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orthokeratology

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

Certificate

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

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!

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.

My Daughter’s Ortho-K Journey

I wear glasses. Most people in my family wear glasses or contacts because they cannot see well at a distance. They have myopia, also known as nearsightedness. This story is similar for my wife, Cristina who is also the office manager at Bright Eyes. She and many members of her family are myopic. So it was not surprising that our older child, Nora, has also become nearsighted. She has now started orthokeratology to help keep her from become even more nearsighted. Read on to find out more about her Ortho-K journey.

Nora's First Eye Exam

Nora’s First Exam

Nora is not alone. All over the world, people are becoming more myopic and kids are needing glasses at earlier ages. At Nora’s regular eye exams (see recommendations here), I have been checking her vision carefully. Two years ago it was obvious that she was going to be become nearsighted. We had been implementing several steps to delay her impending myopia.

Finally, the summer before 4th grade during a game of “eye spy” it was evident that she was having trouble seeing clearly far away. An eye exam was scheduled and a prescription for -1.00 D glasses was written. She picked out some lovely and fun glasses before school started. She also had soft daily disposable contacts for occasional use.

Nora before Ortho-K

Nora Before Orthok

By Spring Break, Nora was squinting again even with her glasses. Indeed, her exam showed that her prescription had increased. We were ready to employ some methods to reduce the rate at which her vision was getting worse. This is called myopia control and the basic options are Ortho-k, soft multifocal contacts, and atropine eyedrops. So Cristina and I decided that it was time for Nora to do Ortho-K. We knew this time would come, it was just a matter of when it was convenient to start. We decided Spring Break was the perfect time.

The first step was to get Nora on board. After all, she liked her glasses and was not excited at first about giving them up. Cristina and I talked with her about freedom from glasses for sports and swimming. We also showed her some of these videos from YouTube. She was ready!

Nora came to Bright Eyes Kids for her Ortho-K exam. This includes more vision testing and special testing of the front part of her eyes called corneal topography. This special test allowed me to design custom NightLens Ortho-K lenses for her. They were produced in a specialized contact lens lab and sent to the office.

Nora was very excited when her Ortho-K lenses came in. At this point she was taught how to put them in and take them out safely as well as everything she needed to know about caring for her lenses. That night, she put the contacts in and went to sleep. It was surprisingly easy. The next day she came to Bright Eyes Kids for her 1-day evaluation and she was seeing 20/20! Her vision has been great ever since. She was able to do everything on her Spring Break trip including kayaking, Everglades Airboat rides, and the Trampoline park all without her glasses.

Nora After Orthok

Nora After Orthok

If you think that your child is a candidate for Ortho-K and want to find out more call us at (813)792-0637 or request an appointment.

By the way, Nora’s brother is two years younger than her and he is not nearsighted yet, but we are trying to prevent it with atropine eye drops. You can learn more about that here.

-Dr. Nate

PS – If you are an eye doctor who has employed any myopia control strategies with your kids, I’d love to talk to you about it. Email me at Doc@BrightEyesTampa.com.

 

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TV News Segment on Orthokeratology and Myopia Control

The mission of Bright Eyes Family Vision Care and Bright Eyes Kids is to empower our patients by providing the best vision care possible. One of the most exciting ways that we are able to do this now is called orthokeratology. It is one of the methods used to keep children from getting more and more nearsighted. Like vision therapy, it is complicated, but very, very rewarding.

I am very happy that word of orthok and myopia control is spreading! You can see for yourself from this excellent recent news segment from 10News CBS WTSP did featuring me and a patient of Bright Eyes.

Here it is:

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A HUGE THANKS to reporter Courtney Robinson She was great to work with and genuinely interested in children’s vision and the effect of screen time. She took the time to come to the office and ask many fantastic questions. You can read her whole story here.

 

I am also thrilled that my daughter, Nora, has started orthok. I will write a blog post about that next. 🙂

If you have any questions, please let us know. Use the button below or call us at (813) 792-0637. And as a reminder, orthok is not just for kids. We do have adult patients that use orthok to be free from glasses for sports or while reading their phones or other activities.

See Well!

-Dr. Nate

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Myopia Control FAQ & Scientific Research

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Understanding Myopia

Myopia, or nearsightedness is a very common vision problem. It's estimated that more than one-third of Americans are nearsighted, and it is increasing.  Nearsighted people have difficulty reading road signs and seeing distant objects clearly, but can see well for up-close tasks such as reading or sewing. If your glasses or contact lens prescription begins with minus numbers, like -2.50, you are nearsighted.

