What Sets Us Apart
Prescription changes must be minimized at all costs for our children. We only get one chance to slow it down, so let’s ensure it’s performed correctly! From the instant you walk into our practice and experience our flow and the information presented in the consultation, it’ll be evident that our practice lives and breathes specialty care.
We invest in the latest technology because it leads to healthier, clearer, and demonstratably more protective outcomes for your children. Learn more about our technological suite below.
Oculus Pentacam
AXL Wave Tomographer
A doctor cannot judge the success of a myopia management program without the use of an optical biometer. Without using optical biometry, the growth of the eye can only be inferred from prescription changes, which is problematic for two reasons. First, the eye lengthens initially and then the prescription changes as a result, which means that if you only monitor change via prescription, you’re already a step behind. Second, prescription changes are monitored in quarter steps (0.25D), which are very large steps in terms of axial length.
We upgraded to a Pentacam AXL Wave due to its ability to monitor axial length to a thousandth of a millimeter, an order of magnitude increase in accuracy over the previous Zeiss unit we employed. This bleeding-edge piece of equipment also allows us to monitor the health of the front and back of the cornea, which is important for early detection of corneal diseases that present in the second decade of life.
Lumen Optometric is among only ten optometric offices in the United States that utilize the most advanced Pentacam ever built.
Medmont Meridia Corneal Topographer
A leading-edge topographer is critical to monitor how the cornea (the clear window of the eye) changes over time with myopia treatments. Medmont is hailed as the leading manufacturer of topographers, with the model “E300” being the gold standard topographer for a decade. Their newest topographer, the Meridia, improves upon the original E300 model by more accurately capturing your child’s cornea in three dimensions. Increased topographical accuracy allows us to more closely monitor your child’s treatment and to fine-tune their vision and protective elements.
Medmont enlisted our help to fine-tune the software for their new Meridia we’re proud to be able to offer this latest form of technology to our patients.
WAVE Custom Lens Design
Lumen Optometric is the only office in Los Angeles County that is recognized as a platinum-level WAVE designer. We utilize Wave to create 100% fully-custom lenses for your child. WAVE combines all the tomographical data from the Oculus Pentacam AXL Wave and allows us to specify and manipulate every aspect of your child’s lens design.
From a doctor’s perspective, the customizable nature of WAVE allows for (1) maximum slowing of myopic progression, (2) more accurate vision correction, and (3) maintaining eye health. For patients, it simply means their eyes are more protected from myopic progression, they see clearer faster and in a safe, healthy manner.
Axial Length Visualization
The axial length is the most important measurement for any child undergoing myopia management treatments. It is the length of the entire eye, which enlarges at a faster rate for myopic children. Being able to track the axial length before and during treatment is critical to understanding the success/quality of the treatment. Tracking axial length is the standard of care. You cannot track treatment success via prescription alone!
Do All Ortho-K Lenses Fit The Same?
The answer is a clear “no.” Depending on the type of lens a practitioner may be limited to (either due to technology or training), their definition of custom will differ. This is an overview of the three different types of “custom” lenses you will encounter as a patient/parent, from our perspective.
Basic
Basic custom – These types of ortho-k lenses are similar to off-the-rack dress shirts in that they come in a certain size. Depending on your needs, you pick a larger or smaller shirt. “Basic custom” ortho-k lenses exist in certain parameters and different lenses are selected based on visual estimation. Due to the lack of personalization, your child can share the same lens design as another patient.
Drawbacks:
- Not form-fitted to each eye. Corneas are rarely spherical.
- Adult designs are typically used for children, which is sub-optimal for minimizing myopia progression
- Difficulty with correcting all forms of astigmatism
Imaging Analogy:
- “Basic” custom lenses are similar to buying a stock photo from Adobe. It might fit your particular need, but there’s likely elements of the photo that you would prefer to change.
