“InSight Radio” is a series of audio-visual interviews where we sit down with the trailblazers of vision science and explore the latest advancements, challenges, and opportunities in the field. This show covers a range of topics from basic research to clinical practice and everything in between. Our guests who are prominent experts, educators, and practitioners will offer their knowledge, experiences and will also share their life journeys and thoughts on the pressing issues faced in the profession today. They’ll provide valuable insights on what it takes to succeed in the field and how to stay on top of the latest developments.
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An Interview with Dr. Glenda Aleman-Moheeputh
by Ms. Sucheta Mitra
Interview summarised by Ms. Sucheta Mitra
Eyes of the Future: Dr. Glenda’s Strategies for Myopia Management
The inaugural episode of Insight Radio begins with the host, Sucheta Mitra, introducing the show’s purpose to delve into various topics related to vision science. Dr Glenda shares her inspiring journey into optometry, fuelled by her passion for patient care and her dedication to addressing the myopia epidemic. She emphasises the importance of early myopia detection and intervention, and highlights the effectiveness of Orthokeratology (Ortho-K) as a non-invasive procedure for myopia control. The episode explores her experiences working with paediatric patients, addressing concerns about Ortho-K’s safety for children’s eyes, and discussing strategies for promoting myopia management. Additionally, she emphasizes the responsibility of doctors to educate parents and patients about myopia risks and available treatment options. The episode concludes with a focus on early eye examinations, outdoor activities, limited screen time, and UV protection as proactive measures to slow down myopia progression.
Dr. Glenda’s expertise lies in myopia management and orthokeratology. Her dedication to finding solutions for the growing myopia epidemic is evident through her venture called OK Myopia Control Experts. As the owner of EyeSmart Vision Care, her private practice, she specialises in treating corneal diseases and myopia control.
The episode aims to unveil Dr. Glenda’s inspiring journey into optometry and her unwavering commitment to myopia control. She recounts how she stumbled into the field by chance, accidentally getting a job at an optical store while accompanying her sister to a job interview. Motivated by her experiences and her passion for patient care, she pursued a career in optometry, initially working as a sales associate at Walmart’s optical department.
During her time at Walmart, an encounter with a patient made her realize her true calling to become a doctor. Despite being a single mother of three children, she was determined to pursue optometry. She took the necessary steps, including completing her undergraduate education and becoming a licensed optician before attending optometry school at Nova South-eastern University. Dr. Glenda discovered her affinity for working with paediatric patients while in optometry school. Recognising her happiness in this area, her family suggested she focus on paediatrics. Embracing their advice, she found great fulfilment in making a positive impact on the lives of children through early disease detection and intervention. She emphasises the power of optometrists in shaping the habits and future of young patients, particularly in areas like contact lens wear.
Dr. Glenda explains that myopia, also known as near-sightedness, is a condition where a person can see objects clearly up close but struggles with blurry vision when looking at distant objects. She highlights the prevalence of myopia in the paediatric population and underscores the importance of managing and controlling myopia, especially in children, due to the associated risks.
Her interest in myopia control blossomed during her optometry school years as she realised her passion for working with children. Dr. Glenda firmly believes that paediatric optometrists should possess knowledge about myopia management and treatment options to educate parents and children about the risks of high myopia.
She further delves into her fascination with Orthokeratology (Ortho-K), a non-invasive procedure that involves using specialized contact lenses worn at night to reshape the cornea. Dr. Glenda highlights the effectiveness of Ortho-K in achieving results similar to LASIK without the need for surgery.
Dr. Glenda’s passion for myopia control deepened when she encountered a 14-year-old patient who had already lost vision in one eye due to high myopia. This experience profoundly impacted her, fuelling her desire to educate and assist children with myopia. It marked a turning point where her focus shifted from personal interest to a mission-driven purpose of learning as much as possible about myopia to better serve her patients.
Addressing concerns and misconceptions parents may have about Orthokeratology (Ortho-K) and its potential harm to children’s eyes, Dr. Glenda takes a proactive approach. She addresses safety concerns upfront, emphasizing that Ortho-K carries similar risks to wearing extended wear contact lenses, which are already commonly used. She reassures parents about the safety features of Ortho-K, such as highly permeable oxygen materials, and highlights that the lenses do not cover the entire cornea.
She explains that Ortho-K is a medical device prescribed and supervised by licensed physicians providing parents with confidence in its FDA approval and established safety. Emphasizing the importance of rigorous follow-up schedules and being accessible to patients, even on weekends, she aims to promptly address any concerns. By prioritising corneal health and maintaining clear communication with parents, she aims to alleviate worries and ensure a successful Ortho-K experience.
She explains that there is no specific age limitation for starting Orthokeratology (Ortho-K) treatment. While the youngest patient she has treated with Ortho-K is five years old, she acknowledges colleagues who have treated patients as young as four years old. The decision to start Ortho-K depends on the doctor’s comfort level and the specific needs of the patient.
However, she mentions that when encountering a three-year-old patient with high myopia, she takes a more aggressive approach to therapy, starting with atropine eye drops and transitioning to Ortho-K once the child reaches four years old. Early intervention is crucial in such cases, as the age of myopia onset strongly predicts high myopia in adulthood
Regarding follow-up guidelines for Ortho-K, Dr. Glenda recommends initial follow-up visits after one night, one week, one month, and three months of wearing Ortho-K lenses. After the first three months, follow-up appointments are scheduled every six months unless the patient experiences any unusual symptoms or irritation, in which case they are encouraged to visit the clinic earlier.
Dr. Glenda emphasizes that the decision to start Ortho-K treatment involves a team effort between the doctor, parents, and the patient. It is important that the child is willing and able to wear contact lenses, or the parent can be instructed on how to handle the lenses for very young children. Ultimately, the age at which a patient can start Ortho-K depends on their individual circumstances and the professional judgment of the doctor.
Dr. Glenda’s approach to handling anxious and scared children during eye exams involves empathizing with the patient’s mood and making them feel comfortable. She adjusts her position to their level, sitting on the floor with them, or even holding them during testing if necessary. Dr. Glenda understands the importance of creating a welcoming environment, using pastel colours, offering snacks, and communicating with children in a way they can understand. She also values giving children their space and respecting their limits. If a child becomes uneasy during an exam, she may split the appointment into two visits to ensure their comfort and prevent them from developing fear or anxiety towards the office.
Regarding promoting myopia management and spreading awareness among patients, Dr. Glenda believes it is every doctor’s duty to educate parents and patients about the risks associated with myopia and the available treatment options. She emphasizes that even if a doctor personally does not enjoy treating myopia, it is crucial to raise awareness and provide basic education about the disease. To actively implement myopia management in their practice, Dr. Glenda suggests starting with education and setting a date to begin. This allows time to establish protocols and operations while ensuring progress is made. Creating a patient database and scheduling follow-ups within the designated timeframe can help initiate conversations about myopia management and treatment options. Dr. Glenda emphasizes that starting small with basic education and resources is sufficient, and doctors can gradually expand their knowledge and equipment over time. The key is to take the first step and experience the enthusiasm and motivation that comes from helping even one patient and their family.
In conclusion, it is crucial to prioritise early eye examinations for young children, ideally before they turn one year old and again around two years old. This is especially important between the ages of two and nine when significant eye development occurs. By taking proactive steps such as encouraging outdoor activities and limiting screen time, we can potentially slow down the onset and progression of myopia.