k lenses press on the eye to reshape the lenses. And if they’re pressing on the eye then that’s going to increase the pressure inside the eye and if you increase the pressure inside the eye that’s going to increase the risk of optic nerve damage called glaucoma. Now the reason why it is not a risk for glaucoma is because Ortho-k lenses don’t actually work by pressing on the eye what they do is they they are kind of a rigid surface that goes over the cornea and then over time the cornea conforms to that lens it- actually kind of expands outwards to meet the shape of the lens so instead of pressing on the eye, the cornea actually reshapes itself or expands to meet the lens. So there’s no reason to think that the pressure inside the eyes increases when we do Ortho-k and therefore there’s no added risk for it for glaucoma. Again kind of like LASIK, nearsightedness itself is a risk factor for glaucoma if you have very high myopia in nearsightedness you have increased risk for for glaucoma. So it may be that doing Ortho-k might actually help reduce the risk long term of glaucoma.

Esther [00:19:25] That’s great information. Thank you. I would say those are the top questions and the last question that I always get at the very end is if these methods are FDA approved?

Dr. Nate [00:19:38] Right. And so here’s the thing about FDA approval all of these methods are FDA approved for a variety of conditions and treatments but not specifically for reducing the progression of myopia. So we’re very clear when we talk to parents and we have it in writing and we explain that while all of these treatments are scientifically valid and there is many studies that talk about the the benefits that the FDA itself has not gotten around to evaluating yet and stating that these methods are specifically approved for the reduction in the progression of nearsightedness. Many other countries have, and there’s lots of scientific evidence to show that it is, but no the FDA hasn’t. Now, all of these things like the atropine eyedrops are approved for treating many, many kinds of conditions including Amblyopia,which is something that we see in the office a lot. A multi-focal contacts are certainly approved for lots of conditions. Specifically, presbyopia for older adults who need to see up close. Ortho-k, the nighttime contacts is approved for treatment of nearsightedness so that people can see clearly throughout the day, but they haven’t gone that extra step yet in approving it specifically for the reduction in the risk of progression. So that’s something that we think it’s important that people understand it doesn’t mean that we shouldn’t do it, but it is in the state of approval right now.

Dr. Nate [00:21:29] Well, hopefully this has been helpful for people who are interested in learning more about myopia control in the future we hope to have some more episodes detailing how each of these methods work. I think it would be kind of fun to have my kids on and they can talk about their experience. That would be that would be interesting to hear it from their own mouth. And we have lots of other topics in mind if you have any suggestions I have topics that you’d like to hear in the future, please let us know. I’d like to thank Esther for joining us and talking to us today. And is there anything else you wanna say before we go now?

Esther [00:22:16] Thanks for having me and to all those listening to this podcast. If there’s any questions if you want to schedule a myopia consultation with Dr. Nate just ask for myself Esther and be more than happy to answer any questions that I can and get you on our schedule right.

Dr. Nate [00:22:34] And if you want to you can call us at 1-813-792-0637. Or you can e-mail the office at office@BrightEyesTampa.com. Until next time,stay dry.

Outro: [00:22:46] Brought to you by Bright Eyes family vision care and Bright Eyes Kids. Find previous episodes and more detailed information at BrightEyesTampa.com. Creative Commons copyright attribution noncommercial use. The only purpose of this podcast is to educate and to inform. There’s no substitute for professional care by a doctor experienced in the area you require. This podcast is provided on the understanding that it does not constitute a medical or other professional advice or services. Please consult your physician for diagnosis treatment.

Intro/outro music: Lucas Warford of Three For Silver.

Dr. Nate Gives Lecture on Myopia Control to Optometrists

Recently, Dr. Nate Bonilla-Warford and Dr. Beth Knighton attended the Hillsborough Society of Optometrists annual Fall Classic. They showcased Bright Eyes Family and Bright Kids at the exhibit hall and talked with area optometrists. Additionally, Dr. Nate gave a lecture about the latest research in myopia control and ways that optometrists keep nearsightedness from increasing. As you can see, it was a packed house.

