Join Bethany as she talks with Johnson and Johnson Global Director of Professional Education for Myopia and International Myopia Institute Co-Founder Dr. Monica Jong about Myopia Management and the Importance of Proactive Treatment.
Date: June 15, 2022
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Dr. Monica Jong: We still have so much work to do in terms of educating practitioners and giving them the confidence and support to offer Myopia Management. Because the US Practitioners Survey said they were very aware of Myopia and its risks except for the actual implementation which was very low probably around 15%.
Bethany Fishbein: Hi, I am Bethany Fishbein, the CEO of the Power Practice and host of the Power Hour Optometry Podcast. And Myopia is certainly a huge topic of discussion amongst our clients and Eye Care practitioners worldwide. It’s getting a tremendous amount of attention and something that we absolutely want to talk and learn more about. So I’m excited today to have a guest, this is Dr. Monica Jong. Dr. Jong is the Global Director of Professional Education for Myopia for Johnson and Johnson. She’s a co-founder of The International Myopia Institute. And she is from Australia so has a great accent that makes her wonderful to listen to on the podcast. So Dr. Jong thank you so much for being here with me and for taking the time to do this today, tonight. Or I guess it’s tomorrow morning for you?
Dr. Monica Jong: It’s a pleasure to be here and lovely to meet you, Dr. Fishbein. And I’m really excited to be on the Power Hour. I’ve always heard a lot about it even from Australia. And I am also an avid listener.
Bethany Fishbein: Good. Cool! Thank you. So before we talk about Myopia and treatment and some of the things that are going on in research and in the industry, help me and my listeners get to know you a little bit. How did your passion for Myopia and your interest in this develop?
Dr. Monica Jong: I think I do have a very interesting story because I stumbled into Myopia. Like all your listeners, I am an Optometrist. I trained in Australia at the University of Melbourne. And then after optometry, I practiced in lots of different settings – remote as well as city and urban settings. And then I did my Ph.D. And at the time when I did my Ph.D., I was kind of just interested in research and I wanted to be an academic. And I did an instructor function using OCT and it wasn’t in Myopia at the time. It was in blood flow and inherited retinal diseases. Then I went on to do my Post Doc at the University of Toronto Opthalmology Department. Once again, retinal imaging and blood flow. But then when I came back to Australia, I met Professor Brien Holden. And many of you may know Professor Brien Holden from his previous work in contact lens design, silicone hydrogel, and high DK type of research. He had the CCLRU and the Brien Holden Vision Institute. And it just so happened that my CV was passed on to Professor Brian Holden’s desk. And he personally called me up and asked me to come interview for a job that really didn’t have a job description at the time. But when I met him, he wowed me away. This is like over 10 years ago. About all the things that BHVI was doing in Myopia. They were doing clinical trials all around the world, looking at pharmaceuticals, spectacles, and contact lenses, China, and Vietnam working with the best people, the best institutes in the US, such as the University of Houston, and Johns Hopkins. And then he said to me, “This is an amazing area. We’re going to change the world. I need you to work with me. Because nobody knows about Myopia, all the issues, and all the complications surrounding Myopia as a disease. Nobody even knows that we need to do any Myopia Management. So let’s do it. We can do this together.” I was from another city at the time in Australia. And right then and there, without even asking for any more details about what we’re planning to do, what the job description was, or even what the salary was. I was like, “Yup, I’m gonna move to Sydney from Melbourne,” which is a 12-hour drive away. I’m gonna relocate and shift and work with Professor Brien Holden because I believed in Myopia Management then and there. Even though I haven’t seen the evidence yet. It had been a while since I left optometry school. And at the time when I left school, we only knew about experimental evidence of plus and minus lenses being able to change the length of the eye in animals. And here was this big huge white male larger than life telling me that we’re going to do all this great stuff together. And from then on, the rest is history. I moved to Sydney. We started doing a lot of work together with the other researchers who are well known in the industry – Professor Padmaja Sankaridurg and Professor. I’ve collaborated with Professor Earl Smith through BHVI. And we were able to develop new technologies in contact lenses at the time spectacles, drug therapies, and patented. We traveled the world talking about Myopia and getting it on the agenda at the WHO, which didn’t even recognize Myopia as a disease at the time. We brought the WHO meeting to Australia with the help of the Australian Government. I had the opportunity to co-author the WHO report, which was the first report to say that Myopia is a public health issue, recommend definitions, and also state there was evidence for treatment for Myopia and delaying it. Even at that time, it was 2015, when we did the meeting and Myopia still wasn’t nearly well known at the practitioner level. And so after that meeting, we decided we need to keep Myopia on the agenda. So let’s establish the International Myopia Institute. So this was where we were able to bring together 150 experts in the field of Myopia, for the first time, to write the white papers which drew all the research together. Thousands and thousands of papers, you know, all the technical and scientific terms that were confusing people and bringing it all together in one place. And these types of white papers today are referenced by the WHO. The WHO is using them to inform them in the future if they’re going through all the evidence together to update the ICD. And then other groups and associations are using these white papers today. Practitioners are using them. And so it’s just been such an amazing experience for me to be at the level of the optometrist seeing patients then being the one that’s in the research at the cutting edge, developing the treatments, and then learning how to advocate and create awareness about Myopia as a disease. And working with groups like WHO, the International Agency for Prevention of Blindness, and trying to change things that are going to really support practitioners by creating the materials needed for practitioners to see their patients and overall make the lives of our patients better. And I think that’s what motivates me, and even today, with Johnson and Johnson, that’s the same approach that I have. So that’s a little bit of my journey. But to add to that I’m also on my own, so it’s a bit personal.
Bethany Fishbein: It’s an extraordinary story because there’s a quote from Margaret Mead that says, “Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it’s the only thing that ever has.” And so to hear that your obvious passion was sparked by someone else’s contagious passion. And now you’re spreading that passion to other practitioners and influential people around the world is just a testament to the effect that somebody’s passionate belief in a cause can have. So thank you so much for sharing that. It’s not totally related. But I’m just curious coming from the US what’s the optometric education in Australia like because I think it’s different than it is here?
Dr. Monica Jong: Yeah, optometric education in Australia is a university degree. So currently when students finish high school, they can go directly into optometry school and the programs currently are an average of five years Master in Optometry degree. And then we also have one university now offering a graduate optometry degree so that’s a four-year degree in addition to the bachelor but the majority of optometrists do graduate after a five-year program. But they are also able to practice full-scope optometry and prescribe certain topical drugs.
Bethany Fishbein: Interesting. So you’re talking about this you’re talking about traveling all over the world. You mentioned China and Vietnam first. But I think thinking about this when I graduated from school, which is 25 years ago, there was a lot of conversation about Myopia treatment being something people had heard about only in Asian countries, or being a more specific problem in Asia. But really, it’s not anymore. I mean, this is worldwide. We’re practicing in the US and the incidence of Myopia is just increasing. What’s the data on that?
