There are still very few FDA-approved treatments for myopia management, such as Stellest spectacle lenses from EssilorLuxottica and MiSight 1 day soft contact lenses from CooperVision, as well as other products regularly used off-label to control myopia, including atropine and orthokeratology lenses. Sourcing all of these, however, becomes a key component of a myopia management practice.
Relationships with Suppliers
It all starts with establishing and building relationships with suppliers. “Effective inventory and vendor management are critical to maintaining continuity of care and operational efficiency,” says Dwight Akerman, OD, MBA, FAAO, Dipl. AAO, FBCLA, FIACLE, global ambassador for the International Myopia Institute. “Strategic vendor partnerships extend beyond procurement to include access to training, technical support, and innovation. These relationships can contribute meaningfully to both clinical and operational performance.”
Why is this so? According to operations and workflow consultant David Carneal, of Digital Efficiency Consulting Group, “In myopia management, manufacturers are far more than product suppliers. They are an extension of the clinical workflow, providing technical expertise, fitting guidance, and ongoing support that help practices deliver consistent patient outcomes without requiring every practitioner to become an expert lens designer.”
Orthokeratology
This is of particular importance when fitting patients with orthokeratology lenses, defined as Class III medical devices that are subject to the most stringent regulatory controls. Fitting young myopes for orthokeratology is among the more challenging, often resulting in the need for technical assistance. Fitting sets can help, and Chandler Mann, OD, of Stone Oak Vision Source in San Antonio, says he experiences a good first-fit success rate when using Paragon CRT, which comes with a fitting set.
When not using a fitting set, which only few lens brands offer, eye care professionals provide the patient’s topography measurements to a lab that will design the lens to fit, often relying on the expertise of the consultants at the lab. This makes the initial lab selection of utmost importance.
“When it comes to OrthoK lenses, your lab should be one of your biggest assets,”says Bethany Peebles, FAAO, ABOC, NCLE-AC, executive director of consultation services, Art Optical Contact Lens, Inc. “Whether you are new to myopia management or new to a specific lens design, reach out to the lab to learn about the design capabilities, fitting protocols, training opportunities, and marketing materials. The lab’s goal is to make working with them easy, efficient, and successful for you and your patients.”
“Effective inventory and vendor management are critical to maintaining continuity of care and operational efficiency.”
Dwight Akerman, OD, MBA, FAAO, Dipl. AAO, FBCLA, FIACLE
Choosing an OrthoK Lab
“Quality, service, and consistency are the three primary criteria that labs must offer doctors to ensure their success. Labs support those three criteria by investing in customer service and fitting consultants, embracing lab technology, and maintaining a quality system that requires continuous improvement in all of the lab’s functions,” says Derrell James, vice president and general manager of X-Cel Specialty Contacts. “Many companies may advertise the ‘flashy,’ but the true partner to the eye care practitioner must ask the daily question, ‘What can I do today to help our customers give the gift of sight?’”
James shares some specific metrics to look for when considering an orthokeratology lab: “ECPs, when evaluating and selecting a lab, can inquire about specific metrics for a lab for measuring quality, service, and consistency, in addition to talking with the leadership about their commitment to one-on-one service.” For example,
- Is the lab ISO13485 certified? This shows a commitment to quality and consistency in processes throughout the business.
- How many or what percentage of employees are customer service and consultants? This shows the investment in resources to partner promptly and professionally with the optometrist or staff.
- Has the lab ever had an FDA finding or recall, or what was the last FDA audit conducted? What were the results? This shows that the lab complies with regulatory, safety, and good manufacturing practices.
- What training is offered (e.g. in person/wet labs/in-office fitting, webinars, online documentation and training, or other product-specific or condition-specific training)?
Spectacle Lenses, Contact Lenses, and Atropine
Most products used for myopia management are not stocked by the practitioner but rather ordered when needed. For example, atropine is generally obtained by the patient directly from a compounding pharmacy, in part because it is being used off label for myopia management.
Essilor Stellest lenses are not stocked in the practice because they must be finished by Essilor labs. Currently, all ELOA, PLG, and Walman lab accounts can make Stellest orders.
Contact lenses, such as MiSight 1 day, are the exception. “We’re able to dispense it same day because we usually have most powers available,” says Dr. Mann. “When you inventory in bulk, you get some cost savings.”
Summing it Up
Successful myopia management is holistic, says Monica Jong, BOptom, PhD, FAAO, FBCLA, head of medical affairs with EssilorLuxottica North America. It starts with prescribing the appropriate treatment for each patient based on their clinical, lifestyle, and patient/parent preferences.
“First and foremost, eye care professionals should look for solutions that have proven efficacy and a strong body of research,” Dr. Jong says. “Today, ECPs have a portfolio of treatment options available, including the only FDA-authorized myopia control spectacle lens Stellest. The availability of a spectacle option that is easy to prescribe and easy for patients to adopt, while correcting and slowing myopia at the same time, increases access to myopia management for many children that would miss out. Equally important is partnering with organizations that continue to innovate and provide continuous clinical and practice support, helping doctors and their staff confidently deliver the highest standard of care. It is a partnership to achieve the best long-term outcomes for children and their families, and no one should do it alone.”
Dr. Mann sees relationships with suppliers in general as a “symbiotic.” While their job is to sell to you, “the ones who are in myopia management want to help you succeed whether you are using their product or not. Give them the time of day. You’ll be surprised how much you get out of it.”