See the treatment options for myopia control.

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myopia-facts-infographic-580x2400Myopia Control FAQ

Does my child need to have a general eye exam before starting Myopia Control?

Yes, a comprehensive eye exam from an eye doctor is required. We would be happy to provide that exam. However, if your child has had an eye exam with another eye doctor within the last year, you can request that doctor refer your child to our office for Myopia Control.

Is there any additional charge for the Myopia Control procedures?

Yes, standard optometric charges apply. We offer several different year-long programs. Following the comprehensive eye exam, a Myopia Control Consult is necessary to determine which program is best for your child.

Can I request to see either doctor?

Either Dr. Nate or Dr. Beth can discuss Myopia Control at your child’s comprehensive eye exam. After that, Dr. Nate performs the Myopia Control Consult and the Myopia Control treatment visits.

What techniques are used in the Myopia Control Program?

There are three options:

  • Orthokeratology (corneal reshaping) is the wearing of special contact lenses at night to provide clear vision during the day without lenses.
  • Multifocal soft contact lenses are worn during the day.
  • Atropine, in the form of eye drops, is used at night time.

Every patient is different – one treatment does not work for all patients. That is why a specialized Myopia Control Consult is necessary before selecting the best treatment method.

How do I get an appointment at Bright Eyes?

You can request an appointment here or call us at 813-792-0637. Be sure to specify that you are interested in Myopia Control so the Bright Eyes staff can book the appropriate appointment for your child.

Do I need to bring anything to the appointment?

Just the patient. 🙂 Bringing previous eye exam history or old glasses can also be helpful at the initial appointment.

Will Myopia Control require many office visits?

There are multiple office visits as the treatment is begun. After that, there are quarterly (every three months) follow up visits to ensure that all is going well for your child.

Will Myopia Control hurt?

No! If your child is new to contact lenses or eye drops, sometimes there can be discomfort while he gets used them, but we use the latest technology to ensure quick adaptation.

I am nearsighted and my child is nearsighted, too, and it’s getting worse. Is there anything I can do for them?

Probably! More children than ever are becoming nearsighted (myopic). Fortunately, there different options to help children of any age.

My eye doctor told me that myopia is in my genes, and that there is no way to slow or stop it. Is there scientific evidence that this really works?

For years, many doctors thought that myopia is caused only by genetics, but in the last 10 years or so, there has been very dramatic research that has shown this to be not the case. Take a look at the research section below to see some of these studies.

Are there vitamins that my child should be taking to keep his vision from getting worse?

No. At this time, there are no studies that show benefits of taking vitamins. However, it is a good idea in general to maintain a healthy diet including more vegetables and less sugar. Talk to your pediatrician for specific information on nutrition.

What about eye exercises?

There are some specific cases where vision therapy (sometimes called eye exercises) may reverse mild nearsightedness due to eyestrain. This is often called “pseudo-myopia”. However, true nearsightedness cannot be reversed or eliminated with eye exercises. A comprehensive eye exam with a doctor trained in children’s vision is necessary to tell the difference.

My child is only 8 years old. Is really OK for them to do Myopia Control? Even if it involves contact lenses?

Yes! It used to be thought that children should not use contact lenses until they were teenagers. Several studies have shown that contact lenses are safe for younger children as long as they are taught proper care of the contact lenses. Also, contact lens materials and designs are safer than ever for all patients.

Does Myopia Control have FDA approval?

No. As of right now, the treatment options that exist for myopia control are FDA approved procedures, but are not specially approved for myopia progression. For example, orthokeratology was FDA approved for the temporary treatment of blurry vision due to myopia, but treatment for Myopia Control is considered “off-label”. The same is true for atropine and multifocal contact lenses. However, this is changing. Recently a meeting was held between the American Academy of Ophthalmology (AAO), American Academy of Optometry (AAOpt), American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and more to establish an FDA study for myopia control.

Do only optometrists offer Myopia Control?

No, both ophthalmologists (MDs) and optometrists (ODs) offer myopia control. Bruce Koffler, MD, an ophthalmologist wrote this important document called “The Case for Myopia Control Now.” You can find doctors all over the whole who provide this service via the American Academy of Orthokeratology and Myopia Control.

Myopia Control Scientific Research

Below is just a small sampling of scientific research supporting myopia control. If you’d like to see more, go to http://myopiaprevention.org.

Increasing Prevalence of Myopia

Development of Myopia

Risks of Myopia

Myopia Control Options

Bright Eyes Kids is Open!