Dr. Monica Jong: Yeah, so we published the paper, at the Holden et al 2016 study that reported the prevalence of Myopia to affect almost 50% of the world by 2050. So initially, we’re seeing these huge prevalences of Myopia in parts of East Asia and they are how the US will be if we continue on this trajectory. So already, the prevalence of Myopia in young children in Southern California was reported to be close to 50% in young children. And we know that overall in the US, the Susan Vitaly study reported that it’s the prevalence of 42% in general across the population. So our study, the 2016 Holden et al study, is projecting that by 2050, the prevalence that we’ll see in the US will be close to 50% to 60%. So we’re gonna see in the US what we see in Asia overall at the moment. So that’s a pretty scary thought. Because we know what’s happened in Asia already. But if we don’t prepare, we don’t start skilling up and offering Myopia Management. Then what we see in Asia will be the situation in the US by 2050. So a lot of people with Myopia complications and needing a lot of injections to prevent macular degeneration and vision impairment. So we can do a lot now by offering Myopia Management to try to slow the increase in Myopia and reduce the risks of disease.
Bethany Fishbein: So one of the things that the International Myopia Institute seems to aim to do is standardize some of the definitions and protocols surrounding Myopia. It’s like you’re trying to get everybody to agree on some things, even to the degree of let’s agree on what Myopia is. So, talk about that a little bit. What are some of the key definitions and ideas that everybody just needs to get on board with?
Dr. Monica Jong: The definitions are very, very important because in the literature, there’s over 400 definitions.
Bethany Fishbein: 400 definitions of Myopia?
Dr. Monica Jong: So a lot of definitions. Over 400 definitions. So there are qualitative definitions about eyeball length increasing or is it the corneal pulping too powerful? Then there’s also pathologic Myopia. Is it due to the power of the eye or is it due to a cut-off of the axial length? Is it -8 diopters or worse or is it -5 diopters or worse? So there’s so many different definitions in there. So having some agreement is very important, because we need to know when we should start to plan Myopia management. So in general, when some spherical equivalent when their accommodation is relaxed, the spherical equivalent is -0.50 diopters or worse then we consider them clinically myopic. And that’s when we suggest that you can offer some form of Myopia Management. And then we have recommended, well the WHO recommended that high Myopia should be -65 diopters or worse and that’s because without spectacles somebody with -5 diopters or more of Myopia is vision impaired by their classification. And also when you’re -5 diopters or worse, the risks of any types of the Myopia related complications exponentially increase. However, we have recommended a new definition entirely which is pre-Myopia. This is when a child is between -0.50 diopters to +0.50 diopters or +0.75 diopters. So if you’re between +0.75 diopters to -0.50 diopters and you’re young, such as under the age of 12, and you may have other Myopia risk factors such as reduced time outdoors and increased near work, then you’re considered pre-Myopic. At this point, you should be offered lifestyle and behavioral counseling and regular monitoring as well. So it’s very important to have some kind of agreed definition so that as a profession, we can approach Myopia Management as an evidence-based method, rather than people just sort of choosing to start doing things when they feel there’s a need or when somebody’s decided that they need Myopia Management.
Bethany Fishbein: I’m sitting here with a clinician hat on and, you know, I know one of the obstacles to Myopia treatment is that often parents haven’t heard anything about it before. And so maybe they’ve been seeing in the prescription has gone from +0.5 to -0.5 to the next year -1.25, -1.75. And it’s progressing without any mention of treatment. And then, okay, now we’re introducing the idea of treatment. They haven’t heard of this before. So as a practitioner, thinking about the potential of everybody being on the same page that families being able to hear the same thing from not only one optometrist to another but from an optometrist to another to the pediatrician to an ophthalmologist to their cousin who’s an eye doctor in another state or another country would really have a tremendous amount of power in helping parents understand the nature of this the seriousness and the likely trajectory if they don’t do any treatment. So I think it’s something that I hadn’t thought a whole lot about, but when you say it, it’s really appealing, like, yes, let’s just get everybody on board here.
Dr. Monica Jong: Definitely! And I agree with everything you said. And the fact is, we do need to get everybody on board because before we can really create awareness at the public level of parents and kids. We need to have everybody on board in terms of pediatricians, and the medical fraternity as well because our patients are going to be seeing the pediatrician. They’ll be seeing the family doctor, and they’ll be talking to nurses and their friends, and their teachers. And so it’s important that over time we educate and work together with the other professions that are involved in the care of children so that they also know about Myopia. They also understand that Myopia is a disease and that there is evidence to support Myopia Management. And that’s some of the work that Johnson and Johnson is also looking to do. We partner with the American Academy of Ophthalmology as well as the American Academy of Pediatric Ophthalmology. We sponsor education events at their conferences. So we have sponsored sessions where we are going to be talking about Myopia as a disease. We realized that we need to educate everybody even though our focus might right now be supporting and educating practitioners but we are working overtime to educate everybody. And we realize that for Myopia Management to become the standard of care. Everybody has to work together. And that’s the only way forward.
Bethany Fishbein: I know you’ve collected a lot of research on clinical treatment and protocols and outcomes, is there research on how many practitioners are offering Myopia treatment and how they’re doing it? Like do we know those kinds of stats?
Dr. Monica Jong: The Wolffsohn, et al study in 2020 surveyed a bunch of practitioners all around the world and they found that the perceived level of active Myopia control in the US was the lowest out of all the regions. So I’m not sure what the percentage is overall. I’d have to look it up but the US actually ranked the lowest in offering Myopia control. And the first line of management was still single vision spectacles and soft multifocal contact lenses from US practitioners. So it just means that even though Myopia Management might be the hottest topic and there are some segments of some practitioners that are really the leaders and doing so much Myopia Management overall, Myopia Management isn’t really actively offered across the US. And so that’s something that we really, it means that we still have so much work to do in terms of educating practitioners and giving them the confidence and support to offer Myopia Management because the US practitioners surveyed said they were very aware of Myopia and its risks, except the actual implementation, was very low. Probably around 15%.
Bethany Fishbein: You said very low, but I was gonna ask like less than 50. but 15 is really low. So, as you said, the beginning of Myopia treatment starts with just a recommendation on education and lifestyle changes for anybody who’s between +75 and -50 and under 12 years old. Because at that point, there’s a high risk for them to develop further Myopia. At what point is it minus 50 or at what point do we start to recommend clinical treatment?
Dr. Monica Jong: The Clinical Management should be recommended at -0.50 diopters or worse of Myopia. So there’s still a big misperception. A lot of practitioners are saying, “Let’s wait until the person is -1 diopters or the child is -1 diopters before we start Myopia Management.” Or they’re saying, “Let’s wait to see Myopia progression in a child that has been diagnosed with Myopia”. But what we do know from a recent study published by Professor Donald Muti, he stated that once a child is diagnosed with Myopia of -0.50 diopters, they are highly likely to progress. So the prior progression is not something that we should really be waiting for based on the child’s age and the risk factors. And the fact that they’re at -0.50 diopters.
