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Interview with Nick Despotidis, O.D. about Corneal Reshaping

[ I haven’t written much for the blog in the last couple of weeks. Mostly I’ve been busy with Javier and Nora. You can see some of Javier’s pictures on Flickr here: http://bit.ly/1MFiuw – Dr. B].

I am very excited to bring you this interview with Nick Despotidis, O.D. (Dr. D). He is one of my mentors in the orthokeratology/corneal reshaping field. He has written, researched, lectured on the subject for many years. I have attended several of his lectures and have always been impressed with his insight and enthusiasm. I was even more impressed when I read his book “My Children are Nearsighted, Too.” Dr. D practices in Hamilton Square, New Jersey.

Dr. B. Writing a book takes a lot of effort. What prompted you to write a book and not just a large pamphlet?

Dr. D. : As health professionals, we often get asked similar questions from patients. However, nothing seems to elicit as much emotion as when parents are discussing their children’s vision. Seeing the concern or sheer disappointment on a parent’s face when I tell them their child needs glasses still moves me, even after twenty years in practice.

Parents often ask: “Why so young? Do they have to wear glasses all the time? Is this inherited? Is it going to get worse? What can be done?” My explanation and subsequent recommendations take time, time we often don’t have while in the examination room, yet parents deserve.

So now I actually give my patients a copy of our book and highlight specific sections I want them to read. Then, after they develop a good background and learn the answers to many of their questions, we discuss how to help their son or daughter. It’s worked amazingly well. I’m very proud after parents tell me how much the book has helped them understand vision and given them an arsenal of recommendations.<

As a parent myself I appreciate the frustration of being told my child requires some type of treatment without fully understanding my options. The book was written to empower parents when it comes to their children’s eyesight.


How long did it take for beginning to end?

Two years!

As an early adopter of corneal reshaping, did you initially suspect that myopia control was going to be as successful as it has recently been shown to be?

No. In 1992 when it was first introduced into our office it was just viewed as a substitute for daytime contact lenses or glasses. That’s it. We reserved recommending corneal reshaping for patients who could not wear contacts during the day or required freedom from contact lenses or eyeglasses during their waking hours. So we had a lot of athletes, teachers and executives wearing the lens, but it was a select few.

However, clinically we observed that teenage athletes wearing the lenses did not need changes to their prescription every year like many of our eyeglass or contact lens wearing patients. In 1998 when my own two sons began wearing eyeglasses, that’s when the light turned out. You see, even though I prescribe eyeglasses daily, when my young children needed eyeglasses, I was upset, even distraught. Seeing the success they’ve had with corneal reshaping inspired me to become an “early adopter” or advocate of this technology.

If corneal reshaping is such a positive and exciting technology, one that may help thousands of young children from having their eyesight worsen, why don’t all doctors provide this service?

That’s a great question, one I get asked daily! Most eye doctors are not familiar with corneal reshaping even though Paragon Vision Sciences, the maker of the CRT design, received FDA approval over 9 years ago! Some doctors may base their opinion on outdated information or personal experience.

As a “seasoned” health provider I understand how long new procedures take to enter mainstream medical offices. But that does not make it fair or right. For example, it took over 30 years for data to arise that a child’s eye coordination skills may affect their ability to read and consequently learn. Even though I understood this in my early training days it took decades to become “accepted.” And even today some practitioners are not on board. Corneal reshaping faces the same challenge. In addition to understanding the technology, doctors need to enjoy seeing patients more often than their contact lens and eyeglass wearing patients. This is often not the case.

Lastly, there is a higher level of technology and training required to perform corneal reshaping properly. Doctors may not be interested enough to upgrade their offices to provide this service.

I personally overcame these apprehensions when I saw how well corneal reshaping helped my own sons. Now, literally 10 years after they started wearing these lenses, their eyesight has not gotten worse. Nothing more needs to be said.


What is your next project?

I’m writing a personal development book extolling the life lessons I’ve acquired as a husband, parent, doctor and philanthropist.


Thanks, Dr. Despotidis, for taking the time. I wish yoy, your family, and your patients the best.


You can read more about Dr. Despotidis and orthokeratology at: http://www.gentlevisionshaping.com/. If you have questions about whether or not corneal reshaping is right for your or child, feel free to contact Bright Eyes at the contact info below or call 813-792-0637.

Be Well!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

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Tampa Optometrist discusses Orthokeratology in Fox 13 News Video

I am happy to note that my friend and colleague, William Stephen O.D. of St. Lucy’s Vision Center was featured extensively discussing orthokeratology, also known as ortho-K, CRT, or Precise Corneal Reshaping (PCR). The video aired on Fox 13’s Dr. Jo health segment.

