OCULUS is building on the program driving its Myopia Master device, helping Australian eyecare professionals to now understand whether a child’s progression is abnormal or not. The management software is also becoming more widely available to Pentacam AXL Wave users.
Myopia induces short-sightedness, often caused by an elongation of the eye that undermines a person’s distance vision and can create an uncertain future for their eye health. Eyecare professionals know this well, and many are now dealing with the consequences of this condition more regularly and in growing numbers.
But what they are now understanding to a greater degree is one of the most powerful ways to combat myopia – and potentially sight-threatening incidents later down the track – is to take a good look into the distance, into the future of how a patient’s disease may progress and ways this can be curbed.
To do that, many Australian optometrists are discovering how to master it with the support of biometers with myopia management capability. It is important business because the numbers are well-known and sobering: for Australia and New Zealand currently 36% of the population is estimated to be affected which is forecast to reach 55% by 2050. Furthermore, Australia is expected to have 4.1 million high myopes by then, unless management is widely implemented.
But new technology is providing those professionals with more and better tools so they can be fully informed in their management of myopic patients.
Mr Richard White is regional director for OCULUS Asia. Many Australian optometrists will know about the German company’s Myopia Master device that screens for myopia, helps determine why a patient might be myopic and predicts progression. It also assists in planning for treatment, monitoring its performance over time, and can now decipher if a child’s progression is normal/abnormal.
When the manufacturer first considered the myopia problem, White says OCULUS was quick to acknowledge it needed a dedicated device, rather than adapting a pre-existing technology.
“Myopia is a refractive issue, so we knew we wanted to include refractive screening to find out whether the patient is actually myopic or not myopic,” he says. “The second part is determining why are they are myopic by looking at a few different parameters: refraction, axial length, and the keratometry. By combining these important factors in myopia, we’re able to bring three into one.”
Beyond the hardware, the Myopia Master stands out for the software that helps the eyecare professional: perform objective data analysis, learn more about environmental factors impacting the individual, prepare an evaluation-based treatment recommendation and monitor treatment success.
Importantly, OCULUS is making this capability more widely available on the company’s Pentacam AXL Wave machines. This means practitioners already with this instrument – many whom offer an advanced contact lens service – don’t need to invest in an additional piece of hardware for myopia management. It fits nicely for practitioners offering orthokeratology for myopia, and will also be a welcome addition for ophthalmologists with this instrument.
The key to these advances is access to and use of data, says White.
One of the standout features, he says, is the fact OCULUS has teamed up with the Sydney-based Brien Holden Vision Institute (BHVI) to create growth curves, including ones that are region specific for Asian eyes, and for every age group.
That data is compared with raw data from the patient’s eye, allowing the practitioner to see where the subject sits in relation to axial length and subsequent myopia compared to normative values. That gives a valuable snapshot but also a glimpse into the patient’s future eye health and potential myopia, highlighting the consequences without intervention and treatment.
At the end of the exam, patient and parent receive a report to help them understand the disease itself, and the importance of treatment and follow-up appointments.
OCULUS has continued to evolve the software and earlier in 2024 rolled out a Growth Control module specifically aimed at analysis of whether a patient’s axial elongation is abnormal, borderline or normal – especially useful once treatment has been initiated to gauge its effectiveness.
The way this is displayed shows the ‘axial length growth rate’ split into red, orange or green bands. As the optometrist introduces a treatment, they can mark this up in the program, and clearly see over time whether it is effective (for example the patient progresses from the red band, to the orange band then to the green band).
“So from one exam to another exam, we can decide whether that’s normal or abnormal growth,” White says. “That’s when you can also see if the treatment is working or not working.”
All of this together gives patients confidence and peace of mind.
“One piece of feedback I received from an Australian eyecare professional was that when the patients come in and they see the Myopia Master machine, it gives them confidence in the practitioner and the practice; it shows them that we’ve invested in them and their eye health.”
It’s a confidence that Mr Cameron Loveless understands.
His company, Designs For Vision, is OCULUS’ sales and distribution partner in Australia and New Zealand. But that’s not the only reason why he confidently promotes the equipment.
“One of the key things that we have always said about Myopia Master is that it’s like a myopia clinic straight out of the box – refraction, keratometry and axial length,” he says.
“The other big thing is that it is backed by BHVI, and that’s pretty huge.
“There’s a lot of people pulling data from freely available sources and using that in their databases to compare eyes, but some – even the well-known studies – were done on the measurements of axial length using different devices and methods, but that’s not the case with the BHVI data.”
Loveless says optometrists are getting value out of another optional module within the Myopia Master, called GRAS (Gullstrand Refractive Analysis System). It compares the patient’s measured data to a theoretical emmetropic eye, modified to match the patient’s age using BHVI’s extensive data. It uncovers where the myopic tendency is coming from: axial length, keratometry and the crystalline lens/accommodation.
“It gets right into the nitty gritty, so optometrists don’t need to research for themselves what a normal curvature of the cornea should be for example,” he says.
“When it reveals the axial length is too long for their age, that’s the cue for the optometrists to initiate discussions about treatment with the parent,” he says. “On the flip side, you might see someone who doesn’t seem to have axial length-related myopia, which is great news for the child, but let’s keep an eye on it.”
Loveless believes the equipment, including the regular free software upgrades, would be an ideal addition to any optometry practice, but especially independents keen to offer a high-end point-of-difference, and less experienced practitioners wanting to professionalise their myopia service.
Among the high-profile optometrists using Myopia Master are Sydney-based Mr Oliver Woo, the first in Asia-Pacific to have one installed, and Melbourne myopia expert Mr Philip Cheng. Sydney’s Mr Jim Kokkinakis is also a user but will be trading in his Myopia Master and purchasing a Pentacam AXL Wave so that he can use it for both his contact lens work and myopia management, saving space.
Given the surge in myopia globally, White says taking it seriously through investment in technology and treatments can be a great practice builder. They are patients requiring ongoing treatment and support.
“You want to keep that patient with you and build that relationship,” he says.
“If you’re not getting active in myopia management, with the lifestyles of children today, with their iPads and so on, with the increased risk of glaucoma, retinal detachments, of cataract, how much have you really taken care of them?”
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