 

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Podcast #10: NaturalVue Contact Lenses with Dr. Douglas Benoit

Welcome to The Bright Eyes Podcast: Advice for Healthy Vision for All Ages. Your hosts are Dr. Nate Bonilla-Warford & Dr. Beth Knighton, residency-trained optometrist that provide eye exams for glasses and contacts, and specialty services including vision therapy, myopia control, orthokeratology, and sports vision training. Their mission to empower patients by providing the best in friendly, professional, and individualized eye care.

In this episode, Dr. Nate talks with Dr. Douglas Benoit about contact lenses and NaturalVue spherical and multifocal lenses from Visioneering Technologies, Inc.

 

The Full transcript:

Intro: 00:11 Welcome to the bright eyes podcast, advice for healthy vision for all ages. Your hosts are Dr. Nate Bonilla Warford and Dr. Beth Knighton, residency trained optometrist providing eye care to all ages with exams for glasses and contacts, and specialty services, including vision therapy, Myopia control, orthokeratology, and sports vision training. Their mission is to empower patients by providing the best in friendly, professional, and individualized eye care.

Dr. Nate: 00:42 Not far from Clearwater beach, the number one beach in the nation, It is the Bright Eyes Podcast. This is episode number 10. I am Dr Nate Bonilla- Warford, and I have a special guest with me. Dr. Douglas Benoit.

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Douglas Benoit, OD

Dr. Benoit: 00:42 Hi Nate.

Dr. Nate: 00:42 Hi, how are you?

Dr. Benoit: 00:55 Doing well, how about yourself?

Dr. Nate: 00:56 I’m great. I’m doing really, really well and I’m excited that you are here with us. We’re going to talk about contact lenses, which you have many years of experience with. Before we get into that, why don’t you tell us a little bit about yourself. I’ll give the basics. You’re an optometrist. You’re a fellow of the American Academy of optometry. You’re the director of professional affairs at Visioneering Technologies, Inc, otherwise known as “VTI”.

Dr. Benoit: 01:21 That is correct. I practiced for 34 years in OD, MD group, we were all sub specialty folks. I had the pleasure of working primarily with contact lens patients, generally the type that had special needs such as GP wearers, people that needed scleral lenses, et Cetera, and I had the opportunity to work with a lot of bifocal patients, which was really a passion of mine. I also, over that period of time did a number of clinical studies, which is actually how I became involved with VTI.

Dr. Nate: 01:53 And you’re originally from New Hampshire, but I gather you get around the country quite a bit these days.

Dr. Benoit: 01:58 Yes. As part of the job I do have to travel quite a bit and with some changes that have occurred recently I’m traveling more much to the chagrin of my wife.

Dr. Nate: 02:08 My Dad actually, he does consulting and speaking in the education field and and he’s on the road a lot, but he’s narrowed down his primary gigs to Hawaii and California.

Dr. Benoit: 02:21 Well that would be a nice goal. My wife would like to travel back to California, I’m sure as it is, sometimes she gets to go with me depending on where it is and how much time I’ll actually get to spend with her.

Dr. Nate: 02:32 Right. Absolutely. So. OK, so for our listeners who are patients, we know that there are many contact lens options, uh, for patients, but a lot of times patients don’t really know what their options are or why they should be interested in them. If you’re like me, you’re probably somewhere, a family gathering or a barbecue or almost anywhere and they find out that you’re an optometrist and they always want to say, oh, you, I was told I cannot wear contacts or uh, you know, I tried contacts 15 years ago, you know, and they didn’t work. Do you feel like things have changed a lot since your, you know, your early days with context?

