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This episode was made possible with the support and partnership of CooperVision.
For many practitioners, a passion for serving pediatric patients grows after we get out into real-world practice and see just how much children need our care. Building out a pediatric focus even within a primary care practice can be a valuable service to the community, and incredibly rewarding as you see the immediate impact that clear vision can have on social, emotional, and school performance. Our guests on this episode are two leading experts in the field of pediatric optometry. Dr. Nathan Bonilla-Warford, OD, FAAO, FCOVD, is the private practice owner of Bright Eyes Tampa and Bright Eyes Kids. Dr. Yos Priestly, FAAO is an optometrist who works in an OD/MD hospital setting in Durham, North Carolina.
Despite their different paths to pediatric specialty, both Dr. Bonilla-Warford and Dr. Priestly are big supporters of the experience of pursuing an optometric residency for interested students. “But there are many different paths you can take,” Dr. Priestly explains for doctors who are entering pediatric care later into their careers. “One year of residency is equivalent to about five years of experience,” Dr. Bonilla-Warford states. “Absolutely you can get that experience in your own clinic outside of a residency, but [with a residency] you will get there faster.” One of the other advantages of the residency experience they both shared was building a network of colleagues to learn from and lean on for guidance in tough cases, and the knowledge of how to interact with pediatric specialties outside of optometry. Creating a network of doctors for referral – from strabismus surgeons to retinal surgeons to pediatricians – is essential for caring for this population.
A referral network is just one step for building a pediatric practice. “We were really proactive early on with building a social media presence,” Dr. Bonilla-Warford says. He utilized Facebook moms groups to help spread the word, and now has embraced TikTok to help communicate with young patients about ocular health on the platforms they are most using. By creating a separate brand identity and location for his pediatric clinic, Dr. Bonilla-Warford has been able to really cater his practice to children. Children have to feel welcome and comfortable in a space, and branding specifically to them is important to show parents that this space was especially made for the care of their child. The waiting room furniture is child-sized; there are Legos on the wall. If you build a practice with kids truly in mind, the space will speak to parents for you.
A vital part to growing their pediatric practices has been embracing myopia management. Dr. Priestly shares that even in an OD/MD hospital setting, myopia management has really grown quickly over the last two years. The biggest thing to move the needle has been the FDA approval of myopia management treatment options and the publication of major peer reviewed studies and scientific evidence to validate the science of myopia management. “I feel fortunate that I work with pediatric ophthalmologists who recognize myopia management as an area of need, and an area that is becoming a standard of care for children,” Dr. Priestly shares. Her practice has embraced the medical aspects of myopia management and prevention with a program that includes routine follow-up care and axial length measurements throughout the year.
Dr. Bonilla-Warford brought myopia management to Bright Eyes Kids about 12 years ago, but at the time it was a very small part of his practice due to the limited treatment options available. “Slowly the pieces came together, and I definitely agree that the MiSight® 1 day FDA approval made a difference, and now every single day I’m doing myopia management,” he says. He recently attended the AAO conference in Boston and was very impressed by the amount of clinical data being published around the effectiveness of myopia control management and the MiSight®1 day soft contact lenses. He has seen a large turn in the conversation over the last few years where pediatric ophthalmologists are now embracing this care.
For practices just getting started with myopia management or who have dabbled in it for years but are now looking to make it a more vital part of their practice, Dr. Priestly and Dr. Bonilla-Warford highly recommend outlining a myopia management program with set costs and follow-up visit schedules. “It’s much better to have a whole system in place before you hit the ‘go’ button,” Dr. Priestly says. Staff training and buy-in is also essential. Dr. Bonilla-Warford’s office has a myopia control coordinator to help streamline patient communication and education, but he also emphasizes that every single staff member has to understand the program and be given the tools to represent myopia management at his practice.
Educating parents and patients is also essential to growing a successful myopia management specialty. Dr. Priestly shares that her office created pamphlets and information sheets that shares pertinent study results that she gives out to parents and referring providers. “Give them the data and options, and allow parents to make the decision with you about which option is the best choice for them,” Dr. Priestly says of her practice philosophy. Dr. Bonilla-Warford shares that the tone of the conversation is also important to get right. He avoids fear tactics or scaring parents into the need for myopia control, and also avoids being too eager or excited. Instead, his presentation is very “matter of fact”. He focuses on a simple drawing of a normal eye and then an elongated axial length eye, and says to the parents, “this is what we want to keep from happening, and this is how we can do it.” He finds this simple approach and illustration of what is happening leads to a more open dialogue with the parent, where the parent is free to ask questions and decide for themselves if this is right for their family. He also mentions that both of his children are doing myopia management, so he’s a big believer in the science for his own family.
You can learn more about myopia management and MiSight® 1 day contact lenses by going to https://coopervision.com/practitioner/myopia-managementmisightpro.com.
Indications for use: MiSight® 1 day (omafilcon A) soft (hydrophilic) contact lenses for daily wear are indicated for the correction of myopic ametropia and for slowing the progression of myopia in children with non-diseased eyes, who at the initiation of treatment are 8-12 years of age and have a refraction of -0.75 to -4.00 diopters(spherical equivalent) with ≤ 0.75 diopters of astigmatism. The lens is to be discarded after each removal.