Bethany Fishbein: Is it always based on diopters? I know that and I feel like there’s some debate here about, “Is it diopters or is it axial elongation?” And what happens if you have one changing without the other? Where does axial length fit into this?
Dr. Monica Jong: So axial length is a very, very important measurement. We use it for clinical trials as the gold standard to validate if a treatment is effective or not. And the reason why we use axial length measurement is because it’s highly accurate. The resolution is like 0.02 microns and is very repeatable and objective. You don’t need to use cycloplegia to take that measurement. So as a profession and also public awareness is about diopters or the power of the eye. So the power of the eye is still very important because the refraction is a sum of everything together. So when we diagnose Myopia, we tend to use the cutoff of -0.50 diopters spherical equivalent. So we can still continue to measure refraction and then use that to diagnose the Myopia. But if we have access to an axial length measurement device, we should consider using that for monitoring Myopia. Because we know that axial length itself is linked to the risk of complications and pathologic Myopia with the axial increase. The axial length is directly linked to eye growth of the eyes. So refraction is great for determining and diagnosing Myopia. But then if we’re going to monitor Myopia long term, then axial length measurement is the better measurement because of its accuracy and its direct link to eye growth. Now, we also know that when axial length is over 26 millimeters or more that’s a significant increase to developing diseases of the eye associated with Myopia. So axial length is also really useful especially with certain treatments because for example, if you’re doing Ortho-K, you don’t have to do the washout where you remove the Ortho-K lens to then let the kid go back to their full prescription so that you can check what their prescription is. And then with certain treatment, drug therapies where, you know, there may not be a complete match in the axial length and certain drug therapies with the refraction may be masked as well. The axial length measurement is very useful and now there’s experimental evidence with axial length first being published for white children, and East Asian children that you can measure the axial length and compare the growth of the eye like a height growth chart and tell the patients and show them where the child is on the growth chart. So they’re very useful.
Bethany Fishbein: So I know you’re working in these organizations to kind of establish a standard of care for Myopia. Obviously, when treatment should begin, is axial length measurement part of that standard? Like if someone doesn’t have that biometer, should they not be doing this or can you do this based on refraction alone?
Dr. Monica Jong: Good question. We want everybody to do Myopia Management because the problem is going to be so huge. It’s a huge public health issue. So we can do Myopia Management without an axial length biometer. Because if you can control accommodation by cycloplegia and do excellent refraction, or you can control accommodation by doing a fogging, then you can monitor and diagnose Myopia very well using refraction. And in some places where the cost of a biometer is so high, not having a biometer should not prevent someone from doing Myopia Management. So the axial length measurement is the gold standard that we will work towards. But it will take a little while to get there when the devices become more available and become low-cost over time. So for now, everyone should be able to do Myopia Management without an axial length biometer. But if you have one, it’s an even better way to manage Myopia because of the extra information that you can have to provide better patient care.
Bethany Fishbein: And here the doctors that are doing Myopia Management treatment, working with overnight orthokeratology lenses or working with atrophy, or working with soft multifocals. There’s some curiosity here now about spectacle lenses that help slow Myopia progression that are available in Canada, Europe, and other parts of the world. Can you talk a little bit about those? Because we honestly haven’t heard too much about them because they’re not available here yet.
Dr. Monica Jong: Yeah. Like I have to say we’re pretty spoiled here in Australia. We have everything. We have every spectacle lens, every approved device as well as contact lenses, and things like that for Myopia Management. So the new spectacle lenses, one of them is the highly aspherical lenslets and the other one is defocus incorporated multiple segments. So these are like spherical zones of Myopic defocus all over the lens, tiny little dots or circular patterns all across the lens and in the middle of the lens. There is also the area where it has the actual distance prescription. So all these lenses provide Myopic defocus in front of the retina wherever the eye looks. So it brings the retinal image in front of the retina and this is how it provides Myopic defocus. And the reports from practitioners, that the vision is good and that they’ve also seen that there is clinical slowing with Myopia in their patients. And there have been studies published in some of the leading peer review journals that have reported that in their clinical trials in East Asian or Chinese children so far, they’ve seen a slowing of up to 50 to 59% on average. So they are reporting that they work almost as well as Orthokeratology.
Bethany Fishbein: And when you look at those efficacy numbers, is there a best option or we hear a lot about personalizing treatment for the patient and, you know, thinking about what’s going to work best for what patient? How do you figure out the treatment that’s going to give the best results for that individual child?
Dr. Monica Jong: Yeah. That’s a great question because personalizing treatment is the key for treatment compliance. Firstly, all of these treatments when they report these averages, we also do need to look at how many hours the child is wearing the treatment for. So for those spectacle-based studies, they’re saying that the kids are wearing the spectacle lenses for more than 12 hours per day. So you have to make sure that for all the treatments that they’ve been worn for the time needed to deliver the benefits. Because if during the day the child is able to take the treatment on and off, then they’re not going to receive the myopic defocus and that will mean that they’re not going to receive the efficacy that studies report. So there has been a meta-analysis that was published previously before these new lenses came on the market. Your spectacle lenses came on the market and they looked at everything out there. Randomized controlled trials and high-quality studies were made and reported that Ortho-K seemed to be the best on average. Along with some of the really high concentration Atropine treatments which themselves have huge rebound effects. So we shouldn’t actually be using a high concentration of Atropine at all. So overall, if we look at the study that was reported by Brennan et al, he found that in the first year you have this huge burst effect for all the treatments and then after that, they kind of slowed down. So overall, you’re not going to benefit by selecting a particular treatment just based on the highest efficacy because they all overall performed similarly in terms of axial length slowing over time. So we need to look at if a child is very active, they like to play sports, then the contact lens option is best because it’s better for their lifestyle. If a child does a lot of swimming, then potentially you know the risk of water in the contact lens you might want to look at Ortho-K for that particular child. Now, we also need to look at the child’s age. If the child is very young, some people do feel they are more comfortable giving a child a spectacle option. But if the child is continuously taking the spectacles on and off throughout the day and the parents are concerned, then a contact lens option might be useful. And then we also need to consider kids breaking spectacles or losing things. Those things come into play as well. And then parents and the patient or the child’s preference is very important. Because if it’s a contact lens option, and the child is young, the child and the parents both need to know how to insert and remove the lens or at least the parent needs to be the one doing that. So we need to have a holistic conversation to understand all these factors in addition to the clinical profile of the child in terms of the refraction, and how fast they’re progressing as well.
Bethany Fishbein: It makes sense, right? The best treatment for the child is going to be the one that the child is able to tolerate being treated for long periods of time. So that lifestyle piece is critical and I’m guessing from maybe a little bit of the background noise that you are a parent yourself.