Dr. Benoit: 03:11 Well, yes, they have changed a large, large amount. When I was first in training a 30 some odd years ago, they had pma lenses and they were just coming out with soft materials. Those were two radically different types of contact lenses and it really took a different approach. Over the years, the old hard lenses have changed slightly, the materials now breathe so that they’re much gentler on the tissue of the eye, but the soft lens is really where the large changes have occurred. In the beginning, these lenses were produced in a vial, they were autoclave for sterility and the lenses were very expensive and you tried to keep them for a year or more using very heroic cleaning methods. Over the intervening years we have gotten smarter about the care, so that has become easier. But in the last 15 or so years, the move has been towards daily disposable lenses so that we can eliminate the problem of solution reactions or just poor cleaning. Anybody that has a question about poor cleaning with a contact lens, just think about your teenage son and his room

Dr. Nate: 04:19 Exactly. That’s something I actually mentioned in the, uh, in the exam chair here at Bright Eyes Kids pretty regularly. What are some reasons that patients might want to consider contacts over glasses

Dr. Benoit: 04:32 Well contact lenses do give you the opportunity to do active things such as working out, riding a bike, golf, things of that nature where glasses sometimes could get in the way either by slipping off or steaming up. So contact lenses are really, really nice in that regard. There are some folks that are into theatrical and in certain situations they might not want to be wearing glasses if they’re doing a period piece. So a contact lens there would give them the opportunity to blend in with their surroundings, so to speak.

Dr. Nate: 05:03 And who is a good candidate for contact lenses?

Dr. Benoit: 05:06 Well, I think anyone that’s motivated and has a healthy eye is a good candidate for contact lenses. At, you know, one point they used to tell folks that they had astigmatism, that they really couldn’t wear a contact lens. Uh, thank goodness that actually is not the case. The original contact lenses which were commercially available in the United States back in 1887 were for severely deformed corneas, primarily a very severe form of astigmatism. So that has evolved over the years. We now have many, many ways to correct both astigmatism and the need for a bifocal in a contact lens and there are some instances where we might actually use a contact lens in youngsters to try and prevent changes in their vision.

Dr. Nate: 05:46 Yes. That’s something that we talk about here a lot at Bright Eyes Kids. Now, you know, you mentioned kids, a lot of parents are very surprised to find that we can do contact lenses at all. A lot of people feel like until children are teenagers contact lenses are just not an option. Do you think that that was true previously that we initially started it at teenagers or do you think that was just a myth that sort of came out of nowhere?

Dr. Benoit: 06:17 I think it’s probably a combination. I think it was the comfort level of the doctor and or the parent as far as getting a contact lens on that particular youngster. What I have found over the years is that it really isn’t an age thing so much so maturity level thing. Some youngsters are ready to wear a contact lens at six years old and some won’t ever be ready again think about that teenage boy.

Dr. Nate: 06:41 I agree completely. I think that a motivation is absolutely everything. The worst case scenario in my opinion is when the parent really wants their kids to wear contacts and the kid really does not because if he doesn’t want the lens in his eye, he’s not going to get it in his eyes. There’s just no way, no way around it, but if there’s, if there’s sports, if it’s cosmetic, if there’s some other motivation than kids who can be very successful at wearing contact lenses. Pretty much independent of the age. That’s my experience for sure.

Dr. Benoit: 07:15 I would agree with that.

Dr. Nate: 07:16 What about people who were either bifocals or reading glasses are contact lenses a good option for them?

Dr. Benoit: 07:23 Yes, they are and there are a number of ways that that can be approached. I mean, one of the simplest ways would be to have contact lenses for distance and then put on a pair of reading glasses when you need it to do something on the computer or to read your cell phone, let’s say. But a lot of folks that are interested in contact lenses really don’t want to be bothered wearing glasses at all. And luckily for them, since about 1949, we have had bifocal contact lens is available and the designs that we have currently are really very, very good at correcting most patients needs as I used to, like to tell my patients if they’re motivated and willing to put up with the adaptation to these different optics in these contact lenses, about eighty percent of the time they’ll be able to function very, very normally and not have to rely on glasses at all.

