axial eye length

Philip Cheng, well-known clinical optometrist from Melbourne, Australia and prolific contributor to the Myopia Profile Facebook group, takes us through the twists and turns of myopia management in practice. Philip founded his greenfield independent practice over three years ago with a near-exclusive focus on myopia management, and in this podcast we discuss how he made the leap to establishing and now running his successful practice, where a majority of his new patients come from word-of-mouth or colleague referral. 

From marketing to in-room communications; from equipment to chair time, Philip encourages you to self-educate, project your expertise, promote your brand, start discussions early and be proactive about fitting and celebrating children wearing contact lenses. We discuss the hot topic of axial length measurement in practice, of which Philip is a strong advocate – how it helps to assess risk and determine success – but also if you don’t have access, how to still offer your own expert myopia management service. Philip and I examine what makes Australia the apparent world leader in practitioner myopia management engagement. Finally we discuss setting treatment expectations; to set up the child, parent and your practice for ongoing success.

Professor Mark Bullimore of the University of Houston, Texas USA, tells us more on the complex topic of 0.01% atropine, including its stability as a compound, and takes us on a short journey through chemistry explaining how current studies are using novel formulations to address this issue. Have you heard of ‘heavy water’? I hadn’t, until now! Mark advocates for you to ‘be the doctor’, using the side effects as a gauge of drug efficacy, and even suggests a novel clinical approach in practice to determine the individual patient’s response and tolerance. We also discuss the mismatch (or otherwise) of refractive and axial length control results in atropine studies which don’t appear to be the case in studies of optical interventions, along with communicating the ‘why’ of myopia management through the dioptric effect of control.

Professor James Loughman from Technological University Dublin, and the Centre for Eye Research Ireland, challenges us to think differently about low dose atropine. What are we actually getting in the bottle? How should we approach atropine usage in practice? What will future research tell us? The message on 0.01% atropine is complex and perhaps not what you expect.