Dr. Monica Jong: Yeah, I am actually. And I’ve got a three-and-a-half-year-old and 11-month-old now. So what I’m doing with them is more prevention actually. I have alarms set on the child’s iPad. The three and a half-year-olds iPad, so I limit him to two hours maximum per day of iPad viewing, and then I also make sure he goes outdoors at least two hours per day every day.
Bethany Fishbein: So you have a perspective as a clinician, as a Myopia doctor, and as a mom to potential myopes. So your experience goes across all of those.
Dr. Monica Jong: Absolutely. Yeah. For me, it’s very important because I know what it’s like to grow up having Myopia. Even though people think it’s very benign and you wear a spectacle, and on your own, your vision is corrected. For me, I didn’t really feel confident having spectacles on my face. You know as a child, you’re made to feel different when you wear spectacles and then I’m in a country where sports are like the priority. You have to be really good at sports. So looking nerdy and not having contact lenses or not even being offered contact lenses when I was a kid, you know that kind of impacted me and I don’t want my kids to go through that as well. And so for me, prevention is very important. Because in the recent ARVO meeting, Mark Bullimore and Noel Brennan presented a study where they found that if you can prevent or delay Myopia onset by about a year it equates to three years of Myopia control treatment. So it’s quite powerful. That’s like hot off the press. We haven’t even published that and it was just shown as a poster and a talk at ARVO.
Bethany Fishbein: Wow! You heard it here first folks. And so now your current role is with Johnson and Johnson. Traditionally, like Johnson and Johnson, we think about soft contact lenses – about Acuvue. What are they doing now for Myopia Management?
Dr. Monica Jong: Good Question! It’s really really exciting and that’s one of the reasons why I decided to move from my previous role of working with the International Myopia Institute and BHVI to working for Johnson and Johnson because the mission is still the same. We all want to prevent future vision impairment from Myopia. So Johnson and Johnson is really approaching this in an evidence-based way. They want to support Myopia Management firstly, by educating practitioners everywhere around the world. All the practitioners are going to know what Myopia is and what the evidence is for managing Myopia, and why we should manage Myopia. Because Johnson and Johnson is a healthcare company, we know that in the future Myopia-related blindness is going to be a huge impact. And Johnson and Johnson knows that we have networks, our innovation, and our support of research that we can come and support practitioners by developing new treatments that will be approved in every country. Because it’s important that we have approved treatments so that our patients and our doctors can have confidence in what they’re offering is evidence-based and will work. Now, we are coming at it understanding that Myopia is a disease. So it’s not going to be corrected by a contact lens that slows Myopia alone because we know Myopia Management requires personalized management. So we are going to be well I should say we are working towards a portfolio of treatments. So we call it the Acuvue Ability Portfolio for holistic management of Myopia. So in this portfolio, in some parts of the world already, we do have an approved Ortho-K lens called the Abiliti Overnight Lens. So outside of the US, it is CE approved for Myopia control. In the US, we have it FDA-approved for Myopia Management. And we also have now launched Abiliti 1-Day Myopia Control contact lens. I should say it’s approved for Myopia Management in Canada, Hong Kong, and Singapore and we’re looking to have it approved in other parts of the world. So this is a completely new technology in the 1-Day lens. It has a RingBoost technology. It delivers treatment of +7 diopters in front of the eye. So very high myopic defocus and the reports are the vision is also quite good and tolerated by our children. And because it’s a daily lens and it’s fit-based on the spectacle prescription, it’s very easy for practitioners to fit and use. So there are two treatments so far in our portfolio and we are looking to develop and bring additional treatments that are not just contact lenses in the future. But to support practitioners, we know compliance is a key question and education so that’s why we also have the SeeAbiliti app. So this is an app that patients and parents can download on their phone. It has information about Myopia, it has information about treatments and then it also allows parents to input near work time and outdoors time and communicate with their practitioner, as well. So so far we have these items and it’s really exciting because we are continuously going to improve this app. So that one day it can be combined with some kind of device and we can automatically help parents to track the kids’ time spent outdoors.
Bethany Fishbein: Very cool. So you said that app is called SeeAbiliti? Is it ability with an I like the abiliti?
Dr. Monica Jong: Yeah, SeeAbiliti. So it’s spelled A-b-i-l-i-t-i.
Bethany Fishbein: Okay. So for more information, people can get that app. Where else can people look to see the work that you’re doing? The Johnson and Johnson are doing? What are some other great resources.
Dr. Monica Jong: So you can go to our website, www.seeyourabiliti.com. So that’s where all the resources will be. There’s a parent portal and there’s a practitioner portal. But in addition, we have resources for practitioners. They’re called HealthCaring Conversations and the HealthCaring Conversations resources. So what they are are leaflets that are a lifestyle guide, and then we have training, as well as face-to-face and online that can help practitioners have those conversations about Myopia and also talk through the different treatments. We also have supporting flyers and educational materials that practitioners can download from us. So there’s a whole ecosystem of support for practitioners to talk about here because we know that communication piece can be a challenge. And we’ve worked with behavioral scientists to develop these materials to ensure that they are what practitioners need.
Bethany Fishbein: Perfect! Doctor Jong thank you so much for your time and for your information. I was having a conversation just before we started recording this with someone. And I said how much I love when people are just passionate about what they’re doing. And I know we’re working with a lot of doctors who are absolutely passionate about Myopia treatment and looking for ways to grow this and raise awareness in their own practices and own communities. And I appreciate all of the information that you’ve given today. I think it’s valuable not only for practitioners to learn from but I think every single thing that you spoke about is something that parents need to be aware of as well. Because if the statistic of 15% or close to that of practitioners are offering this then parents need to be self-educating so that they can advocate to find the places to get the appropriate treatment for their kids. So I hope that this gets out past the Eye Care community and into the hands or earbuds of some parents of children who have Myopia. So this is extraordinary. Thank you so much for your time.
Dr. Monica Jong: It’s a pleasure to be here and I’m really excited to be with Johnson and Johnson because really we are going to make Myopia Management the standard of care. And we will be educating every practitioner who wants to learn about Myopia Management and supporting them to fit a whole variety of management options. And then we’ll also be advocating to the parents and the kids about Myopia down the track. So it’s a long journey but I’m passionate and we’ll all be there together.
Bethany Fishbein: Fantastic. And to everybody out, there thank you so much for listening. For more information about Power Practice, you can find it on our website, www.powerpractice.com
Johnson & Johnson Vision Care Website: https://www.jjvision.com/
Seeyourabiliti Website: www.seeyourabiliti.com
SeeAbiliti App for Google play store: https://play.google.com/store/apps/details?id=com.jnj.seeabiliti&hl=en&gl=US
SeeAbiliti App Apple Store: https://apps.apple.com/sg/app/seeabiliti/id1568962995
International Myopia Institute Website:https://myopiainstitute.org/
Myopia: A Global Epidemic
Dr. Monica Jong: We still have so much work to do in terms of educating practitioners and giving them the confidence and support to offer Myopia Management. Because the US Practitioners Survey said they were very aware of Myopia and its risks except for the actual implementation which was very low probably around 15%.