Dr. Nate: 08:12 Yeah. Some of the happiest patients are ones that are so irritated with their reading glasses, misplacing them, having one in every room in the house except for the room that they’re in. And uh, you know, getting those patients into contacts is extremely rewarding.

Dr. Nate: 08:27 Now, when I first got my first pair of contacts, I was in high school, I got one pair, one for each eye. The pair had to last the entire year and I told all my friends, I’m like, Hey, I’m coming to school tomorrow and I’m going to be in my contacts. I’m not going to be wearing my glasses. And the very first morning I let one go down the drain and that was, I don’t know, $80 worth, you know, or something. Nowadays, you know, it, the idea of a fitting a child in an annual lens is just completely unheard of. I definitely have seen in my practice going to the, uh, the daily disposable or single use lenses has dramatically increased the comfort. Um, but most importantly, the health and safety of lenses. You travel around and talk to docs from, from all over. Do you think that that’s something that every doctor’s reporting?

Dr. Benoit: 09:25 I agree with that, yes, the advent of daily disposables of single use lenses has really improved the health of all patients. It makes it a lot easier for travel. If you do have one go down the drain, which you shouldn’t because the water shouldn’t ever be running when you’re doing your contact lenses, but if you should happen to lose a lens in that fashion, you can just open up another lens and put it in your eye. I don’t have to refer it to wearing glasses until you can order a new lens.

vti differenceDr. Nate: 09:50 One of the things that we see as doctors is companies are, you know, they come out with contact lenses on a very regular basis. Sometimes it’s a little bit overwhelming for doctors because there’s just, there’s so many products. However, um, I was very excited when Brian, our rep from, from VTI, from Visioneering Technologies came in, uh, because I had been trying to get my hands on the natural view of Lens set for patients because I’d heard so many good things about it. So why don’t you tell us just a little bit about what sets Natural View apart from some of the other lenses that are out there.

Dr. Benoit: 10:30 Well, the natural view multi-focal contact lens is a one day Lens. It has a center distance design where the majority of multi-focal soft daily disposable lenses are currently center near designs, a the center distance design also uses what we call an extended depth of focus mechanism to actually create the power for reading, so folks that have the need for a bifocal that are say 42 or someone like myself that is 63 can wear the same lens and not have to worry about having a different add power as we call it. So it’s very, very nice for the doctor because you have one shape, one size and this universal add and you don’t have to worry about trying to pick too many parameters at once. So it really makes it very convenient for the doctor.

Dr. Nate: 11:21 So I’m, I’m very happy and very impressed with the lens and the patients have been too, before we wrap up here today, I appreciate your, your time. I appreciate you coming to the office. It’s always fun to be able to record in person as opposed to to over skype, which we do sometimes. Uh, is there anything else that you’d like to tell a patient? Maybe they’re interested in contact lenses. Anything else that you’d like them to think about that, that maybe they hadn’t thought about before?

Dr. Benoit: 11:51 Well, I think that anyone that’s listening to this podcast, if you haven’t thought about contact lenses, maybe you should. Contact Lenses can work for pretty much anyone as long as you’ve got motivation to where the contact lens and certainly here at a bright eyes, you will get to some of the best care that you will get anywhere.

Dr. Nate: 12:11 Well, thank you for that Dr. Benoit. So to all of our listeners, thank you for listening. If you have any questions, comments, or suggestions, you can email us at office@brighteyestampa.com. Until next time, we’ll all be at the beach,

Exit: 12:30 Brought to you by Bright Eyes Family Vision Care and Bright Eyes Kids. Find previous episodes and more detailed information at brighteyestampa.com, creative Commons, copyright attribution, non-commercial use. The only purpose of this podcast is to educate and to inform. It is no substitute for professional care by a doctor experienced in the area you require. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Please consult your physician for diagnosis treatment.

 

Intro/outro music: Lucas Warford of Three For Silver.

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