Atropine

While currently there few FDA-approved treatment methods to control myopia in the United States like Misight soft bifocal contacts, there are several options that have been approved in other countries that are available “off label” in the US. These treatment options include therapy with eye drops, orthokeratology, and soft toric multifocal contacts. --It has been determined that the best option for your child for slowing down myopia progression is soft multifocal contacts.-- Slowing of myopia progression is expected but not guaranteed. We are excited to journey together with your family in this program now and into the future. We are committed to be available along this journey and we ask for your commitment to the visit schedule and lens wear expectations. The contacts have a special dual-focus multifocal design with full corrective power in the center of the lens and less power in the periphery. The central portion of the lens provides the distance myopic vision correction while the peripheral surround reduces hyperopic defocus. This in turn, will minimize the stimulus for myopia progression by focusing the light in front of the peripheral retina. Studies evaluating children wearing soft multifocal contact lenses have found a 41% to 59% reduction in myopia progression compared to control subjects. The risk of microbial keratitis can occur with contact lenses, but less with day use of contacts rather than with overnight wear of contact lenses. It is imperative that your child do not sleep in these contacts to avoid this risk. There has been reported side effect in studies of haloes at night while wearing bifocal contacts. Your doctor will work to minimize this side effect during the fitting process. Soft Bifocal Contact Lens Options: 1. Misight Contacts (daily lenses) -for prescriptions for myopia with minimal to no astigmatism *MiSight 1 day® contact lens is the only FDA approved soft contact lens indicated to slow the progression of myopia (nearsightedness) in children, aged 8-12 at the initiation of treatment. At the end of 3 year study, the results were: -59% myopia control at end of 3 years -52% control in axial length, a 0.32 mm difference in axial length at end of treatment. MiSight contacts are daily use only to be thrown away at the end of the day or after 10-14 hours of use. Cost of Coopervision MiSight FDA approved contacts and program is $2300 for the 1st year = [$800 for initial contact lens training, 2-3 followup visits to finalize prescription, then 4 months and 8 months + 1 year supply of daily use contacts $1500), and enrollment in Brilliant Futures support program with Coopervision (includes mobile appt with reminders for follow ups and other tools). Year 2 fees are reduced due to need for less frequent follow up visits= [$165 renewal fee at yearly exam: $125 and 6 month follow up:$290) + 1500 for contacts =1790] 2. Specialeyes: Custom Multifocal Toric (MFT) Soft Contact Lenses (quarterly lenses) Specialeyes Custom Contacts are center distance lenses that are utilized for off label use for slowing myopia progression. Similar effectiveness have been found for reduction of myopia progression compared to the Misight and Biofinity MFT lenses. Cost of Specialeyes MFT contacts and program is $1790 for the 1st year = [$800 for initial contact lens training, 2-3 followup visits to finalize prescription, then 4 months and 8 months] + $990 for year supply of contacts for both eyes. 2nd year and every year thereafter: Contact lens renewal exam at yearly exam [$165 renewal fee at yearly exam and $125 at the 6 month follow up:total $290 for year 2 +) plus the cost of year supply of contacts: $990 = $1280 3. Biofinity Multifocal Toric or Biofinity Multifocal Toric Soft Contact Lenses -(monthly lenses) Biofinity Contacts are center distance lenses that are utilized for off label use for slowing myopia progression. Similar effectiveness have been found for reduction of myopia progression compared to the Misight and Specialeyes lenses. The range of power of available range up to -/+10.00, up to -5.75 astigmatism, reading add up to 2.50, with 1 base curve option. Cost of Biofinity contacts and program is $1385 for the 1st year = [$785 for initial contact lens training, 2-3 followup visits to finalize prescription, then 4 months and 8 months] + $600 for year supply of contacts for both eyes. At end of 1 year treatment at time of comprehensive exam: $165 for contact lens examination for renewal in addition to copay for comprehensive exam fees are due. For 2nd year of treatment and every year thereafter a 6 month visit follow up in between exams is $220 Payment is expected in full at time of the first training appointment. If your child should discontinue the program within the first 60 days, cost of year supply of contacts (this varies depending on which contact lenses were prescribed $600-$1500) will be refunded to you. After 60 days, there are no refunds. [You have the option to apply the funds to other myopia management treatments] While several studies have shown that there are benefits with the treatments mentioned above, not every child will respond the same way. Some children may have the same amount of myopia progression while wearing or not wearing a contact lens for myopia control, but less likely given the clinical evidence. Furthermore, even though there are methods on how to predict how much myopia can be reduced given a certain treatment method, there are still risk factors the patient may have and/or environmental factors that can effect the overall result. If at any time during the program your child experiences eye pain, discomfort, and/or redness, your child should remove the lenses immediately and you should contact our practice to speak with your doctor (or if the office is closed, contact our after-hours phone number at [916-246-8111). Diagnosis and treatment of any eye infection, corneal abrasions, or other eye conditions other than myopia are not part of the Myopia control program and are therefore subject to additional expenses and, if applicable, your medical insurance co-pays and deductibles. I have read all the above information and understand the commitment asked of my child and I to maximize my child’s success. I agree to contact my doctor as outlined in the last section if anything abnormal were to arise. I hereby authorize Eyes of East Sacramento to initiate the Myopia Management Program with the contacts indicated above