Bethany Fishbein: Hi, I am Bethany Fishbein, the CEO of the Power Practice and host of the Power Hour Optometry Podcast. And Myopia is certainly a huge topic of discussion amongst our clients and Eye Care practitioners worldwide. It’s getting a tremendous amount of attention and something that we absolutely want to talk and learn more about. So I’m excited today to have a guest, this is Dr. Monica Jong. Dr. Jong is the Global Director of Professional Education for Myopia for Johnson and Johnson. She’s a co-founder of The International Myopia Institute. And she is from Australia so has a great accent that makes her wonderful to listen to on the podcast. So Dr. Jong thank you so much for being here with me and for taking the time to do this today, tonight. Or I guess it’s tomorrow morning for you?
Dr. Monica Jong: It’s a pleasure to be here and lovely to meet you, Dr. Fishbein. And I’m really excited to be on the Power Hour. I’ve always heard a lot about it even from Australia. And I am also an avid listener.
Bethany Fishbein: Good. Cool! Thank you. So before we talk about Myopia and treatment and some of the things that are going on in research and in the industry, help me and my listeners get to know you a little bit. How did your passion for Myopia and your interest in this develop?
Dr. Monica Jong: I think I do have a very interesting story because I stumbled into Myopia. Like all your listeners, I am an Optometrist. I trained in Australia at the University of Melbourne. And then after optometry, I practiced in lots of different settings – remote as well as city and urban settings. And then I did my Ph.D. And at the time when I did my Ph.D., I was kind of just interested in research and I wanted to be an academic. And I did an instructor function using OCT and it wasn’t in Myopia at the time. It was in blood flow and inherited retinal diseases. Then I went on to do my Post Doc at the University of Toronto Opthalmology Department. Once again, retinal imaging and blood flow. But then when I came back to Australia, I met Professor Brien Holden. And many of you may know Professor Brien Holden from his previous work in contact lens design, silicone hydrogel, and high DK type of research. He had the CCLRU and the Brien Holden Vision Institute. And it just so happened that my CV was passed on to Professor Brian Holden’s desk. And he personally called me up and asked me to come interview for a job that really didn’t have a job description at the time. But when I met him, he wowed me away. This is like over 10 years ago. About all the things that BHVI was doing in Myopia. They were doing clinical trials all around the world, looking at pharmaceuticals, spectacles, and contact lenses, China, and Vietnam working with the best people, the best institutes in the US, such as the University of Houston, and Johns Hopkins. And then he said to me, “This is an amazing area. We’re going to change the world. I need you to work with me. Because nobody knows about Myopia, all the issues, and all the complications surrounding Myopia as a disease. Nobody even knows that we need to do any Myopia Management. So let’s do it. We can do this together.” I was from another city at the time in Australia. And right then and there, without even asking for any more details about what we’re planning to do, what the job description was, or even what the salary was. I was like, “Yup, I’m gonna move to Sydney from Melbourne,” which is a 12-hour drive away. I’m gonna relocate and shift and work with Professor Brien Holden because I believed in Myopia Management then and there. Even though I haven’t seen the evidence yet. It had been a while since I left optometry school. And at the time when I left school, we only knew about experimental evidence of plus and minus lenses being able to change the length of the eye in animals. And here was this big huge white male larger than life telling me that we’re going to do all this great stuff together. And from then on, the rest is history. I moved to Sydney. We started doing a lot of work together with the other researchers who are well known in the industry – Professor Padmaja Sankaridurg and Professor. I’ve collaborated with Professor Earl Smith through BHVI. And we were able to develop new technologies in contact lenses at the time spectacles, drug therapies, and patented. We traveled the world talking about Myopia and getting it on the agenda at the WHO, which didn’t even recognize Myopia as a disease at the time. We brought the WHO meeting to Australia with the help of the Australian Government. I had the opportunity to co-author the WHO report, which was the first report to say that Myopia is a public health issue, recommend definitions, and also state there was evidence for treatment for Myopia and delaying it. Even at that time, it was 2015, when we did the meeting and Myopia still wasn’t nearly well known at the practitioner level. And so after that meeting, we decided we need to keep Myopia on the agenda. So let’s establish the International Myopia Institute. So this was where we were able to bring together 150 experts in the field of Myopia, for the first time, to write the white papers which drew all the research together. Thousands and thousands of papers, you know, all the technical and scientific terms that were confusing people and bringing it all together in one place. And these types of white papers today are referenced by the WHO. The WHO is using them to inform them in the future if they’re going through all the evidence together to update the ICD. And then other groups and associations are using these white papers today. Practitioners are using them. And so it’s just been such an amazing experience for me to be at the level of the optometrist seeing patients then being the one that’s in the research at the cutting edge, developing the treatments, and then learning how to advocate and create awareness about Myopia as a disease. And working with groups like WHO, the International Agency for Prevention of Blindness, and trying to change things that are going to really support practitioners by creating the materials needed for practitioners to see their patients and overall make the lives of our patients better. And I think that’s what motivates me, and even today, with Johnson and Johnson, that’s the same approach that I have. So that’s a little bit of my journey. But to add to that I’m also on my own, so it’s a bit personal.
Bethany Fishbein: It’s an extraordinary story because there’s a quote from Margaret Mead that says, “Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it’s the only thing that ever has.” And so to hear that your obvious passion was sparked by someone else’s contagious passion. And now you’re spreading that passion to other practitioners and influential people around the world is just a testament to the effect that somebody’s passionate belief in a cause can have. So thank you so much for sharing that. It’s not totally related. But I’m just curious coming from the US what’s the optometric education in Australia like because I think it’s different than it is here?
Dr. Monica Jong: Yeah, optometric education in Australia is a university degree. So currently when students finish high school, they can go directly into optometry school and the programs currently are an average of five years Master in Optometry degree. And then we also have one university now offering a graduate optometry degree so that’s a four-year degree in addition to the bachelor but the majority of optometrists do graduate after a five-year program. But they are also able to practice full-scope optometry and prescribe certain topical drugs.
Bethany Fishbein: Interesting. So you’re talking about this you’re talking about traveling all over the world. You mentioned China and Vietnam first. But I think thinking about this when I graduated from school, which is 25 years ago, there was a lot of conversation about Myopia treatment being something people had heard about only in Asian countries, or being a more specific problem in Asia. But really, it’s not anymore. I mean, this is worldwide. We’re practicing in the US and the incidence of Myopia is just increasing. What’s the data on that?
