What if there was a method that combined with OrthoK virtually assured stability of refractive error?What if the method required use of medications in the eye and the technique needed to be repeated at regular intervals to keep the effect stable? What if the technique wasn't FDA approved for myopia control, so its use would be off-label? What if your state board is against or silent concerning your ability to use the technique?

Am I talking about cross-linking for corneal stability of an OrthoK molding? Or am I talking about using very low dose atropine? Or am I talking about the next technique that we don't know about yet? Our profession continues to be defined by law and the laws do not always keep up with current technology. Wouldn't it be strange to find ourselves in a situation where we could treat the blinding medical condition of glaucoma but we couldn't treat the refractive condition of myopia with the best clinical tools?

We are generally very adamant about keeping insurance companies out of the equation when talking about orthokeratology. We've seen from prior experience that there is no benefit to traveling down that road. I think we need to realize that we could be blindsided from unexpected directions. You need to investigate your state laws with an eye towards determining your freedom to practice what has to be full-service optometry. If you don't like what you see, specifically with the ability to treat refractive errors with medications, then start working on it now. There are so many battles over health insurance - don't get locked out of what many of us may assume is our fall-back position if vision plans and health insurance fail to deliver what we and our patients need.

Richard L. Anderson, O.D.

Richard L. Anderson, O.D. is a fellow of the academy and has been assigned to head a committee tasked with creating a myopia prevention protocol. He has practiced in Camarillo California for more than a few years and his passion for myopia prevention led him to most recently create a website for patients and doctors at http://www.MyopiaPrevention.org.

Research is moving fast and what many of us thought was true just isn't so. RGPs don't slow myopia significantly. Just that one fact is not believed by many contact lens fitters. A protocol that goes against their cherished belief has a high bar to overcome. Not only must the protocol lay out the science behind what suggestions are made, it needs to make a solid case for why other alternative protocols don't make sense.

I think the protocol also needs to comment on techniques that have different levels of proof. This is commonly referred to as "levels of evidence." At the top level (from another's listing) would be evidence obtained from meta-analysis of randomized controlled trials while at the lowest rung would be evidence obtained from expert committee reports or opinions and/or clinical experiences of respected authorities. That's a large span but I think it is important to both guide individual doctors and guide future research.

Here's an example: A patient who is -4.50 and progressing and not willing to go for orthok or other treatments, asks you if it would in any retard their myopia progression if they went without their glasses for part of the day. I'm sure the majority of offices say something to the effect "Just wear them - your glasses don't make your eyes better or worse, they just compensate for the blur. If you get more nearsighted, we'll change your prescription next year." Certainly there is no research out there to support either view.

You, in your enlightened state of mind however, are willing to entertain a thought process that might go like this: "Hmm - myopia seems driven by peripheral hyperopia. It is better to have peripheral myopia and animal studies have shown that short intervals daily of peripheral myopia can compensate for long intervals of negative lens blurring. If this patient takes off their glasses that are most likely creating peripheral hyperopia and looks at anything beyond their fingertips, they most likely will have significant peripheral myopia. So yeah - I think they SHOULD take their glasses off an hour or so a day and go for a walk."  

Now that's a somewhat radical recommendation coming from a "traditional" optometrist. But if expert opinion agrees, maybe it needs to be mentioned in a protocol.

I don't know what the experts think yet. Imagine where you might stand.

Richard L. Anderson, O.D.

Richard L. Anderson, O.D. is a fellow of the academy and has been assigned to head a committee tasked with creating a myopia prevention protocol. He has practiced in Camarillo California for more than a few years and his passion for myopia prevention led him to most recently create a website for patients and doctors at http://www.MyopiaPrevention.org.

My best memories of Nick came during my days leading The National Eye Research Foundation trying to deal with a man that was anything but predictable. Difficult but worthwhile negotiations were always the order of the day as we worked through issues large and small. I will never forget that twinkle in his eyes and the feeling that whatever we had just agreed to was somehow exactly what he had intended in the first place. Whether he was involved in negotiating lens sales at the yearly educational meetings of NERF in Las Vegas or lecturing all us on difficult fits or future innovative design challenges he was always involved and passionate.I will miss him greatly.

