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Achieving success with orthokeratology
Abstracts / Contact Lens & Anterior Eye 36 (2013) e1–e15
Achieving success with orthokeratology Robert Gerowitz ∗ , Jan Jurkus The addition of a major new clinical service is often considered by practitioners to be a daunting task. Current in-practice clinical commitments may deter many contact lens fitters from introducing a new service which will take time to learn and incorporate successfully. However, although orthokeratology is a substantive clinical treatment with its own learning curve, integrating it into a practice is relatively straightforward. By carefully identifying patients who will be good candidates for the treatment, using proven empirical fitting methods and learning basic troubleshooting skills, the orthokeratologist joins the vanguard of myopia correction and control. As one of the most effective methods to retards myopia progression, orthokeratology has been shown by numerous studies from around the world to help children contain their level of myopia through to adulthood. By keeping children from becoming pathologically short sighted, the risk of retinal
e15
and Meibomian Gland Dysfunction (MGD) being more and more frequently seen in our patients. Because of that, the assessment of the anterior segment is the basis for the overall satisfaction of patients as well as for a successful contact lens fitting. Most of the current assessment methods have limitations regarding the invasiveness of the test, the subjective influence of the investigator or the inability of the investigator to classify the observed findings. This workshop primarily aims at providing an overview of newly available assessment methods for the anterior eye, such as bulbar redness, the tear film and the meibomian glands. Participants will get a hands on experience with novel software assisted measurements and devices assisting them in the assessment of the anterior eye. These include a training tool for the classification of slit lamp findings including a novel morphing software or the assessment of meibomian glands using meibography. http://dx.doi.org/10.1016/j.clae.2013.08.063 Systematic fitting of the corneo-scleral lenses
http://dx.doi.org/10.1016/j.clae.2013.08.061 OCT imaging of the anterior eye Stefan Bandlitz ∗ , Andreas Berke Optical coherence tomography provides non-invasive high resolution images of most ocular tissues. Previously, the focus was the evaluation of the posterior segment of the eye. A wide range of new instruments came up to the market, which in addition allows imaging and measurements on the anterior segment. Therefore, this technology could also be of interest to the cornea and tear film specialist as well as to contact lens practitioners. The workshop will explain the technical principle of OCT and compare it to other imaging techniques like Scheimpflug. OCT applications, like pachymetry, topography, anterior chamber biometry, angle assessment, densiometry and tear film evaluation will be discussed. The objective of the workshop is to enable the participants to decide which system is suitable for their clinical practice and which system is affordable. detachment and glaucoma from developing a high level of myopia in later life will be greatly reduced. The presenters of this workshop have close to 30 years’ combined experience in this relatively new field and together have successfully fitted many thousands or orthokeratology patients. Consequently, they are in a unique position to explain clearly the theory involved in making orthokeratology work successfully but also how to apply it in practice. As well as adding an important new clinical treatment to the practice which offers important benefits to patients of all ages, practitioners will also benefit financially from a treatment which ‘locks in’ patients. By the end of this workshop, attendees will have the tools necessary to make accelerated overnight orthokeratology a successful part of their practice. http://dx.doi.org/10.1016/j.clae.2013.08.062 Novel diagnostic methods for the assessment of the anterior eye Wolfgang Sickenberger ∗ , Marc Schulze The integrity of the ocular surface and the tear film is of particular importance in today’s clinical practice, with dry eye syndrome
Paul Rose, Jennifer Choo Semi scleral and scleral lenses have made a revival over recent years because of new materials and improved manufacturing techniques.. For some particular types of irregular cornea, a semi or corneoscleral design is ideal, and will give better comfort and stability, than a smaller intra-limbal lens. Most semi scleral designs are fitted by using sagittal heights and judging tear layer thickness under the lens, which are factors not usually considered when fitting a corneal lens. For this reason fitters are sometimes reluctant to try semi scleral designs as they consider this will require new skills and learning curves. In this workshop a simple 5 step systematic fitting system will be described in detail, which is very easy to use even for fitters who have not fitted a semi scleral design before, as it uses the same principles as fitting a normal intra- limbal GP lens. In a recent international trial involving 17 GP fitters, some who had never fitted a semi scleral lens before, a total of 120 cases of irregular cornea were fitted using this 5 step fitting process, resulting in a final success rate of over 75%. The fitting method proved easy to use even in the hands of the inexperienced semi scleral lens fitter (average of 1.6 lenses per eye) and was used to fit a wide range of irregular corneal conditions. It was also used successfully to prescribe a design which in a number of cases replaced the patients existing piggyback lens system or thick soft lenses. http://dx.doi.org/10.1016/j.clae.2013.08.157
