Dr. Shefali Miglani

Optometric Physician
Myopia Control Specialist
Director of the Myopia Care Center

Dr. Shefali Miglani has been in private practice serving patients for over 20 years.

Dr. Miglani is a myopia control specialist focusing on helping reduce the progression of myopia in kids. She created the Myopia Care Center housed within Monroe Eye Care to help kids and parents get informed about myopia progression and how myopia control options can be utilized to preserve good ocular health.

Dr. Miglani is a graduate of Rutgers University where she majored in Psychology and Chemistry where she was at the top of her class. She was inferred with the highest honor of Henry Rutgers Scholar by the University, an honor only given to a select few who have the highest academic excellence.

After graduating at the top of her class with highest honors from the prestigious State University of New York (SUNY) College of Optometry, she worked in challenging environments in Brooklyn and also a community health center in lower Manhattan. An active participant in medical conferences and the Optometric physician community, she is also a proud member of the New Jersey Society of Optometric Physicians (NJSOP) and the American Association of Optometry (AOA) and the Myopia Control Community of Doctors where she is a leader in Myopia Control.

Dr. Miglani is highly trained in managing myopia in kids and is a sought after doctor and speaker from parents who are passionate about preserving their child’s vision.

What is Myopia (Nearsightedness)?

Myopia, also known as nearsightedness, is a common type of refractive error where close objects appear clearly, but distant objects appear blurry.

When you look at an object, light rays reflect off that object and pass through the cornea and the lens of the eye, which bend (or refract) the light and focus it on the retina at the back of the eye. If you have perfect vision, the rays focus directly on the surface of the retina. But in a myopic eye, the eyeball is usually too long from front to back. This causes light rays to focus at a point in front of the retina, rather than directly on its surface. This makes distant objects blurry.

Myopia can also be the result of a cornea that is too curved for the length of the eyeball or a lens that is too thick. For some people, their myopia may be caused by a combination of problems in the cornea, lens, and length of the eyeball.

The National Eye Institute (part of National Institute of Health) on Myopia

Why is My Child’s Prescription Getting Worse?

What Are the Symptoms of Myopia?

If you have myopia, you have trouble seeing things far away, but you can see nearby things clearly. This is why myopia is commonly called nearsightedness.

If you can see well enough to read what’s on your laptop or in a book, but you struggle to see what’s on the television or a movie screen, you may be nearsighted. Sometimes people with undiagnosed myopia will have headaches and eyestrain from struggling to clearly see things in the distance.

How Common is Myopia?

Based on a study published in 2008(link is external), experts at NIH estimate that at least 33 percent of Americans are nearsighted. According to a 2009 study(link is external), the number of Americans with myopia has increased significantly from the 1970s to the early 2000s.

The prevalence of myopia has also been increasing in many other countries around the world. It is particularly prominent among school-aged children living in urban areas in some Asian countries. In the past, people thought children might become myopic from spending too much time reading and writing, which require close-up vision, or from reading in poorly lit rooms.

Myopia can also be the result of a cornea that is too curved for the length of the eyeball or a lens that is too thick. For some people, their myopia may be caused by a combination of problems in the cornea, lens, and length of the eyeball.

More recent studies confirm that myopia (nearsightedness) especially in kids between 8-14 is growing at epidemic proportions. Recent studies(link is external) suggest that the increase of myopia in children could be related to a decrease in the amount of time they spend outdoors.

Learn More About Myopia with Kids in NJ:

What Are the Treatments for Progressive Myopia in Kids?

Myopia control in NJ for especially for kids ages 8-14 can include the following:

  • Lifestyle changes such as reducing device use, taking frequent breaks while studying and increase outdoor play or activities
  • Orthokerotology (Ortho-K)
  • Atroprine Drops
  • Dual Focused Contact Lenses

What is Ortho-K Treatment for Kids?

Orthokerotology (Ortho-K) is a non-surgical treatment plan using specially customized contact lenses to gently reshape the curvature of the eye to improve vision. This is an FDA approved non-invasive procedure that eliminates the need for glasses or daytime contact lenses. It improves vision by gently reshaping your eye WHILE YOU SLEEP using specially designed therapeutic contact lenses. You just put the specially fitted lenses in at bedtime, and when you awake, take out the GVSS lenses and you will have clear, sharp, natural vision for your waking hours.