Here is the description of the video from the Fox 13 website. “Patients head to the eye doctor every year, often times for a stronger prescription. But, some people are getting “perfect vision” without contacts or glasses. FOX 13’s Dr. Joette Giovinco shows why “Eye Braces” are being called the vision of the future.”

You can watch the entire video here:

There are several optometrists that provide Ortho-K in the Tampa area. We the only office in Westchase to provide the service. If you have any questions about this exciting treatment option or want to schedule a screening, please do not hesitate to call the office at 813-792-0637 or email at office@brighteyestampa.com.

Be Well!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Dr Nate Google PlusBright Eyes Tampa on Google PlacesBright Eyes Tampa on FacebookBright Eyes Tampa on TwitterBright Eyes Tampa on YelpBright Eyes Tampa on foursquareWestchase Patch

Ortho-K: Possible Method of Slowing the Progression of Myopia in Children (SMART Trial)

Ahah! I was scooped on this story by one of my favorite bloggers, Ann Z. from LittleFourEyes. I was going to write a post about this exciting news today, but since she already has. Check it out here.

I Will leave you with a quote from yesterday’s press release:

According to Dr. S. Barry Eiden the trial will also investigate why these special lenses may be effective in slowing myopia.

“Current thinking suggests that these CRT lenses flatten the cornea but other evidence suggests that these lenses may influence the growth in eyeball length (termed axial length). A major contributor to progressive nearsightedness is axial length elongation. Corneal reshaping may actually result in decreased axial length growth. The exact mechanism by which this happens is still being investigated” said Dr. Eiden.

“The results of the SMART Study so far are very exciting,” said Dr. Davis. “The outcomes of this study may revolutionize how we manage young nearsighted patients from this point forward”.

You can go to the SMART study facebook page to find more information.You can also watch a news report on the study here.

It should also be noted that the SMART study is building on additional recent studies that have also found that Orthokeratology has been successful in slowly the progression of myopia.

To find orthokeratology doctors in Tampa and elsewhere: go to the Orthokeratology Academy of America. If you are curious, feel free to call or come in for our no-cost consultation to determine if you are candidate.

Be Well.

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Dr Nate Google PlusBright Eyes Tampa on Google PlacesBright Eyes Tampa on FacebookBright Eyes Tampa on TwitterBright Eyes Tampa on YelpBright Eyes Tampa on foursquareWestchase Patch

Nighttime contact lenses show promise in controlling nearsightedness

There is increasing clinical evidence that orthokeratology is an effective method of reduce myopic progression. The latest study, the SMART (Stabilization of Myopia by Accelerated Reshaping Technique) Trial, a national study led by Chicago researchers Drs. S. Barry Eiden and Robert Davis, adds additional evidence:

“At the end of one year, the test group was absolutely rock solid, no progression (of nearsightedness) at all,” Eiden said. “The control group had two power steps of progression on average.” One power step equals a change of .25 diopters in prescription strength.

If the study’s hypothesis holds up, children with mild nearsightedness could have healthier eyes as adults, with a greater chance of successful LASIK, vision-correcting surgery and less risk of retinal complications later in life, Eiden said.

This is exciting because many parents ask me about methods to reduce or eliminate the development of nearsightedness. This study is far from over, but it appears to be supporting the efficacy of orthokeratology as a means to control myopia.

Bright Eyes is one of the few offices in Tampa and the only in Westchase to offer orthokeratology. If you have any questions about orthokeratology, or whether or not you or your children are candidates, contact the office at 813-792-0637.

Be Well!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Dr Nate Google PlusBright Eyes Tampa on Google PlacesBright Eyes Tampa on FacebookBright Eyes Tampa on TwitterBright Eyes Tampa on YelpBright Eyes Tampa on foursquareWestchase Patch

A Brief and Wonderful Note From a Patient

The other day when I was beginning the follow-up for a patient who is doing Precise Corneal Reshaping, I was handed a small Thank You card.

This patient is a wonderful 10 year old girl who is very funny. She and her mother were very interested-enough to drive from Pinellas to the Westchase area of Tampa, several times- in PCR because the girl’s prescription in her glasses had been increasing every six months . When she started, we talked about how PCR might be difficult because her prescription was high, but that it would give her the best chance of minimizing an increase in her prescription.

Well, after 1 week of wearing the reshaping lenses, she was seeing almost 20/20 without glasses or contacts. She was able to swim and do other summer activities without worry. She was so excited that she wrote the note below:

thankyou

This is the great thing about being a doctor! Letters like this!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

enough to drive from Pinellas to the Westchase area of Tampa, several times

Video on Children’s Ortho-k

While people are now learning about Corneal Reshaping, or Orthokeratology, here in the United States, it has been very popular in Asia for quite some time. This is due to the fact that there is a very high prevalence of myopia in many Asian countries and corneal reshaping has been shown to not only temporarily eliminate nearsightedness, but can also reduce its progression.