Achieving success with orthokeratology Robert Gerowitz ∗ , Jan Jurkus The addition of a major new clinical service is often considered by practitioners to be a daunting task. Current in-practice clinical commitments may deter many contact lens fitters from introducing a new service which will take time to learn and incorporate successfully. However, although orthokeratology is a substantive clinical treatment with its own learning curve, integrating it into a practice is relatively straightforward. By carefully identifying patients who will be good candidates for the treatment, using proven empirical fitting methods and learning basic troubleshooting skills, the orthokeratologist joins the vanguard of myopia correction and control. As one of the most effective methods to retards myopia progression, orthokeratology has been shown by numerous studies from around the world to help children contain their level of myopia through to adulthood. By keeping children from becoming pathologically short sighted, the risk of retinal
e15
and Meibomian Gland Dysfunction (MGD) being more and more frequently seen in our patients. Because of that, the assessment of the anterior segment is the basis for the overall satisfaction of patients as well as for a successful contact lens fitting. Most of the current assessment methods have limitations regarding the invasiveness of the test, the subjective influence of the investigator or the inability of the investigator to classify the observed findings. This workshop primarily aims at providing an overview of newly available assessment methods for the anterior eye, such as bulbar redness, the tear film and the meibomian glands. Participants will get a hands on experience with novel software assisted measurements and devices assisting them in the assessment of the anterior eye. These include a training tool for the classification of slit lamp findings including a novel morphing software or the assessment of meibomian glands using meibography. http://dx.doi.org/10.1016/j.clae.2013.08.063 Systematic fitting of the corneo-scleral lenses
http://dx.doi.org/10.1016/j.clae.2013.08.061 OCT imaging of the anterior eye Stefan Bandlitz ∗ , Andreas Berke Optical coherence tomography provides non-invasive high resolution images of most ocular tissues. Previously, the focus was the evaluation of the posterior segment of the eye. A wide range of new instruments came up to the market, which in addition allows imaging and measurements on the anterior segment. Therefore, this technology could also be of interest to the cornea and tear film specialist as well as to contact lens practitioners. The workshop will explain the technical principle of OCT and compare it to other imaging techniques like Scheimpflug. OCT applications, like pachymetry, topography, anterior chamber biometry, angle assessment, densiometry and tear film evaluation will be discussed. The objective of the workshop is to enable the participants to decide which system is suitable for their clinical practice and which system is affordable. detachment and glaucoma from developing a high level of myopia in later life will be greatly reduced. The presenters of this workshop have close to 30 years’ combined experience in this relatively new field and together have successfully fitted many thousands or orthokeratology patients. Consequently, they are in a unique position to explain clearly the theory involved in making orthokeratology work successfully but also how to apply it in practice. As well as adding an important new clinical treatment to the practice which offers important benefits to patients of all ages, practitioners will also benefit financially from a treatment which ‘locks in’ patients. By the end of this workshop, attendees will have the tools necessary to make accelerated overnight orthokeratology a successful part of their practice. http://dx.doi.org/10.1016/j.clae.2013.08.062 Novel diagnostic methods for the assessment of the anterior eye Wolfgang Sickenberger ∗ , Marc Schulze The integrity of the ocular surface and the tear film is of particular importance in today’s clinical practice, with dry eye syndrome
Paul Rose, Jennifer Choo Semi scleral and scleral lenses have made a revival over recent years because of new materials and improved manufacturing techniques.. For some particular types of irregular cornea, a semi or corneoscleral design is ideal, and will give better comfort and stability, than a smaller intra-limbal lens. Most semi scleral designs are fitted by using sagittal heights and judging tear layer thickness under the lens, which are factors not usually considered when fitting a corneal lens. For this reason fitters are sometimes reluctant to try semi scleral designs as they consider this will require new skills and learning curves. In this workshop a simple 5 step systematic fitting system will be described in detail, which is very easy to use even for fitters who have not fitted a semi scleral design before, as it uses the same principles as fitting a normal intra- limbal GP lens. In a recent international trial involving 17 GP fitters, some who had never fitted a semi scleral lens before, a total of 120 cases of irregular cornea were fitted using this 5 step fitting process, resulting in a final success rate of over 75%. The fitting method proved easy to use even in the hands of the inexperienced semi scleral lens fitter (average of 1.6 lenses per eye) and was used to fit a wide range of irregular corneal conditions. It was also used successfully to prescribe a design which in a number of cases replaced the patients existing piggyback lens system or thick soft lenses. http://dx.doi.org/10.1016/j.clae.2013.08.157