I See Overnight – Interview with Dr. Moshe Schwartz
What’s the difference between ortho-k or Orthokeratology and the I See Overnight program? Learn about the program directly from Dr. Moshe Schwartz OD FAAO of EyeSymmetry Vision Center.
Most practices call this service ortho-K, orthokeratology, and some people call it CRT because they strictly use Paragon’s product. What inspired you to call it I see overnight?
When we started to look different deeper and further into corneal reshaping. we realized there are different makes, different brands, and different designs that can help us assist our patients to achieve good outcomes after overnight wear. However, every company has certain restrictions as far as the parameters go. What I want to do for each patient is find the right combination by picking and choosing among the various companies and different manufactures certain parameters. Then, the lens could be custom-made and tailored for that particular patient. Paragon has a great product as well as medicines, but they have restrictions as well. Wave has its own restrictions, and so on. I want to be able to provide the patient with a 100% customized lens that I can actually address accurately.
If I check into the manufacturing process and identify all the different parameters first, that can lead to successful and safer results. That’s why, we came up with the idea of ISeeOvernight because we ensure that what happens after wearing an overnight lens, you will see.
Do you find that the versatility and the variety of lenses that you use differ because of the eye? Because of age? What are the factors?
When we go to evaluate assess and prescribe these type of lenses, it’s extremely important and crucial to address not just the prescription but there are other variables that could lead to a successful outcome, such as the tear film, the anatomy of the cornea, the physiology of the cornea, the size of the cornea, among them, of course, is the prescription, the age of the patient, the pupil diameter, etc. It’s not cut and dry. You don’t just plug it in and populate certain data.
You have to take in a whole lot of other variables into the decision-making and into the manufacturing process in order to achieve very good results. That’s why we use two different topographers. We don’t rely on the data just from one. I use multiple instrumentations in the process of the evaluation, prescribing, and follow-up.
Do you find that I see overnight is better for children because of myopia control?
Yes, ISee Overnight provides a very good solution to an epidemic. Statistically and scientifically we’re all seeing a progression of nearsightedness across the board across the world whether you come from China Germany South America or Baltimore. We see a progression of prescriptions 1.75 to 1 diopter a year. And, historically people used to correlate the fact that your child is growing older and getting taller, and that’s why the prescription changed. But they didn’t understand that basically, one has nothing to do with the other because prescription progressively getting worse means that their axial length is growing longer.
Their eyes becoming longer, not taller. What we try to do is to provide something similar to the brain that the length of the eye has achieved its optimum. and what we call in our language emmetropization. You don’t need to grow any longer, and as a result, we hope any progression of myopia or nearsightedness.
So a byproduct is you have a child that you know whether they actively engage in sports you don’t have to worry about sports goggles or whether they’re glasses for when they play baseball and when they jump in the pool they can open their eyes to get out of the pool they can see clear as barrel and so that’s a nice byproduct but the most important thing is to prevent progression that could consequently lead to macular changes, retinal detachment, glaucoma, and, of course, blindness down the road. That’s why it’s so important to not allow them to get worse.
You'd say it's really "family tested?
Well, here’s the thing. My wife is significantly nearsighted at minus eight. She had LASIK surgery to correct it. Now, we know that there’s some genetic predisposition for nearsightedness.
Along with that, we see with this generation of myopia, it was virtually given that my kids will become extremely nearsighted really really fast. I wasn’t going to be the chance that possible down the road we’ll have to deal with some severe complications.
So, as soon as they needed glasses, boom. They were riding through those lenses. Age of eight, nine years old. My son was ten. But they all hopped in and now are all doing great.
Could you share just a short patient story that they started this program and they saw great success?
I have 4 kids. Each and every one of them wears them. Between my 22-year-old, my 20-year-old, my 15-year-old, and now 11-year-old all each and every one of them wear these lenses.
Is their eyesight say 2020 or close to it?
All patients that are going through the program – and the reason why I emphasize it’s a program because this is a treatment against progression. This is not just wearing regular glasses of spectacles that give you temporary relief.
We are treating the eye against the progression of their nearsightedness. Virtually everybody has 20/20 vision uncorrected throughout the day. Of course, you have to wear through these specialty, highly customized medical contact lenses at night time but during the day, they see perfectly well.