OSO 2016: The Way of OrthoK

OSO 2016 was held from the 23–25 September at the Surfers Paradise Marriott Resort & Spa. It was also the 5th Congress of the International Academy of Orthokeratology (IAO).

Opening the congress, OSO president Dr. Gavin Boneham described ortho-K as “turning up at the right place and at the right time”. He stated that there is a big myopic epidemic and ortho-K is one of the best ways to treat myopia progression. Gavin also noted that the people involved in ortho-K are very passionate, excited and devoted.

IAO president Dr. Cary Herzberg followed Gavin’s opening and acknowledged the great work of the OSO – the oldest ortho-K society in the world.

Younger myopes progress faster and are therefore at greater risk of high myopia, making delaying onset critical

Tackling Myopia

Dr. Fabian Conrad (Brien Holden Vision Institute) presented the first lecture at OSO, and set the tone of the Congress. He said myopia and high myopia are dramatically increasing globally across all groups of populations. Given the current trends in the rising prevalence of myopia and high myopia, by 2050:

• Five billion people will be myopic, which will be half the world’s population
• There will be one billion high myopes – 10 per cent of the world’s population.

Myopia increases the risk of blindness due to myopic maculopathy, retinal detachment, glaucoma and cataracts. High myopia (5.00 D or more) significantly increases the risk of these sight-threatening conditions and is a major cause of blindness.

Dr. Conrad went on to say that the age of onset of myopia is of great concern. Younger myopes progress faster and are therefore at greater risk of high myopia, making delaying onset critical.

Controlling progression is also essential. It is encouraging that a 50 per cent reduction in the rate of progression would result in over 90 per cent fewer high myopes. This would substantially reduce the risks of sight-threatening complications of myopia later in life.

Fortunately, we do have optical and pharmacological treatment strategies, as well as lifestyle interventions, to help delay onset and control progression. It is therefore important to identify risk factors so we can predict which children are more likely to become highly myopic. The first proven risk factor is parental myopia, especially if both parents are myopic.

Continuing on the theme of risk factors, Dr. Paul Gifford presented a lecture about a great online resource he created with Kate Gifford to help practitioners – www.myopiaprofile.com contains the latest research on myopia development and assists in treatment strategies. Additionally, Paul and Kate have created a resource for parents –www.mykidsvision.org. This simple, six question online survey helps parents assess their child’s risk of myopia.

As Fabian commented, once we identify those at greatest risk, we can begin treatment strategies earlier, combine treatment strategies and monitor them more closely for compliance.

The Dynamic Duo

Beginners and experienced orthokeratologists are always inspired by Professor Pat Caroline and Dr. Randy Kojima.

Randy is a world expert in topography. Given that accurate topography is essential to successful orthokeratology, the beginners’ session began with his superb basic topography lecture. Randy initially explained the importance of adjusting scales correctly before moving on to stress the importance of patient eyes being as wide as possible, rings being clear and the importance of multiple pre-fit (baseline) maps. Anybody serious about ortho-K should make sure they see Randy lecture one day.

Patrick Caroline introduced beginners to the fundamentals of ortho-K lens design. He explained that we have one objective when fitting myopic orthokeratology – we are trying to create a minus powered lens made of epithelium. Patrick then demystified reverse geometry lenses. Beginners marvelled that Patrick Caroline actually made the technical component sound interesting.

The Legend’s Last Lecture

While beginners were being inspired by Pat and Randy, little did anyone realise that something momentous was about to occur in the main ballroom – legendary author and speaker, Professor John Mountford was giving another great lecture on ortho-K, this time on astigmatism.

John Mountford is often described as “one of the fathers of modern orthokeratology”. He is the principal author of Orthokeratology: Principles and Practice and the co-designer of the BE ortho-K lens. John was the first of four Don Noack award winners – an award presented by the OSO for an individual’s outstanding contribution to our understanding of ortho-K.

John has lectured locally and internationally on advanced contact lens design and fitting, myopia control and orthokeratology. His lectures, supported by scientific evidence, were about the best techniques and getting the finest results.

At the end of his lecture, much to everyone’s surprise, John announced that he was retiring from lecturing. His lectures will be greatly missed!

Fellowship of the IAO Examinations

Fellowship of the IAO (FIAO) is determined by an orthokeratologist’s experience and expertise. Rigorous case presentations are followed by written and oral examinations. Those rare orthokeratologists who achieve fellowship status display the highest level of knowledge and are committed to adhering to the highest standards of care. FIAOs serve as mentors and role models for new orthokeratologists.

In Australia, until recently, only two OSO members had achieved the accolade of FIAO – Oliver Woo and Duc Pham – both had to travel to the USA to complete their fellowship.

OSO 2016 was the first opportunity for OSO members to complete both their written and aural examinations in Australia. Another seven OSO members achieved FIAO – Dr. Gavin Boneham, Celia Bloxsom, Eleisha Dudson, Shonit Jagmohan, Jagrut Lallu, Alex Petty and Lachlan Scott-Hoy. Congratulations on your magnificent achievement and your dedication to ortho-K.

Fun, Fun, Fun!

One of the core concepts behind OSO congresses is the provision of plenty of time for networking in the evenings. The ‘Meet the Speakers’ drinks are a rare opportunity to socialise with the greatest orthokeratologists in the world, however, the highlight of the social program is the gala dinner. Everyone who has been to an OSO Congress knows the dinners are memorable thanks to the creativity of OSO vice-president Celia Bloxsom. This year Celia excelled herself, presenting the OSO Olympics.

From the moment president Gavin Boneham lit the OSO Olympic Cauldron until the declaration of Latvia as winners of the OSO Olympics, there wasn’t a moment when we weren’t laughing ourselves silly. Delegates became ‘athletes’ for the night and excelled at various ‘sporting’ events. The synchronised swimming, the climax of the evening, will never be forgotten by those lucky enough to be present.

Missed Out on OSO 2016?

Do you believe providing some form of myopia control is an optometrist’s duty of care? Would you like to start offering ortho-K or improving your skills and status? The OSO will run four boot-camps next year in Sydney (March), Perth (May), Melbourne (August) and Adelaide (October). These will be suitable for beginners and inexpert ortho-K fitters.

Attendance at an OSO or IAO congress, or completion of an OSO boot-camp, along with ownership of a topographer entitles you to become an OSO member. OSO membership is an excellent way to show your patients, colleagues and other health professionals your commitment to safe and effective orthokeratology. To register your interest in membership please email Lee Pepper: [email protected]

Amanda Rungis is the owner of Sure Eye Care in West Gosford. A qualified optometrist and orthokeratologist, Ms. Rungis holds a Bachelor of Optometry with honours and a Master of Optometry from the University of New South Wales. She is a board member of the OSO, a board member of the IAO, member of Optometry Australia and a national committee member of Optometry Giving Sight.