Semi-custom
Semi-custom – This category of ortho-k lenses begins to incorporate technology such as topography in the design of the lens. Lens design software will use the topographical data to “pre-fill” a pre-established template. To return to the dress shirt analogy, measurements are taken for a dress shirt to be made, but the shirts still have certain non-modifiable assumptions made about the proportions. One such example is attempting to shrink or widen the neck area of a dress shirt. It’s a near impossible task without having to deconstruct the whole shirt.
Drawbacks:
- The lenses are still limited by the guidelines set by the software manufacturer.
- This is an issue for those with complicated prescriptions or for those with tighter eyelid anatomy (common amongst our Asian demographic).
Imaging Analogy:
- Think of these lenses as an image generated by an AI model. They will likely capture the general subject matter in addition to additional details, but the details are not easily modifiable (or modifiable at all).
Fully-custom, individualized designs - We only fit these
Fully-custom, individualized designs – WAVE lenses are all fully-custom designs. WAVE lenses incorporate tomographical data of the eye which can then be fully-manipulated by a Certified WAVE Designer (CWD). Every aspect of the lens can be changed relative to one another, leading to the most form-fitting and visually effective lens. We utilize WAVE lenses because our patients see the best out of them and their eyes worsen the least!
Drawbacks:
- Lenses take longer to create due to the doctor having to design each lens
- More revisions are necessary to tackle complicated prescriptions (high Rx or significant levels of astigmatism)
Imaging Analogy:
- Designing fully custom lenses is similar to creating an image with Adobe Illustrator and then fine-tuning with Adobe Photoshop.
Tip – If a doctor can’t show you the visual layout of your child’s lens design (like what you see up above), it’s likely not a fully-custom lens. If you point to any one aspect of the design and ask for it to be changed in real time for demonstration, yet it can’t, it’s likely not a fully-custom lens. Lastly, fully-custom lenses are all doctor-designed from start to finish, meaning that the lenses are all designed in-house by the same doctor taking care of your child. Basic or semi-custom lens designers outsource their change requests to lens consultants.
Fully-custom lenses require more training to design and troubleshoot, in addition to requiring very specific hardware. We only fit fully-custom lenses because they are the healthiest option for your child.
What about the visual benefits of fully-custom lenses?
The basic, semi, and fully-custom designations in the section above only refer to the shape of the lens. Properly designing a well-fitting lens is only the first step in protecting your child’s eyes.
Only after a proper fitment is established can the optics of a lens be considered. The optic of the lens is what actually protects your child against myopic progression.
Click the dropdowns below to learn more about the most common Ortho-K designs (adult designs are much more prevalent) and why your child needs a child-specific design for the most protection.
Designs for children
OK lens on-eye (with dye)
Smaller circular treatment ring
Increases overall amount of protection
Subtle dye leakage inside the ring
Allows for protection within the pupil
Design of an OK lens for a child/teen
The Ortho-K treatment goal for children/teens is different than adults, which means their lens designs must be different.
Smaller treatment zones (the green and red circles) have been demonstrated to be more protective for the eye than large treatment zones.
Place your mouse over the white dots to learn what’s specific to children’s designs, then mouse over the respective dots in the adult design (shown below) to learn the difference.
Results of OK wear (topography map)
Small treatment zone
The treatment zone (red ring) is wrapped tightly around the pupil (white circle)
Peak values should be > 3
Values of ~3 are good. Values >3 (like these) are great for slowing progression.
Designs for adults
OK lens on-eye (with dye)
Larger, concentric treatment ring
A larger treatment ring also reduces glare
Lack of bleed inside of the concentric ring
Results in less glare at night for adult driving
Design of an OK lens for an adult
The treatment zones for an adult are wider because we don’t need to worry about myopic progression with adults.
The main concern with adults is glare minimization, so the treatment zone should be larger.
Mouse over the white dots to learn what’s specific to adult designs and then compare with the children’s designs above.
Results of OK wear (topography map)
Large treatment zone
The treatment zone (red ring) is outside of the pupil (white circle)
No myopic bleed into the pupil
Less bleed into the white circle results in less glare
Allow us to take part in your vision care and you’ll love what you see.