This 7 minute video was not made in Tampa, but in Asia where ortho-k is very popular, so the girls speak little English. Still, the video demonstrates how well two young girls do with the reshaping lenses. One girl is quite young and gets help from her parents. Another girl is perhaps 8 or 9 years old and shows how well she handles the lenses by herself.

Click here

Be well!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

How Comfortable is Ortho-K?

big question mark

A patient recently asked me:
I read something on the internet about Ortho-k lenses being uncomfortable. Is this true? How uncomfortable are they?”

Well, there isn’t any way to sugar-coat this. The reshaping lenses can initially be uncomfortable for some patients. One study showed that 31% of patients experienced initial discomfort. Understandably, some patients are concerned about this. But this alone need not be a reason to dismiss ortho-k. Here are some reasons why:

  1. You may be able to feel the lenses, but they should not be painful. If they are painful, then there is something wrong. Possibly the lens has debris on it. Possibly you inadvertly scratched your eye. No matter what, if the lens is painful, then you should take the lens out, examine it and call the office.
  2. These lenses are specifically selected and designed for your eyes. The reshaping lenses that you are given are carefully chosen to be the healthiest, be the most comfortable, and, of course, provide the best vision possible.
  3. The procedure for utilizing the lenses is designed to minimize discomfort. In fact, a particular type of lubrication drop is recommended each night to both keep the eyes moist, but also keep the eyes comfortable.
  4. Remember, the central goal of ortho-k is to reshape your cornea. The lens will fit better and be more comfortable after your cornea takes on the new shape. This does take a few days to occur. After two or three days, your lenses will feel much more comfortable.

Does all this mean that you do not feel the lenses when you wear them the first time? No. Lens awareness is very normal. This awareness may cause your eyes to water in the beginning. But after your eyes adapt to the lenses, they will return to their usual comfort level.

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Dr. Jo from Fox 13 Covers Ortho-K

Here is a recent health news story on PCR (a.k.a. Orthokeratology) by Tampa’s own Dr. Jo of Fox 13. The brief segment nicely shows the benefits of rehsaping lenses. It features two young patients, one of whom can now play volleyball without glasses or contacts. She also mentions the importance of taking care of your lenses to reduce the risk of infection. Remember, this applies to reshaping lenses as well as all other kinds!

Click here to watch the video.

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

 

Here Comes Ortho-K!

In 2003 I completed my contact lens externship. It was a chance to see how contact lenses helped a variety of patients in different settings. The majority of these patient encounters were relatively routine in that I was determining the contact lens that provided the patient with clear vision. Some people simply needed a modification of their current contact lens prescription, some were having difficulty with their contacts for astigmatism, and others were experiencing multi-focal contact lenses for the first time.

But there were also some special patients that were trying something that at the time was new and exciting: Precise Corneal Reshaping (ortho-K). Although it goes by many names, including orthokeratology, PCR is the wearing of a reshaping lens (similar to rigid gas permeable contact lens) during sleeping hours to mold the cornea and eliminate the need for daytime glasses and contacts.

When orthokeratology was first created in 1962, it was rather crude and unpredictable. The process was refined over time but it has only been in the last 5 years that we have seen a tremenedous increase in both scientific studies and utilization of PCR. In 2002, Corneal Refractive Therapy ™ (CRT) by Paragon was the first modern system to receive FDA approval. In those days there were very few practitioners doing CRT and I was lucky enough to have this experience early on.

In the last year I have been asked several times if I am still providing this service. Well, after some work and investment in equipment, I am happy to announce that Bright Eyes Family Vision care is now offering PCR for eligible candidates! We are the only eye care office in Westchase and one of the few in Tampa to offer this service.

Who is an eligible candidate? Well, the procedure can correct myopia (nearsightedness) with or without some astigmatism. It is approved for all ages and is reversible, so it can be prescribed for kids and teens as well as adults. Since PCR changes the shape of the cornea, candidates must have healthy eyes and corneas that will respond to the treatment. Through a series of tests, such as computerized corneal topography, I can determine whether or not a patient will be a good candidate. Because not everyone is a candidate, we are offering the PCR Pre-Evaluation at no charge. This also gives patients (and parents) a chance to ask questions before deciding on the procedure.

PCR will be a great vision correction option for active adults – no worries about contacts while swimming, biking, playing sports, etc. It will be great for kids and teens – no worries about breaking glasses or losing contacts, since the reshaping lenses stay at home and are only worn at night.

In time, I will write about some of the latest research about PCR slowing the progression of myopia, but if you have any questions, you can always call the office for a patient information packet. You can also attend one of the seminars that I will be offering on November 8th, and 15th. Call 813-792-0637 for more information.

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

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