Providing a seamless and engaging myopia management experience goes beyond just prescribing treatment—it’s about educating families, building trust, and ensuring long-term compliance. From the first point of contact to follow-up care, creating a structured yet personal approach can make all the difference. In this article, Dr. Devan Trischuk shares the strategies he’s developed to streamline consultations, improve parent and patient understanding, and maintain consistency across his practice—all while keeping the child’s visual needs at the centre of care.
1. How do you ensure a seamless and engaging patient journey from the first point of contact, whether through your website, phone call, or in-office visit?
Prior to patients and families attending their myopia assessment appointment, they are sent home with information sheets that provide a background on:
- General myopia progression and axial length information,
- Different possible treatment options we may consider for their child,
- What to expect at their myopia assessment appointment (testing/drops/etc),
- The importance of what we are measuring at this appointment.
By providing the family with background information prior to their appointment at the office, the time spent during the myopia assessment appointment is much more efficient – answering higher level questions from the parents and getting to know the child and their visual demands. All staff members at our office are comfortable having conversations with families regarding myopia management, and the pre-assessment materials are provided in person or emailed to families at the time of booking their myopia assessment.
2. What key strategies have you implemented during the clinical consultation to improve parent and patient understanding of myopia and its management options?
Visual aids are very useful in helping parents and children understand why we want to slow axial length change. As part of each myopia assessment, a child has widefield Optomap imaging performed. Showing the family the child’s eye and explaining the increased risk of long-term ocular health issues that might present with increasing axial length is a powerful visual. The majority of these young myopic kids are already starting to show early signs of a myopic crescent.
Utilizing the side, zoomed out view of the Optomap image allows me to demonstrate an eye getting larger as the child is growing and effectively communicate the increased structural strain placed on the eye as if it continues to grow larger at a fast pace.
Utilizing age-matched axial length graphs is also a very powerful visual for parents and children. A lot of these kids are 75th-95th+ percentile in regard to their axial length and age based on normative data. It is easy to show parents that if we don’t intervene with myopia treatment, there is a high likelihood of continued progression and growth in years to come.
Keeping the child and parents involved in all conversations is crucial! I make sure I don’t turn my back to the child and only speak to the mom/dad/caregiver, or vice versa. I like to back up from my regular exam room position near the patient and make sure that I can see the parent and the child and be able to react to any verbal or non-verbal cues that may present while having a conversation with the family. Being able to best determine which treatment option a family will be compliant with is a key part of the assessment.
If an optical treatment option (spectacle/contact lens) is chosen and prescribed, the companies offering these products have done an excellent job of providing brochures with images that show how peripheral defocus is achieved. I also like to pull out a piece of paper and do a rough drawing (I’m not much of an artist!) of a myopic eye and demonstrate to the family how we are going to focus light with our treatment device and how that differs from a single vision lens.
3. How do you structure your follow-up care to keep patients engaged and compliant with their myopia management plans?
At every visit, I will summarize with the family how much axial length growth and myopic progression has occurred over the last 6-12 months and discuss if this is successful, or if the treatment needs to be adjusted. I will reiterate again at the conclusion of each visit that we will continue to see your child every 6 months to monitor their myopia.
Patients pay an annual myopia fee that covers all appointments over the year, whether they come in twice, or 5 times in the year. We find having an annual fee prevents parents from waiting until the next scheduled follow-up if any issues have presented.
4. What training and protocols have you put in place for your practice team to ensure they deliver a consistent and high-quality experience for myopia management patients?
I cannot stress enough how important staff training is to ensure that patients have a consistent, high-quality myopia management experience.
With about 25 staff and 8 Optometrists at our office, consistency was a significant challenge initially, but we have worked hard at keeping all staff and doctors educated to a high level. A few specialized staff will handle higher-level questions from patients, but all staff can answer basic questions and know the protocols for the myopia management program.
We have used multiple different education formats to keep the staff informed and engaged:
- Presentations given by the ODs at the office during staff meetings,
- Optometrists interacting within smaller groups explaining myopia and the treatment options,
- Staff-specific training programs through myopia advocacy groups (Brien Holden Vision Institute, Myopia Profile). For these we have ordered supper to office and worked through the training modules together as a team.
