Interview with Dr. Glenda Alemann Moheeputh: OD and CEO of OK Love Myopia

Transcription

Sreeja: Thank you so much for taking the time to join us today. Just to give an overview of our campaign, "Beyond the Blur" is a project management community awareness campaign that Bhavya and I created this year with the purpose of raising awareness for pediatric myopia. We just want to ask a few questions about it so we can learn more and share some information with our audiences.

Dr. Aleman Moheeputh: I have some questions for you girls. What inspired you to launch this campaign?

Sreeja: Yeah, so we're doing this for a project for a competition called DECA. The reason we chose this specific topic is that ever since we were young, we saw that from almost the start of elementary school, our friends and classmates were getting glasses, contacts, and things like that. We noticed that in the previous generation, like our own parents, people didn't get these corrective devices as early. So, we saw that this was a progressing issue, and further research confirmed the prevalence of this issue. So, we just wanted to go ahead and research it and raise awareness. 

Dr. Aleman Moheeputh: I love that! Oh my gosh, you guys are so inspiring. I congratulate you and applaud you for what you're doing. I mean, that's what I do. That's my whole mission, and I created a clinic dedicated to myopia control. I'm one of the leaders, recognized nationally and internationally, and it's just amazing to see two young ladies not in the field, you know, taking the initiative to do that. Kudos to you guys. I will see if there's any way that I can support you. I am here, and I would love to follow you guys in the process and see if you win.

Bhavya: So, Dr. Alamein given your extensive experience in myopia control? Could you share insights into the factors contributing to the rise of pediatric myopia especially in the context of children's increased use of screens and technology? 

Dr. Aleman Moheeputh: Myopia is a multifactorial disease, meaning that several factors affect its progression and onset. One of the factors that we know of is genetics. Children whose parents have myopia are more likely to have myopia. If a child has one parent with myopia, they have three to four times more chances of developing myopia, and if the child has two parents with myopia, then they have up to seven times more chances of developing myopia.

But it is not only genetics; another factor is what you alluded to, which is the use of screens. Not necessarily the use of a screen, but what we are finding out is that it has more to do with the working distance. For example, when you are working on a smartphone a tablet, or a computer screen for extensive hours, the working distance matters. There is a misconception among the general public that it only has to do with the screen itself, but it is also related to the working distance. If you are reading or engaging in activities like painting at a constant, very near distance, myopia, the medical term for nearsightedness, can develop. It is a process of adaptation where, as a species, we adapt to our conditions.

In lectures, we often mention that back in the day, cavemen were adapted to their environment, needing good distance vision for hunting. Now, due to electronics and the amount of work in school, there is a significant demand for working at a very short distance. This is a substantial factor that can trigger the development of myopia. Lastly, the lack of outdoor activity contributes, as our environment, especially in home offices, promotes shorter distances. My eyes, for instance, are adapting to function better at a distance of about four to five feet, where I work every day. Does that make sense?

Sreeja: Yes, thank you so much. For our second question, we are wondering, as a practitioner dedicated to preventing and controlling myopia, what role do you see optometrists playing in educating parents, educators, and children about the risks of pediatric myopia?

Dr. Aleman Moheeputh: Yes, I think that optometrists have a paramount role in the awareness of the disease. We are at the forefront because we are typically the first physicians or clinicians to inform parents or detect that a child has myopia. Currently, the cycle involves the child going to the pediatrician, who may or may not conduct a thorough vision screening. If a pediatrician detects the presence of a refractive error, they then refer the patient to either an ophthalmologist or an optometrist. Therefore, either an ophthalmologist or an optometrist will be the first to see the child.

I believe we have a significant responsibility on our hands, given our profession. It is crucial for optometrists to take the time to educate parents and children about the importance of implementing different routines in their daily lives to prevent the development of myopia. If myopia is already present, our role is to slow down its progression. I work with various companies to develop programs that collaborate with pediatricians, providing them with a better understanding of the disease. Locally, for instance, one of my associate doctors manages a program where we visit local schools to speak to school nurses and relevant personnel about myopia awareness and the importance of vision screenings. This proactive approach aims to catch and address myopia in children early in its development, as early intervention can significantly slow down progression.

Bhavya: Definitely, early intervention can play a big role, and that leads us to our next question. So our campaign emphasizes the need for preventative measures. In your perspective, what practical advice can you offer parents to reduce the risk of pediatric myopia in their children?

Dr. Aleman Moheeputh: Number one, first and foremost, it's really important that parents bring their child to the optometrist or ophthalmologist very early. A common misconception is that parents don't think they need to bring their children to the eye clinic or an eye doctor until they are fully in, sometimes for developmental issues related to their whole visual system. However, waiting until then might be too late. It's crucial for early detection and early intervention. According to the Pediatric Association, parents should have every child examined at one year, two years, and before they start school. These are the three major timelines for bringing the child to the optometrist for a proper comprehensive visual exam. This helps detect not just myopia but also other vision disorders, and early intervention at these stages leads to better prognoses.

The next important aspect is emphasizing the importance of time outdoors. The Pediatric Association and the World Health Organization recommend that every child should spend at least two hours a day outdoors. Being outdoors has a significant positive impact on myopia and its development. Encouraging children to spend two hours a day outside and minimizing their screen time or nearby work to no more than two hours per day is crucial. To simplify, you can use the 20-20 rule or the two-two rule: two hours outdoors and no more than two hours on screen time or near work.

