Myopia Control Program Protocol

Annual Routine Exam

1. Myopia progression is determined.
2. Dr. Recommended child is a candidate for the Myopia Control Program.
3. Myopia Control Evaluation Scheduled (Dr. visit to discuss options, payment, FAQ)
4. Myopia Control Information PACKET is sent via Weave Text Template (post comprehensive exam)

Myopia Control Evaluation

(Myopia Control Information Packet attached to appointment reminder)

1. Outline treatment options (Dr.)
   -Ortho K Paragon Overnight Lenses
   -MiSight Daily Contact Lenses
   -Atropine Eye Drops
2. Specific measurements taken if needed for OrthoK or MiSight (Dr.)
3. Go over payment plan (Optician)
4. Provide Myopia Control Agreement & Pricing FORM to PT Parents
   -Patient is considered Enrolled once agreement is signed and submitted

Enrolled Myopia Control Patient | Agreement & Implementation

1. Signed agreement received
2. Treatment Swag given to patient per treatment option (OrthoK & MiSight)
3. Product ordered for PT
4. FAQ Form sent with appointment reminder inRevIntake (per specific treatment option)
5. Schedule follow up appointments per treatment plan
   -See reverse side per treatment plan

Ortho K Paragon Overnight Lenses

1. Patient measured during the Myopia Control Evaluation
2. Specialty contacts ordered by Dr.
3. Patient schedule for first OrthoK fitting & follow up when contacts arrive
4. OrthoK Fit & Follow Appointment Types (3 & 6 month Evaluations):
   –First Visit: insertion & training
   –Second Visit: Next day, early morning
   –Third Visit: One weeks post. Morning appointment. Autorefraction & Typography Scan. Determine if lenses fit correctly, modifications needed.
   –Third Visit: scheduled based on Dr. recommendation.
   -Continued follow ups based on Dr. recommendation & patient progress
5. Year to date of treatment: determine progress of treatment and next steps

MiSight Daily Contact Lenses

1. Patient measured during the Myopia Control Evaluation
   -Fitted with MiSight Trials
   -Insertion and training
2. Six month supply of MiSight contact ordered by office, shipped to patient
3. Patient schedule for first MiSight follow up two weeks post evaluation
4. MiSight Follow Up Appointment Types (3 & 6 month Evaluations):
   -Evaluation
   -Two Week Follow Up (additional as needed)
   -Three Month Consultation
   -Six Month Consultation… Order next six month supply, ship to patient
   -One Year Follow Up
5. Year to date of treatment: determine progress of treatment and next steps

Atropine Eye Drops

1. Patient is enrolled as an Atropine Eye Drop patient post evaluation
2. Dr. will prescribe the dosage needed per patient and order from Redline Pharmacy
3. Redline Pharmacy will dispense a 6 weeks supply of eye drops via shipping FedEx One Day Air (cold).
4. Patient will keep bottle one in the refrigerator and use it for two weeks while freezing bottles two and three. After two weeks the patient will dispose of bottle one and use bottle two for two weeks. And so on. Redline Pharmacy
   will contact the patient to schedule additional shipments.
5. Atropine Eye Drop Follow Up Appointment Types:
   -Every three months
6. Year to date of treatment: determine progress of treatment and next steps

See our pricing and agreement information below:

Myopia Control Program Pricing & Agreement Form [PDF]