- Training provided by companies and reps – breakfast/lunch and learn (CooperVision, Hoya, etc.),
- Online myopia training modules that staff work through on their own during slower times at the office – provided through our buying group (Eye Recommend),
- Closing the office for a half day to complete Myopia Management training with all staff members and doctors.
This last training scenario was particularly beneficial as it allowed for great conversations between the doctors and staff and helpful feedback in regard to the patient experience as they interact with the different areas of the office. These conversations resulted in significant patient experience improvements.
Staff training has not been a one-and-done event. Continuing to train staff and doctors to keep them up to date on the most recent myopia information/studies is critical for a positive, consistent patient experience.
In terms of protocols, if more than one Optometrist at an office is offering myopia management, implementing a consistent protocol across all doctors is a key to success. In our experience, staff crave consistency and set protocols. This allows them to be confident in communicating information to patients and ensures that all patients that are enrolled in a myopia program receive the same, high level of care.
When instituting office protocols, I am a big fan of the KISS rule – “Keep it simple silly!”
5. How do you streamline the booking and scheduling of follow-up appointments to ensure continuity of care in myopia management?
Every myopia patient is seen at minimum every 6 months. For those children at higher risk of fast progression or more complicated treatment plans they may be seen every 3 months. Prior to leaving the office on the day of an appointment, the next myopia follow-up visit will be scheduled when they check out at the front desk.
The family receives a reminder text/phone call 2 days prior to their next appointment.
It is clearly communicated to the family at the time of the initial assessment that their child will be scheduled every 6 months for myopia follow-up visits while undergoing treatment and that the child will most likely remain in myopia treatment until around age 15 at minimum, most likely longer.
6. What advice would you give to other optometrists looking to refine their patient experience for myopia management?
My first piece of advice is that providing high-quality myopia care is not possible an Optometrist attempts to jam the testing, counselling, patient discussion, and treatment recommendation into a routine child’s exam.
Children that would benefit from myopia care should be identified during the routine exam, a quick 2-3 minute ‘elevator’ pitch should be utilized to explain to the family the nature of progressive myopia, and a myopia assessment appointment should be booked at a later date, ideally around 1-2 weeks down the road. The family will be sent home with background information and resources so that they can familiarize themselves with progressive myopia.
At the myopia assessment, necessary testing is performed (topography, Optomap imaging, binocular vision work-up, cycloplegic refraction, axial length measurement, etc).
However, the most important parts of the myopia assessment are:
- Building a strong rapport with the family and child,
- Understanding the child’s visual demands and which treatment options give the best chance of compliance,
- Demonstrating that you are knowledgeable and building trust, and
- Ensuring that the family understands the “why” of myopia management and buy into the treatment you are providing.
Myopia Management should be treated as a sub-specialty in optometry. Utilizing a similar approach comparable to high-level management of dry eye, glaucoma or binocular vision/vision therapy – patients are brought back in for specific testing, assessments and treatment recommendations.
My second piece of advice would be to attempt to implement well thought out and relatively simple office protocols for myopia patients. Every myopia management patient that enters the office should experience the same appointment structure, fees, communication, testing, follow-up protocol, etc.
Biography:
Dr. Devan Trischuk has practiced at Family Focus Eyecare in Saskatoon, SK, Canada, for the past 13 years and has been a partner for over eight years. He serves as a council member of the Saskatchewan Association of Optometrists and represents Saskatchewan on the council of the Canadian Association of Optometrists. Born and raised in Yorkton, SK, he completed his Bachelor of Science – Honours Physiology at the University of Alberta in 2007 and earned his Doctor of Optometry (Dean’s Honour List) from the University of Waterloo in 2011, where he received the Michael Gutwein Memorial Award. Dr. Trischuk’s interest in optometry began at a young age, fueled by his own experience of rapidly progressing myopia and yearly visits for stronger glasses. Myopia management has become a primary focus of his practice, and he is passionate about helping children and families slow its progression to support long-term healthy vision. In addition to his clinical work, he actively advocates, raises awareness, and lectures across North America, educating fellow optometrists and healthcare professionals on myopia management. Outside of work, he is a proud father of four—Emma, Desmond, Willa, and Rose—and husband to his wife, Jen. He enjoys coaching his kids in sports and spending at least two hours outdoors daily with his family.