Cary M Herzberg O.D. FOAA

We have a big job ahead of us.

Invite another optometrist to Scottsdale!

Richard L. Anderson, O.D.

 Richard L. Anderson, O.D. is a fellow of the academy and has been assigned to head a committee tasked with creating a myopia prevention protocol. He has practiced in Camarillo California for more than a few years and his passion for myopia prevention led him to most recently create a website for patients and doctors at http://www.MyopiaPrevention.org.

With the help of The Gas Permeable Lens Institute(GPLI) and Ed Bennett we are inviting contact lens residents of all the major Optometry schools to attend our meeting in Scottsdale . We have found in the past that while these residents are attending meetings like The GSLS they have not been able to or not aware of the opportunity to attend the greatest show on Earth for corneal reshaping. This year that will not be the case and relationship with Ed and GPLI has helped us accomplish this goal.

Bausch & Lomb has been one of our key supporters since the beginning of the academy. With the help of John Hibbs,Andrew White and David Bland we have been able to forge a new working relationship. This has been especially helpful in two key areas for us. Vision By Design will have a record number of exhibitors at this years meeting due in part to the efforts of Bausch & Lomb. With the help of both B&L and Paragon Vision Sciences we are offering core curriculum courses and live wet labs on corneal reshaping and specialty lens fitting for the first time this year.

Paragon Vision Sciences has been very instrumental in providing resources to us that allow us to advertise our meetings to the CRT community. Like B&L they have provided opportunities that we have found helpful to growing our membership. This year we will again have a booth, presentation and workshops in San Diego at the San Diego Specialty Contact Lens Symposium courtesy of Jerry Legerton, The San Diego Optometric Society and Paragon. At our meeting in Scottsdale Paragon will be providing a Slit Lamp for our wet labs and coordinating a golf tournament on the Wednesday before the meeting as well as several special outings during the event.

Never one to rest on their laurels the academy with he help of its members continues to grow new opportunities. Several years ago Eyequip/Wave was a newcomer as far as exhibiting at our events. Today they are supplying incentives to the "Wavers" to attend our meetings and workshops. This the direct result of our great relationship with Scott Lewis and the result of many hours of work from our Wave community. BE Enterprises/Precision Technology and Randy Kojima have made outstanding contributions to our meeting content. Euclid Systems and Joann Simonsen have supported us both locally in the US and overseas. Oculus and Michael Wolber a new vendor at last years event has increased their support at Scottsdale. Steve Ernst (Contex)has contributed workshops and lectures for many years now as has Tom Reim(Dreimlens). Patrick Caroline(Paragon) has been invaluable in presenting the latest corneal reshaping trends in a manner that has been both entertaining and educational.

At this years meeting we will have several new exhibitors including Optovue who will provide a OCT for our Scleral Wet Lab. Peter Wilcox was extremely important in getting this done for us. Blanchard,Valley Contax and Acculens will be participating their Scleral Lens designs in our Wet Lab as well as our exhibit hall all through the efforts of John Hibbs of B&L. The decision to include specialty fitting in VBD 2012 has been an objective of our board and Eddie Chow and was made part of our strategic objectives laid down at VBD 2009 in Phoenix.

At the recent Global Specialty Lens Symposium in Las Vegas I approached the Contact Lens Manufacturers Association(CLMA) in hopes of engaging them in a cooperative effort to work together to grow the GP industry and the IAO/OAA. Our group I believe can be the key to efforts to grow the GP industry to a level that can support healthy growth in the CLMA member labs. In much he same way that the American Academy of Optometry (AAO) is able to support their programs and annual education meeting the IAO/OAA can serve that same role in providing fertile ground to grow demand for GP products and attending educational meetings like GSLS, SDSCLS and VBD. With the help of CLMA to promote IAO/OAA through its labs and working with us we can and will develop the best GP education on the planet with record turnout to support it.