Dr. Monica Jong: Yeah, so we published the paper, at the Holden et al 2016 study that reported the prevalence of Myopia to affect almost 50% of the world by 2050. So initially, we’re seeing these huge prevalences of Myopia in parts of East Asia and they are how the US will be if we continue on this trajectory. So already, the prevalence of Myopia in young children in Southern California was reported to be close to 50% in young children. And we know that overall in the US, the Susan Vitaly study reported that it’s the prevalence of 42% in general across the population. So our study, the 2016 Holden et al study, is projecting that by 2050, the prevalence that we’ll see in the US will be close to 50% to 60%. So we’re gonna see in the US what we see in Asia overall at the moment. So that’s a pretty scary thought. Because we know what’s happened in Asia already. But if we don’t prepare, we don’t start skilling up and offering Myopia Management. Then what we see in Asia will be the situation in the US by 2050. So a lot of people with Myopia complications and needing a lot of injections to prevent macular degeneration and vision impairment. So we can do a lot now by offering Myopia Management to try to slow the increase in Myopia and reduce the risks of disease.
Bethany Fishbein: So one of the things that the International Myopia Institute seems to aim to do is standardize some of the definitions and protocols surrounding Myopia. It’s like you’re trying to get everybody to agree on some things, even to the degree of let’s agree on what Myopia is. So, talk about that a little bit. What are some of the key definitions and ideas that everybody just needs to get on board with?
Dr. Monica Jong: The definitions are very, very important because in the literature, there’s over 400 definitions.
Bethany Fishbein: 400 definitions of Myopia?
Dr. Monica Jong: So a lot of definitions. Over 400 definitions. So there are qualitative definitions about eyeball length increasing or is it the corneal pulping too powerful? Then there’s also pathologic Myopia. Is it due to the power of the eye or is it due to a cut-off of the axial length? Is it -8 diopters or worse or is it -5 diopters or worse? So there’s so many different definitions in there. So having some agreement is very important, because we need to know when we should start to plan Myopia management. So in general, when some spherical equivalent when their accommodation is relaxed, the spherical equivalent is -0.50 diopters or worse then we consider them clinically myopic. And that’s when we suggest that you can offer some form of Myopia Management. And then we have recommended, well the WHO recommended that high Myopia should be -65 diopters or worse and that’s because without spectacles somebody with -5 diopters or more of Myopia is vision impaired by their classification. And also when you’re -5 diopters or worse, the risks of any types of the Myopia related complications exponentially increase. However, we have recommended a new definition entirely which is pre-Myopia. This is when a child is between -0.50 diopters to +0.50 diopters or +0.75 diopters. So if you’re between +0.75 diopters to -0.50 diopters and you’re young, such as under the age of 12, and you may have other Myopia risk factors such as reduced time outdoors and increased near work, then you’re considered pre-Myopic. At this point, you should be offered lifestyle and behavioral counseling and regular monitoring as well. So it’s very important to have some kind of agreed definition so that as a profession, we can approach Myopia Management as an evidence-based method, rather than people just sort of choosing to start doing things when they feel there’s a need or when somebody’s decided that they need Myopia Management.
Bethany Fishbein: I’m sitting here with a clinician hat on and, you know, I know one of the obstacles to Myopia treatment is that often parents haven’t heard anything about it before. And so maybe they’ve been seeing in the prescription has gone from +0.5 to -0.5 to the next year -1.25, -1.75. And it’s progressing without any mention of treatment. And then, okay, now we’re introducing the idea of treatment. They haven’t heard of this before. So as a practitioner, thinking about the potential of everybody being on the same page that families being able to hear the same thing from not only one optometrist to another but from an optometrist to another to the pediatrician to an ophthalmologist to their cousin who’s an eye doctor in another state or another country would really have a tremendous amount of power in helping parents understand the nature of this the seriousness and the likely trajectory if they don’t do any treatment. So I think it’s something that I hadn’t thought a whole lot about, but when you say it, it’s really appealing, like, yes, let’s just get everybody on board here.
Dr. Monica Jong: Definitely! And I agree with everything you said. And the fact is, we do need to get everybody on board because before we can really create awareness at the public level of parents and kids. We need to have everybody on board in terms of pediatricians, and the medical fraternity as well because our patients are going to be seeing the pediatrician. They’ll be seeing the family doctor, and they’ll be talking to nurses and their friends, and their teachers. And so it’s important that over time we educate and work together with the other professions that are involved in the care of children so that they also know about Myopia. They also understand that Myopia is a disease and that there is evidence to support Myopia Management. And that’s some of the work that Johnson and Johnson is also looking to do. We partner with the American Academy of Ophthalmology as well as the American Academy of Pediatric Ophthalmology. We sponsor education events at their conferences. So we have sponsored sessions where we are going to be talking about Myopia as a disease. We realized that we need to educate everybody even though our focus might right now be supporting and educating practitioners but we are working overtime to educate everybody. And we realize that for Myopia Management to become the standard of care. Everybody has to work together. And that’s the only way forward.
Bethany Fishbein: I know you’ve collected a lot of research on clinical treatment and protocols and outcomes, is there research on how many practitioners are offering Myopia treatment and how they’re doing it? Like do we know those kinds of stats?
Dr. Monica Jong: The Wolffsohn, et al study in 2020 surveyed a bunch of practitioners all around the world and they found that the perceived level of active Myopia control in the US was the lowest out of all the regions. So I’m not sure what the percentage is overall. I’d have to look it up but the US actually ranked the lowest in offering Myopia control. And the first line of management was still single vision spectacles and soft multifocal contact lenses from US practitioners. So it just means that even though Myopia Management might be the hottest topic and there are some segments of some practitioners that are really the leaders and doing so much Myopia Management overall, Myopia Management isn’t really actively offered across the US. And so that’s something that we really, it means that we still have so much work to do in terms of educating practitioners and giving them the confidence and support to offer Myopia Management because the US practitioners surveyed said they were very aware of Myopia and its risks, except the actual implementation, was very low. Probably around 15%.
Bethany Fishbein: You said very low, but I was gonna ask like less than 50. but 15 is really low. So, as you said, the beginning of Myopia treatment starts with just a recommendation on education and lifestyle changes for anybody who’s between +75 and -50 and under 12 years old. Because at that point, there’s a high risk for them to develop further Myopia. At what point is it minus 50 or at what point do we start to recommend clinical treatment?
Dr. Monica Jong: The Clinical Management should be recommended at -0.50 diopters or worse of Myopia. So there’s still a big misperception. A lot of practitioners are saying, “Let’s wait until the person is -1 diopters or the child is -1 diopters before we start Myopia Management.” Or they’re saying, “Let’s wait to see Myopia progression in a child that has been diagnosed with Myopia”. But what we do know from a recent study published by Professor Donald Muti, he stated that once a child is diagnosed with Myopia of -0.50 diopters, they are highly likely to progress. So the prior progression is not something that we should really be waiting for based on the child’s age and the risk factors. And the fact that they’re at -0.50 diopters.