This safe and effective treatment can correct near-sightedness (including high prescriptions), astigmatism and presbyopia (blurred near vision).

Learn More About Ortho-K

Benefits of Ortho-K

  • Slow down or stop the rate of progression of your or your child’s nearsightedness (myopia). Due to electronic devices, nearsightedness is getting worse especially in kids. By slowing the rate of progression of nearsightedness, you decrease the likelihood of serious eye complications in the long term.
  • Be glasses and contacts free during the day. Play sports, go to work, study and enjoy a better quality of life without the hassles of glasses or contact lenses during the day. Videos of real patients on Ortho-K:

Testimonials of Myopia Management Patients

Frequently Asked Questions (FAQs)

What is it called technically speaking?

Orthokeratology (Ortho-K) or Corneal Refractive Therapy (CRT).

I keep hearing different terms for Orthokeratology. Do they all mean the same thing?

Yes! Orthokeratology may be also be known as: Ortho-K, Corneal Refractive Therapy, CRT, Vision Shaping Treatment, VST, Gentle Shaping System, The Gentle Vision Shaping System, Corneal Molding, Wave Front Corneal Molding, Gentle Molding.

Additionally, the treatment devices used to achieve corrected vision may be referred to as:

Retainer Lenses, Vision Retainers, Retainers, Ortho-K Lenses, Corneal Molds, Molds, Wave Lenses and CRT Lenses.

At Monroe Eye Care, we use the terminology Ortho-K and utilize FDA approved Paragon Corneal Refractive Therapy (CRT) gas permeable lenses. Paragon lenses have been around the longest and have an excellent efficacy and safety record.

What is the Ortho-K Treatement Plan?

The Ortho-K Treatement Plan uses specially designed vision retainer lenses to gently and gradually reshape the front surface of the eye (the cornea) to eliminate or reduce nearsightedness (myopia) or astigmatism.

The principle is similar to the use of a dental retainer used by an orthodontist to realign crooked teeth. The vision retainers are similar to contact lenses and are usually worn while sleeping. They are removed upon awakening to provide clear vision without using glasses or contact lenses! The retainers are comfortable and very easy to care for.

Ortho-k lenses are prescribed for two purposes:

Ortho-k lenses are also called “corneal reshaping contact lenses” or “overnight contact lenses to correct or control myopia.”

There are different brands of gas permeable or “breathable” lenses which include Bausch + Lomb’s Vision Shaping Treatment (VST) and Paragon CRT (Corneal Reshaping Therapy). Both provide similar benefits.

How Long Does the Ortho-k Effect Last?

You should be able to see acceptably well without glasses or contact lenses for a day or two, sometimes longer. For best results, you should wear the ortho-k lenses every night.

What is the evidence documenting the safety of Ortho-K?

Myopia control studies involving Ortho-K Treatment Plan for Corneal Shaping Therapy (Ortho-K) include;

Multifocal contact lens myopia control Walline JJ1, Greiner KL, McVey ME, Jones-Jordan LA.

Which Vision Problems Can Ortho-k Correct?

Orthokeratology is most frequently used to temporarily correct myopia (nearsightedness). Generally, ortho-k can correct upwards of -6.00 diopters (D) of myopia.

Ortho-k also can correct lesser degrees of astigmatism, hyperopia and presbyopia.

The type and amount of refractive error that can be effectively managed with orthokeratology differ on a case-by-case basis. Your eye doctor will be able to give you more specific guidance after examining your eyes.

Who Is a Good Candidate for Orthokeratology?

Most people with mild to moderate myopia (with or without mild astigmatism) are good candidates for ortho-k.

Because the corneal reshaping effect is temporary, little risk is involved, and you can discontinue wearing the lenses at any time — provided you are willing to start wearing glasses or contacts again when your myopia returns!

Children and young adults who want to be glasses-free but are too young for LASIK or are not good candidates for refractive surgery for other reasons (dry eyes, for example) often are good candidates for ortho-k. People who participate in contact sports or work in dusty environments that can pose problems for contact lens wear also can be good candidates.

What Results Can You Expect From Ortho-k?