The board of directors passed a resolution to explore the creation of an international academy in Chicago at VBD 2010 by setting up a committee led by Marino Formenti and myself. At VBD 2011 the committee recommended going forward with the international academy and it came into being by an act of our membership during that meeting. We are proceeding at break neck speed as the IAO becomes fully involved in Europe and Asia. A delegation from the IAO will be traveling to Hangzhou in late March to participate in the AOSLC and the launching of the International Academy of Orthokeratology Asia Section(IAOAs). We are blessed by great leadership of Asia Section from Drs, Lufan and Xie with expert help from our own Helen Duan.There will be a membership meeting of IAOAs and their first full corneal reshaping training sessions for attendees that weekend of the meeting. Later this year in Madrid the IAO will be participating in our European Section(EurOk) first education meeting. Marino Formenti,Antonio Calossi,Mauro Frisani,Basil Bloom, Jose Meijome and many others have put in many hours of planning sessions and are to be applauded for this great accomplishment.

In the next month you will be receiving a proxy from the academy. This proxy will ask for your approval of our new IAO board of directors and also a change in our by-laws creating a fourth section of our academy called Oceania. Later this year I will be traveling with Bruce Williams,Marino Formenti and Matt Herzberg to attend the Orthokeratology Society of Oceanias (OSO) annual education event. There we will meet with the membership to answer questions they may have about becoming a section of IAO. After that there will be a vote to officially join the IAO.

What's in the cards for the future. The OAA initiative to develop an integrated myopia control protocol will soon be center stage not only at VBD 2012 but in publications around the world. This initiative will be a practice changer as the committee members making up a cross section of the leading authorities in the eye care field makes its recommendations. It seems hard to believe that just ten short years ago the OAA began. While it certainly has been a challenging decade I believe that we are now poised to reap the benefits of our accomplishments. As they say only time will tell!

Cary M Herzberg O.D. FOAA

This year the OAA will have a lecture opportunity on Hyperopic molding and two workshops on corneal reshaping. We will also be in the exhibit hall as well. Several OAA members will also be present contributing as well. Michael Lipson will be covering CRT applications and Peter Wilcox will be speaking on OCT and Scleral Lens fitting. Kevin Reeder will be assisting us in the OAA workshops and Barry Eiden will be speaking on custom soft contact lenses.

This conference is unique in that it encourages practitioners to bring along a key staff member at no additional charge to the event. This exposure will help improve the success of specialty lens fitting once the doctor returns from the conference. Please check out the conference details at www.specialtycontactlens.org and if you are attending stop by and say hello at our booth.

Cary M Herzberg O.D. FOAA

The IAO delegation will be comprised of myself, Matt Herzberg,Bruce Williams,Eddie Chow, Sami El Hage,Dennis Leung, Marino Formenti and Helen Duan. While there we will be contributing to the conference itself and helping our Asia section as it is officially launched. On Saturday evening March 31 The International Academy of Orthokeratology Asia Section (IAOAs) will hold its first membership meeting and the following morning April 01 will have its first training sessions for attendees at the COOC.This will be a truly historic moment for all of us. A great deal of thanks to Drs Xie and LuFan along with Dr. Helen Duan for all their hard work to make this happen. I would like to also congratulate the entire board of IAOAs and the meeting organizers of AOSLC.

The launching of IAOAs is extremely timely in light of the incidence of myopia now in China where close to ninety percent of college attendees are nearsighted. If we are to have any chance of preventing another generation of children from the affliction we call myopia we must train and equip the eye care practitioners with the latest tools and techniques to deal with this health hazard to our children's well being. I am looking forward to our trip to China and contributing to these great events.

Cary M Herzberg OD. FOAA

To accomplish this we will need to grow dramatically over the next few years. In part this will happen naturally as our membership outside the US becomes integrated within the new IAO. Still we must also look towards our own America's for more growth. The goal to grow an international membership of over five thousand members and locally to increase our own membership three fold. This would give us a combined total similar to the American Academy of Optometry and with an increased influence as well.