Bethany Fishbein: Is it always based on diopters? I know that and I feel like there’s some debate here about, “Is it diopters or is it axial elongation?” And what happens if you have one changing without the other? Where does axial length fit into this?
Dr. Monica Jong: So axial length is a very, very important measurement. We use it for clinical trials as the gold standard to validate if a treatment is effective or not. And the reason why we use axial length measurement is because it’s highly accurate. The resolution is like 0.02 microns and is very repeatable and objective. You don’t need to use cycloplegia to take that measurement. So as a profession and also public awareness is about diopters or the power of the eye. So the power of the eye is still very important because the refraction is a sum of everything together. So when we diagnose Myopia, we tend to use the cutoff of -0.50 diopters spherical equivalent. So we can still continue to measure refraction and then use that to diagnose the Myopia. But if we have access to an axial length measurement device, we should consider using that for monitoring Myopia. Because we know that axial length itself is linked to the risk of complications and pathologic Myopia with the axial increase. The axial length is directly linked to eye growth of the eyes. So refraction is great for determining and diagnosing Myopia. But then if we’re going to monitor Myopia long term, then axial length measurement is the better measurement because of its accuracy and its direct link to eye growth. Now, we also know that when axial length is over 26 millimeters or more that’s a significant increase to developing diseases of the eye associated with Myopia. So axial length is also really useful especially with certain treatments because for example, if you’re doing Ortho-K, you don’t have to do the washout where you remove the Ortho-K lens to then let the kid go back to their full prescription so that you can check what their prescription is. And then with certain treatment, drug therapies where, you know, there may not be a complete match in the axial length and certain drug therapies with the refraction may be masked as well. The axial length measurement is very useful and now there’s experimental evidence with axial length first being published for white children, and East Asian children that you can measure the axial length and compare the growth of the eye like a height growth chart and tell the patients and show them where the child is on the growth chart. So they’re very useful.
Bethany Fishbein: So I know you’re working in these organizations to kind of establish a standard of care for Myopia. Obviously, when treatment should begin, is axial length measurement part of that standard? Like if someone doesn’t have that biometer, should they not be doing this or can you do this based on refraction alone?
Dr. Monica Jong: Good question. We want everybody to do Myopia Management because the problem is going to be so huge. It’s a huge public health issue. So we can do Myopia Management without an axial length biometer. Because if you can control accommodation by cycloplegia and do excellent refraction, or you can control accommodation by doing a fogging, then you can monitor and diagnose Myopia very well using refraction. And in some places where the cost of a biometer is so high, not having a biometer should not prevent someone from doing Myopia Management. So the axial length measurement is the gold standard that we will work towards. But it will take a little while to get there when the devices become more available and become low-cost over time. So for now, everyone should be able to do Myopia Management without an axial length biometer. But if you have one, it’s an even better way to manage Myopia because of the extra information that you can have to provide better patient care.
Bethany Fishbein: And here the doctors that are doing Myopia Management treatment, working with overnight orthokeratology lenses or working with atrophy, or working with soft multifocals. There’s some curiosity here now about spectacle lenses that help slow Myopia progression that are available in Canada, Europe, and other parts of the world. Can you talk a little bit about those? Because we honestly haven’t heard too much about them because they’re not available here yet.
Dr. Monica Jong: Yeah. Like I have to say we’re pretty spoiled here in Australia. We have everything. We have every spectacle lens, every approved device as well as contact lenses, and things like that for Myopia Management. So the new spectacle lenses, one of them is the highly aspherical lenslets and the other one is defocus incorporated multiple segments. So these are like spherical zones of Myopic defocus all over the lens, tiny little dots or circular patterns all across the lens and in the middle of the lens. There is also the area where it has the actual distance prescription. So all these lenses provide Myopic defocus in front of the retina wherever the eye looks. So it brings the retinal image in front of the retina and this is how it provides Myopic defocus. And the reports from practitioners, that the vision is good and that they’ve also seen that there is clinical slowing with Myopia in their patients. And there have been studies published in some of the leading peer review journals that have reported that in their clinical trials in East Asian or Chinese children so far, they’ve seen a slowing of up to 50 to 59% on average. So they are reporting that they work almost as well as Orthokeratology.
Bethany Fishbein: And when you look at those efficacy numbers, is there a best option or we hear a lot about personalizing treatment for the patient and, you know, thinking about what’s going to work best for what patient? How do you figure out the treatment that’s going to give the best results for that individual child?
Dr. Monica Jong: Yeah. That’s a great question because personalizing treatment is the key for treatment compliance. Firstly, all of these treatments when they report these averages, we also do need to look at how many hours the child is wearing the treatment for. So for those spectacle-based studies, they’re saying that the kids are wearing the spectacle lenses for more than 12 hours per day. So you have to make sure that for all the treatments that they’ve been worn for the time needed to deliver the benefits. Because if during the day the child is able to take the treatment on and off, then they’re not going to receive the myopic defocus and that will mean that they’re not going to receive the efficacy that studies report. So there has been a meta-analysis that was published previously before these new lenses came on the market. Your spectacle lenses came on the market and they looked at everything out there. Randomized controlled trials and high-quality studies were made and reported that Ortho-K seemed to be the best on average. Along with some of the really high concentration Atropine treatments which themselves have huge rebound effects. So we shouldn’t actually be using a high concentration of Atropine at all. So overall, if we look at the study that was reported by Brennan et al, he found that in the first year you have this huge burst effect for all the treatments and then after that, they kind of slowed down. So overall, you’re not going to benefit by selecting a particular treatment just based on the highest efficacy because they all overall performed similarly in terms of axial length slowing over time. So we need to look at if a child is very active, they like to play sports, then the contact lens option is best because it’s better for their lifestyle. If a child does a lot of swimming, then potentially you know the risk of water in the contact lens you might want to look at Ortho-K for that particular child. Now, we also need to look at the child’s age. If the child is very young, some people do feel they are more comfortable giving a child a spectacle option. But if the child is continuously taking the spectacles on and off throughout the day and the parents are concerned, then a contact lens option might be useful. And then we also need to consider kids breaking spectacles or losing things. Those things come into play as well. And then parents and the patient or the child’s preference is very important. Because if it’s a contact lens option, and the child is young, the child and the parents both need to know how to insert and remove the lens or at least the parent needs to be the one doing that. So we need to have a holistic conversation to understand all these factors in addition to the clinical profile of the child in terms of the refraction, and how fast they’re progressing as well.
Bethany Fishbein: It makes sense, right? The best treatment for the child is going to be the one that the child is able to tolerate being treated for long periods of time. So that lifestyle piece is critical and I’m guessing from maybe a little bit of the background noise that you are a parent yourself.