Eye care practitioners usually aim for 20/20 vision after ortho-k, but 20/40 vision (the legal minimum for driving in most of the United States) often is considered an acceptable outcome.

In the FDA clinical study for approval of Paragon CRT lenses, 93 percent of patients achieved 20/32 vision or better, and 67 percent achieved 20/20 or better. In the clinical study for FDA approval of one VST design, about 95 percent achieved 20/40 or better, and 73 percent achieved 20/20 or better. Both studies followed patients for at least nine months.

What to Expect When You Begin Ortho-k

The eye doctor will begin by measuring the curvatures of your corneas using an instrument called a corneal topographer — a painless procedure that takes a few minutes and produces a topographical map of your eye’s surface.

Your doctor might use an in-office inventory of lenses for fitting your eyes with ortho-k lenses the same day corneal topography measurements are taken, or she may order custom ortho-k lenses for fitting at a later date.

You may need a series of temporary lenses to see properly until you reach the desired prescription. In most cases, up to three pairs of lenses are required to achieve the maximum vision correction effect.

When you begin to wear ortho-k lenses, you will likely have some awareness of the lenses on your eyes until you fall asleep. With time, the lenses typically become more comfortable immediately upon insertion.

How Long Does it Take for Maximum Ortho-k Effect?

This depends on many factors, especially the amount of nearsightedness (and possibly astigmatism) you have when you begin the ortho-k process.

Some people can have excellent vision after a day or two of overnight ortho-k. But for higher prescriptions it can take two weeks or longer for maximum correction.

Until your eyes are fully corrected, you might notice blurred vision and glare and halos around lights. In some cases, you may need to wear glasses (with a lesser prescription than you originally had) during the ortho-k process. Also, in some cases, mild glare and halos might persist even after maximum ortho-k correction.

Is this New?

No. Reshaping the cornea with contact lenses to improve vision isn’t new; some eye doctors have practiced it for decades. However, before FDA approval for overnight wear, the procedure had limited appeal. Now with safe, more oxygen permeable materials, the process has grown in effectiveness, safety and popularity.

Click Here to See Ortho-K in the News.

Is it Permanent?

No. It is temporary. If you stop wearing the lenses regularly while you sleep, your vision will return to its original state in as little as 72 hours.

Is it safe?

Ortho-K lenses have shown to be safe and effective. With proper hygine, lens use is safe for children and adults and is an excellent alternative for children who are just first becoming nearsighted. Studies have demonstrated that it is safe and effective for children and adults. However, there is a small risk of infection or abnormal blood vessel growth involved when any contact lens is worn. The risk is minimized by adhering to scrupulous disinfection and care procedures, by wearing your night time lenses only as instructed and by coming in for regular progress checks.

Have there been long term studies on Ortho-K?

Actually, Ortho-K has been in practice for 40 years and FDA approved for kids since 2002. There has been an avalanche of studies supporting its efficacy for myopia control and lifestyle benefits for children. The longest study documented was a 5 year study with great results. Also, there are more ongoing long term studies underway.

Here’s the link for that study: http://iovs.arvojournals.org/article.aspx?articleid=2128645

In addition, here’s a National Institute of Health study documenting the safety of Ortho-K lenses: http://www.ncbi.nlm.nih.gov/pubmed/17975424

Will my vision gradually go back to the way it was if I discontinue Ortho-K lenses?

Yes, if you ever decide to discontinue Ortho-K lens wear, your vision will gradually go back in about 3 days to a couple of weeks. You can resume your wearing your eyeglasses.

Does Health Insurance Cover the Myopia Control with Ortho-K in NJ?

Unfortunately, health insurance considers both surgical (LASIK) and non-surgical Myopia Control vision improvement do not cover this procedure. However, vision insurance may cover a portion of the costs through material benefits. Please speak to our myopia control coordinator, Summiya Shine by calling our office (609) 235-9770.

How much does Ortho-K cost?

The entire Myopia Care program includes all of the professional visits (which can be from 8-12) for two years and two sets of retainer lenses. This does include all the tests. Fees depend on the prescription and a number of other factors. Kindly make an appointment with Myopia Control specialist in New Jersey, Dr. Shefali Miglani to learn more.

Call (609) 235-9770 and set up an appointment to learn more about Myopia Control in NJ.

Download FAQs in PDF, please click here.