The OAA has reached an agreement with David Davidson to acquire his Ortho-K website along wih many other popular potential web addresses. This in one bold stroke gives us control over the number one website address in our industry! As all of you know a listing on this website has been included in your membership. However there have also been practitioners who have benefited from being listed that were not members of our group. In the future this will not be possible.

The OAA has engaged in extremely productive dialogues with both Paragon Vision Scinces and Bauch & Lomb. This will be realized in Scottsdale when you see our large exhibit area filled with vendors. In addition we have decided to offer a core curriculum in specialty lens fitting in Scottsdale. This has allowed us to appeal to a border base of labs who utilize both Paragon and Bausch & Lomb to supply these larger buttons. Due to our new relationships we can now rely on boh these companies to work through their practitioner networks to get the word out about our events. This allows us more spending flexibility which means better content and speakers.

Towards the end of 2011 the board of directors authorized the creation of a special committee charged with developing an integrated approach to myopia control. Richard Andrson was selected as the chair of this semi independent group. In the lst few months he has been active selecting the top people from all the different disciplines who will have input on the myopia control protocol. Attendees to VBD 2012 will receive the benefit of this as they learn what steps in their own practices they need to be taking to practice in this exciting field. Indeed the OAA itself is a world leader in this myopia control and we intend to remain so.

Your OAA at this moment is engaging with other groups like CLMA to grow both the fields of corneal reshaping and specialty fitting. I believe that we should enter into strategic partnerships that see all GP organizations prosper. In that light we have talks on going with the organizers of GSLS ( Global Specialty Lens Symposium) and SDSLS( San Diego Specialty Contact Lens Symposium)to see what will benefit both and grow the field and our organization. You have to appreciate how far we indeed have come and our increased influence as opportunities like these present themselves. We can no longer be ignored and that is because of our success carrying out our strategic visions.

Cary M Herzberg O.D. FOAA

While in Las Vegas I met with many of our exhibitors and detailed what we were expecting for our meeting. I am happy to report that this year we are working more closely then ever with Bausch & Lomb and Paragon Vision Sciences to promote Vision By Design 2012. I am also thrilled to tell you that we have close to thirty exhibitors this year. That means that attendees to our event will have a lot of booths to visit during our meeting.

Great meeting and excellent cuisine highlighted my stay in the city that never sleeps. While at the GSLS I had meetings with our colleagues from EurOK and we were able to lend them support for their first European Ortho-K meeting taking place in Madrid this June. As your President I also met with the leadership of GSLS about more cooperation between our two groups.

Cary M Herzberg O.D. FOAA

This years event will feature two wet labs devoted to corneal reshaping and large diameter lens fitting. We are blessed to have the likes of Pat Caroline and Randy Kojima to walk us through the reasons why we need to consider fitting Scleral lenses. Joining them will be Peter Wilcox and David Bartels to help facilitate a successful lab experience. Our other wet lab will be devoted to corneal reshaping. Bruce Williams will direct this lab. Subjects will be prefit the night before and attendees will get to view the fitting process through film and see first hand how the outcomes turn out.

Our legendary Bootcamp ably directed by Caroline Cauchi will also take place on Thursday April 19th and feature lots of useful information for those who are inexperienced or new to cornel reshaping . This year we are also offering a special opportunity for your staff to take part with special sessions given by techs from successful Ortho-K practices relating how they work up and instruct their corneal reshaping patients.

For those OAA members who would like to pursue Fellowship we have sessions going on Thursday as well. In the morning we have mandatory lectures from Rob Gerowitz and myself required for fellowship. Topics include the responsibilities of a fellow, useful information about corneal reshaping and our new international academy.In the afternoon the actual fellowship testing will begin and last till the evening.

After we're all done for the day we have a Wine & Cheese event in the exhibit hall for all attendees to VBD 2012. Come and enjoy the food in our spacious exhibit hall, view all the high tech products on display and talk with our exhibitor partners who make an event lke this possible. Meeting information is available at www.orthokmeeting.com .

Cary M Herzberg O.D. FOAA