Dr. Monica Jong: Yeah, I am actually. And I’ve got a three-and-a-half-year-old and 11-month-old now. So what I’m doing with them is more prevention actually. I have alarms set on the child’s iPad. The three and a half-year-olds iPad, so I limit him to two hours maximum per day of iPad viewing, and then I also make sure he goes outdoors at least two hours per day every day.
Bethany Fishbein: So you have a perspective as a clinician, as a Myopia doctor, and as a mom to potential myopes. So your experience goes across all of those.
Dr. Monica Jong: Absolutely. Yeah. For me, it’s very important because I know what it’s like to grow up having Myopia. Even though people think it’s very benign and you wear a spectacle, and on your own, your vision is corrected. For me, I didn’t really feel confident having spectacles on my face. You know as a child, you’re made to feel different when you wear spectacles and then I’m in a country where sports are like the priority. You have to be really good at sports. So looking nerdy and not having contact lenses or not even being offered contact lenses when I was a kid, you know that kind of impacted me and I don’t want my kids to go through that as well. And so for me, prevention is very important. Because in the recent ARVO meeting, Mark Bullimore and Noel Brennan presented a study where they found that if you can prevent or delay Myopia onset by about a year it equates to three years of Myopia control treatment. So it’s quite powerful. That’s like hot off the press. We haven’t even published that and it was just shown as a poster and a talk at ARVO.
Bethany Fishbein: Wow! You heard it here first folks. And so now your current role is with Johnson and Johnson. Traditionally, like Johnson and Johnson, we think about soft contact lenses – about Acuvue. What are they doing now for Myopia Management?
Dr. Monica Jong: Good Question! It’s really really exciting and that’s one of the reasons why I decided to move from my previous role of working with the International Myopia Institute and BHVI to working for Johnson and Johnson because the mission is still the same. We all want to prevent future vision impairment from Myopia. So Johnson and Johnson is really approaching this in an evidence-based way. They want to support Myopia Management firstly, by educating practitioners everywhere around the world. All the practitioners are going to know what Myopia is and what the evidence is for managing Myopia, and why we should manage Myopia. Because Johnson and Johnson is a healthcare company, we know that in the future Myopia-related blindness is going to be a huge impact. And Johnson and Johnson knows that we have networks, our innovation, and our support of research that we can come and support practitioners by developing new treatments that will be approved in every country. Because it’s important that we have approved treatments so that our patients and our doctors can have confidence in what they’re offering is evidence-based and will work. Now, we are coming at it understanding that Myopia is a disease. So it’s not going to be corrected by a contact lens that slows Myopia alone because we know Myopia Management requires personalized management. So we are going to be well I should say we are working towards a portfolio of treatments. So we call it the Acuvue Ability Portfolio for holistic management of Myopia. So in this portfolio, in some parts of the world already, we do have an approved Ortho-K lens called the Abiliti Overnight Lens. So outside of the US, it is CE approved for Myopia control. In the US, we have it FDA-approved for Myopia Management. And we also have now launched Abiliti 1-Day Myopia Control contact lens. I should say it’s approved for Myopia Management in Canada, Hong Kong, and Singapore and we’re looking to have it approved in other parts of the world. So this is a completely new technology in the 1-Day lens. It has a RingBoost technology. It delivers treatment of +7 diopters in front of the eye. So very high myopic defocus and the reports are the vision is also quite good and tolerated by our children. And because it’s a daily lens and it’s fit-based on the spectacle prescription, it’s very easy for practitioners to fit and use. So there are two treatments so far in our portfolio and we are looking to develop and bring additional treatments that are not just contact lenses in the future. But to support practitioners, we know compliance is a key question and education so that’s why we also have the SeeAbiliti app. So this is an app that patients and parents can download on their phone. It has information about Myopia, it has information about treatments and then it also allows parents to input near work time and outdoors time and communicate with their practitioner, as well. So so far we have these items and it’s really exciting because we are continuously going to improve this app. So that one day it can be combined with some kind of device and we can automatically help parents to track the kids’ time spent outdoors.
Bethany Fishbein: Very cool. So you said that app is called SeeAbiliti? Is it ability with an I like the abiliti?
Dr. Monica Jong: Yeah, SeeAbiliti. So it’s spelled A-b-i-l-i-t-i.
Bethany Fishbein: Okay. So for more information, people can get that app. Where else can people look to see the work that you’re doing? The Johnson and Johnson are doing? What are some other great resources.
Dr. Monica Jong: So you can go to our website, www.seeyourabiliti.com. So that’s where all the resources will be. There’s a parent portal and there’s a practitioner portal. But in addition, we have resources for practitioners. They’re called HealthCaring Conversations and the HealthCaring Conversations resources. So what they are are leaflets that are a lifestyle guide, and then we have training, as well as face-to-face and online that can help practitioners have those conversations about Myopia and also talk through the different treatments. We also have supporting flyers and educational materials that practitioners can download from us. So there’s a whole ecosystem of support for practitioners to talk about here because we know that communication piece can be a challenge. And we’ve worked with behavioral scientists to develop these materials to ensure that they are what practitioners need.
Bethany Fishbein: Perfect! Doctor Jong thank you so much for your time and for your information. I was having a conversation just before we started recording this with someone. And I said how much I love when people are just passionate about what they’re doing. And I know we’re working with a lot of doctors who are absolutely passionate about Myopia treatment and looking for ways to grow this and raise awareness in their own practices and own communities. And I appreciate all of the information that you’ve given today. I think it’s valuable not only for practitioners to learn from but I think every single thing that you spoke about is something that parents need to be aware of as well. Because if the statistic of 15% or close to that of practitioners are offering this then parents need to be self-educating so that they can advocate to find the places to get the appropriate treatment for their kids. So I hope that this gets out past the Eye Care community and into the hands or earbuds of some parents of children who have Myopia. So this is extraordinary. Thank you so much for your time.
Dr. Monica Jong: It’s a pleasure to be here and I’m really excited to be with Johnson and Johnson because really we are going to make Myopia Management the standard of care. And we will be educating every practitioner who wants to learn about Myopia Management and supporting them to fit a whole variety of management options. And then we’ll also be advocating to the parents and the kids about Myopia down the track. So it’s a long journey but I’m passionate and we’ll all be there together.
Bethany Fishbein: Fantastic. And to everybody out, there thank you so much for listening. For more information about Power Practice, you can find it on our website, www.powerpractice.com
Johnson & Johnson Vision Care Website: https://www.jjvision.com/
Seeyourabiliti Website: www.seeyourabiliti.com
SeeAbiliti App for Google play store: https://play.google.com/store/apps/details?id=com.jnj.seeabiliti&hl=en&gl=US
SeeAbiliti App Apple Store: https://apps.apple.com/sg/app/seeabiliti/id1568962995
International Myopia Institute Website:https://myopiainstitute.org/