Know Your Strengths and Play to Them

HOT TOPIC

Comparing Cost-Effectiveness of Myopia Correction Options

A study recently published in JAMA Network Open has determined that atropine drop dosage is the most cost-effective prescription intervention for controlling myopia. Although many effective options exist for slowing myopia progression in children, their cost-effectiveness has been studied significantly less than their efficacy. In the study, researchers used a Markov model to analyze which myopia progression interventions are most cost-effective.

The study compared 13 different myopia management options for children who were 10 years of age. These interventions included topical atropine in 0.05% and 0.01% concentrations, myopia control spectacle lenses, soft lenses (daily disposable and multifocal), gas permeable lenses, progressive addition lenses, bifocal spectacle lenses, orthokeratology, regular outdoor activity, and red light therapy. These were all compared with single-vision lenses, and costs were determined by the Chinese University of Hong Kong and Hong Kong hospitals.

They found that, over 5 years, atropine 0.05% and regular outdoor activity are the most cost-effective options, with incremental cost-effectiveness ratios of $220 and $5 per spherical equivalent reduction, respectively. The study also found red light therapy, highly aspheric spectacle lenses, and orthokeratology lenses to be good investments, although more expensive than atropine.

My Two Cents

Although these costs would obviously vary in the US eye care market, the findings make sense. One would expect atropine drops and spectacle lenses to be the most cost-effective treatment options for patients, but does this mean fantastic lenses, such as CooperVision’s MiSight 1 day, will go the way of the dodo bird? Absolutely not! Those incredible modern marvels also correct a patient's refractive error and make myopia management “cool” in the eyes of patients and their parents, thus killing two birds with one stone.

OUTSIDE THE LANE

Eye Antibiotic Saves Dog’s Life?

John and Becky Oliver say their award-winning golden retriever Ike has recovered from the potentially deadly respiratory condition known as canine infectious respiratory disease complex (CIRDC)after receiving an ophthalmic antibiotic. The Olivers believe Ike contracted CIRDC while competing in dog shows in September.

CIRDC starts as a cough and can potentially develop into a deadly situation, with pneumonia-like symptoms. The Olivers took to Facebook to tell friends about Ike’s worsening condition and were contacted by a stranger, who suggested they try chloramphenicol, an ointment typically used to treat bacterial conjunctivitis. (CIRDC is thought to be resistant to traditional antibiotic treatments.) The couple was willing to give it a try, and the drug worked effectively for Ike, providing hope for other dog owners dealing with the same mysterious illness.

My Two Cents

This is one of those rare cases where the hive mind of social media may have actually offered someone good medical advice. However, much has yet to be discovered about the mysterious canine disease, as it sweeps the country. Cases have been discovered in Oregon, Indiana, Illinois, Washington, Idaho, California, Nevada, and throughout much of the Northeast. This seems to be an interesting development.

CAN YOU RELATE

How great are sports? They teach us so much about so many facets of life. Over the Thanksgiving weekend, my fiancé, son, and I flew to Michigan to celebrate the holidays with family and friends. While there, my father and I braved the ~25˚ weather to attend the number-three ranked University of Michigan versus number-two ranked Ohio State football game.

As a Michigan alumnus, I am a die-hard fan of the school’s football team, and spending the day with my dad was a memory I’ll never forget. Michigan’s team is hard-nosed, blue-collar, and doesn’t have a true “superstar.” They are known for being tough and wanting to run the ball down their opponent’s throat. In a game of rock, paper, scissors, Michigan will tell their opponent they’re going to throw “rock” and then expect that their “rock” will out-execute whatever you throw due to their discipline and training.

Ohio State, on the other hand, has some of the best wide receivers in the country and an undoubtedly generational wide receiver named Marvin Harrison Jr (aka Maserati Marv). Their team is full of some of the best athletes ever assembled on the college field.

Why am I telling you this? Because Ohio State’s coach, Ryan Day, doesn’t understand his own team’s identity. Earlier in the year, his team’s “toughness” was questioned, and he gave a now viral response. Against Michigan, it was apparent that he wanted to prove how tough his team was to the entire world. The problem is, that’s not what his team was built for, and he chose not to play to their strengths. Consequently, Michigan won its third game in a row against Ohio State because their coaching staff knew their identity and played to their strengths while doing their best to hide their deficiencies.

As eye doctors, we can’t be all things to all people. In my highly medical clinic, we have an upscale optical boutique. We’re not going to compete with discount optical chains and we’re not going to try to play that game, as it’s not what we’re built for. Just like those same chains aren’t going to go all in investing in the absolute best OCT, intense pulsed light therapy, Pentacam, wavefront aberrometer, etc, or carry the finest independent frame lines with a high dollar price tag. They’re going to stay in their lane and do their best to play to their strengths.

We need to understand what our strengths are and play to them; otherwise, we’ll do exactly what Ryan Day has done the past 3 years: lose to a team with substantially less talent but a strong identity.

QUOTE OF THE WEEK

“The more you give, the more you will have.”

— Dr. Seuss