He’s only just had the upgrade installed but already this optometry practice owner is seeing the need for others to take up the software and play their part in pushing back against the building wave of myopia.
Mr Gavin Boneham is excited.
The owner and principal optometrist at Boneham Optometrist Eyecare Plus in Sydney is also president of the Orthokeratology Society of Oceania.
As part of that he has long had a focus on myopia control and how the use of orthokeratology (orthok), among other treatments, can slow its progression.
And now he has an upgraded piece of kit to help him in that endeavour.
Two days before talking with Insight, Boneham received the new Myopia Management software upgrade for his REVO 80 OCT scanner. And he’s still buzzing about what this will mean for his patients and practice, and its potential, once he puts the technology to work in his myopia clinic.
He was already impressed with the REVO device – made by Polish manufacturer Optopol and distributed in Australia by OptiMed – and the support he gets with it.
“I’ve had a REVO for a few years now and it allows me to do an axial length measurement for myopia control. I can look at the retina, I can do OCT imaging of the retina, and they’re always updating their software.”
A device with many functions means more value for money and space in the testing room.
Those functions include up to 130,000 A-scan/sec scanning speeds and OCT-A. There’s a full-colour fundus camera and the ability to combine simultaneous OCT and fundus images.
There’s also optional ‘modules’, such as T-OCT for corneal curvature maps, and B-OCT for biometry in myopia management and intraocular lens calculation, capturing axial length, central cornea thickness, anterior chamber depth, lens thickness, pupil size, choroidal thickness, and white to white.
But what has Boneham particularly excited about the Myopia Management software is its ability to turn his REVO OCT into a powerful myopia management and monitoring device.
OptiMed says the upgrade allows for biometric and topography monitoring. It also enables “trend analysis over population norms”.
That means access to data from three key population databases: Nicer European, a scale representative of younger European children; Tidman, a model based on a wider European age-range; and Sanz Diez, based on research carried out in China, with its higher prevalence of myopia.
That is combined with the device’s measurement of the axial length and its already extensive scans of the anterior and posterior boundary of the cornea, the anterior and posterior boundary of the lens, as well as the posterior boundary of the retina.
When that data is compared with inputs about the patient’s family history and environmental conditions, including how much time they spend outdoors and on small screens, this helps to deliver a clearer idea of where that patient falls compared with others of similar age and ethnicity.
REVO OCT also provides the user with the ability to measure choroidal thickness and populate this data into the myopia management module.
The ability to measure this metric is something standard biometers can’t not perform, but with REVO being an OCT it already has the capabilities to measure every layer of the retina and the ability to enter this data into the programme is becoming increasingly important for those monitoring this patient database.
More information is coming out on its relevance and being able to correlate and measure this metric as part of the module sets REVO aside as unique and adds even more value to this device being at the forefront of this new wave of myopia management.
Analysis using the artificial intelligence within the software gives the practitioner a clearer picture of that person’s myopia risk, what is likely to happen if changes are not made, and then information about the efficacy of any treatments prescribed.
Despite only recently accessing the module, Boneham is already confident that his patients, especially the parents of potentially myopic children, are going to be just as impressed as he is.
“So you can show the parents – OK, your kid is at this stage; if he or she keeps going this way, they’re going to end up here. So we’ve got to be a bit aggressive, or not, depending on the information.
“It’s also us saying, here’s the best, the latest myopia module and analysis program. So we’ve got your kid, you can rest assured that your child is getting the best care with our practice.”
Using the upgrade during follow-up appointments can quickly track if treatments are working or need adjusting.
Boneham says that gives him the confidence to “hit it hard”, and means patient and parent are more likely to listen and act, even if that means lifestyle changes, such as more time outdoors and less time on small screens.
But it’s not just the patient who benefits. Boneham can see numerous advantages for the practice as well.
He says the module is easy to use for anyone considered “computer-savvy”.
“I can do it; it passed the Grandpa test.”
It fits nicely into the practice workflow and actually speeds up the process with patients.
“The software does all of this straight away, I don’t have to do it manually,” he says. “It will probably save about five minutes for each patient.”
Boneham is an early adopter of the module and the technology.
But he doesn’t see it as a luxury or a nice-to-have. As much as it might help one independent practice differentiate itself from others, he believes the tsunami of myopia around the world means this equipment should be commonplace in optometry practices around Australia.
“The World Optometry Council has said everyone has to practise myopia management – that’s the standard of care now.
“Every practice should be doing it. And if you want to do it, you want to do it well, with an OCT and an axial length measurement.
“And this shows the parent as well, I’m paying all this money but we’re getting this result.”
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