Sreeja: Okay, thank you so much! Building on that, again, what kind of guidance would you provide to parents in fostering clear-sighted futures for their children?

Dr. Aleman Moheeputh: Yeah, it's not just bringing the child to the optometrist at those milestones I mentioned. It's important to have a yearly eye exam to continuously monitor and ensure that everything is okay. Even if everything was okay in one year, it doesn't guarantee that everything will be fine in the future. Continuous monitoring allows us to notice any changes in the child's vision, especially the development of myopia, and intervene promptly to start therapy to slow down the progression.

I would also encourage parents to spend more time outdoors with their kids, as mentioned earlier. Being proactive in monitoring their children's activities is crucial. Another important tip to prevent or slow down myopia progression is to ensure proper posture. Some kids tend to put their heads close to the desk or almost lie down when writing, which is not good for their eyes. Having the right posture, sitting at a table or desk for homework and other activities, is beneficial.

Once a child has developed myopia, the good news is that there are effective myopia therapies to slow down the progression. Monitoring is the key to prevention because being proactive allows us to start intervention as soon as we notice changes indicating potential myopia development.

Bhavya: Along with that, we wanted to know what motivated you to focus on myopia control treatments.

Dr. Aleman Moheeputh: I love working with pediatrics, and my motivation to focus on myopia control treatments stems from my passion for children. If your girls were local, you could see my office, which I designed to be a welcoming and child-friendly space. The environment is clean, warm, and has interactive features like dry-erase boards, snacks, a waterfall, and a projector in the exam room to entertain kids during tests. I wanted to create a space where children feel safe and not intimidated by a typical doctor's office. My motivation comes from the joy of working with kids—I have five children myself.

When designing my office, I knew that myopia is prevalent in children, and I wanted to be the best pediatric optometrist, including offering myopia management services. Working with kids brings out the best in me, and I want to provide the best care for their vision. Learning about the risks associated with myopia progression, such as the potential for retinal detachment in the future, motivated me to be passionate about myopia management.

The turning point for me was a patient, a 14-year-old boy with minus 12 diopters of myopia in one eye, rendering him blind in that eye. This experience was not a theoretical concept anymore; it was a real, heartbreaking situation with a human being sitting in my chair. That incident made me realize the significant impact I could have on each patient and the privilege of having the tools to prevent such outcomes. It shifted my focus entirely to myopia management.

I want to emphasize the positive aspect and the fact that we can do something about it. While it's essential to communicate the risks, it's crucial to be thoughtful about how we word it, especially considering the potential impact on children. I always aim to focus on the positive in interviews and articles, highlighting the proactive measures we can take.

Sreeja: That makes sense. Thank you, and leading on to the other side of that, can you share some success stories or examples when early intervention in myopia control treatments has significantly reduced the progression of pediatric myopia?

Dr. Aleman Moheeputh: Absolutely. So my very first patient in myopia management control specifically involved ortho-k. Are you guys familiar with that procedure? Yes, it's like a contact lens. So that's what I do. My office is called "Okay Love" because the long name for ortho-k is orthokeratology. I thought, "Okay, love." And it just fell into place. 

My first patient was right after I graduated from optometry school. I took a job position in New York, and that was the only way I could bring my kids there for vacation. I have three boys and two girls. My daughter was 14 at the time, the only girl in the group. She asked me to bring her best friend. They went skiing, and her glasses broke. She was -3. So, we're in New York, and I had just graduated, been in the office for one week, and my daughter's best friend broke her glasses. I thought, "This is what I want to do." It was the perfect opportunity to test if ortho-k works. It sounds crazy—go to sleep with these contacts, and you wake up with clear vision. Even with -7, you can see everything clearly without any glasses or contacts. So, I did the treatment on my daughter's best friend. One night she slept with the lenses. The next morning, she took them out, and I took her back to the clinic. She was 20/15. The best part is that now, six years later, she and my daughter are both 21, and she hasn't progressed at all in ortho-k. That is my greatest success story. Now, I have thousands of ortho-k patients, and most have stopped progressing. A few still progress a little, but nothing compared to before. Every patient in ortho-k has either completely stopped progressing or, if there's progression, it's minimal. It's amazing and rewarding. I get messages from parents thanking me, and it never gets old. Every new patient is exciting, and I wish I could fast forward to see how I've changed their lives. One of the biggest successes in preventing someone from becoming myopic involved siblings. One of my first myopia patients, who was -9, is now in college. When I first saw her at 14, she had a baby sister who was three. After training the older sister, the mother wanted me to start seeing the younger one to prevent myopia. Mia is now eight and has successfully delayed the onset of myopia by at least four years. This is one of the patients I'm most proud of because it's hard to convince a parent to treat their child preventatively. In Mia's case, the family understood the benefits due to the older daughter's advanced myopia, and we were able to postpone the onset by four years.

Bhavya: Thank you, doctor, for sharing your expertise on pediatric myopia prevention. Your commitment to myopia prevention is truly inspiring, and it greatly contributes to our campaign. We appreciate you joining and taking the time to share your knowledge with our audience.