 

This is no April Fool’s joke! Bright Eyes Kids is open!

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This is the moment that we have been waiting for…We are ready to see general children’s appointments at Bright Eyes Kids, as well as Vision Therapy, and Orthokeratology patients! 🙂

Bright Eyes Kids is the only optometry office around dedicated specifically to children’s vision. We do care the same great infants and children’s glasses that you can find at Bright Eyes Family Vision Care. The new office is located at 15303 Amberly Drive Suite C, Tampa, FL, 33647. It is office Bruce B. Downs, near the Bank of America and LA Fitness. The hours currently are Monday and Tuesday 9am to 5pm.

If you have a special child in your life that needs their eyes and vision checked, call us at 813-792-0637 (yes, the same number as Bright Eyes Family Vision Care) for more information or make an appointment. Bright Eyes Kids also has its own Facebook page.

Dr. Nate

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
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Bright Eyes Kids is Coming Soon!!

Bright Eyes Kids

Bright Eyes Kids is coming soon!

Since we opened Bright Eyes Family Vision Care in 2006, the number of pediatric patients has steadily grown. At first we saw very few, but now almost half of our patients are under 18 years old. And that is no accident. After I completed my Residency in Pediatric Optometry and Binocular Vision in Chicago, I knew I wanted to work with kids. I wondered if I was crazy for moving home to Florida, the retirement capital of the world.

Well, lo and behold, there are children in Florida and many of them need eye care. So we have been planning for the last year to expand our services specifically to children. And I am now very, very happy to announce that in March we will be opening a new location specifically for children’s eye care. Called Bright Eyes Kids, it will bring the skill and care you expect from us at Bright Eyes Family Vision Care to New Tampa and be tailored specifically for children!

Why New Tampa? Well there are many reasons. The first is that we frequently have patients that come from areas such as Gainesville, Winter Haven, and other places east of Tampa. Located near I-75, the new office will be much more accessible for patients because they will not have to drive all the way across town. Another reason is that my family and close relatives actually live in the New Tampa area and it will be great to practice closer to home. The new address is 15303 Amberly Drive, Suite C, Tampa, FL 33647.

What will be offering at Bright Eyes Kids? Eye exams for infants, toddlers, and gradeschoolers and teens. We will be fitting contact lenses and specialty glasses for young kids. We will have an expanded area to offer vision therapy, to help children develop the visual skills they need to be successful at school and life. We will offer orthokeratology for kids who want 20/20 vision all day while not wearing glasses or contacts.

But don’t worry – nothing will change at Bright Eyes Family Vision Care in Westchase. I will still be seeing patients there regularly and we will. Moms, grandpas and other adults are welcome to come see us there!

Now, please. Help us making Bright Eyes Kids the best it can be by completing this very, very short survey. While we are finalizing details about the new office, this is your chance to help us get them right. Click here to take the brief survey.

Dr. Nate

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
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Happy Orthokeratology Patients at Bright Eyes

Orthokeratology goes by many names…. Ortho-k, corneal refractive therapy, Gentle Vision Shaping, corneal molding, and others. At Bright Eyes Family Vision Care, we tend to call it corneal reshaping or Orthokeratology. But regardless of whatever terms we choose to call it, our patients call it “awesome!”

Watch for yourself:

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(Click here to watch on Youtube).

This last weekend I was fortunate enough to attend and speak at the Orthokeratology Academy of America (OAA) educational conference. The OAA is an international organization of orthokeratologists who provide a nonsurgical alternative to refractive surgery for nearsightedness, astigmatism and hyperopia. Current research also shows that Ortho-K can slow myopic progression in children.

The international faculty of presenters covered topics including myopia control (including soft lens technology), corneal reshaping research, safety of corneal reshaping, progressive/hyperopic Ortho-K lens designs, new corneal reshaping techniques. I heard speakers from Australia, Japan, China, Italy, Spain, and from all over the US.

President Dr. Cary Herzberg had the pleasure of announcing the inception of the new International Academy of Orthokeratology(IAO). The IAO brings together ortho-K organizations from the America (OAA) as well and Europe and Asia. This international organization will support, promote and advance corneal reshaping worldwide thru quality education and research presentations at meetings held around the world. For more information about the OAA click here.

At Bright Eyes, we have successfully treated patients from 7 to 59 years old with orthokeratology. This includes pilots, lawyers, retirees, and lots of kids like Christopher (above). If you would like more information about Orthokeratology, call our office in Westchase at 813-792-0637 or visit http://BrightEyesOrthoK.com

Dr. Nate

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

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