Myopia — also known as nearsightedness — is becoming increasingly common in children, and many parents are noticing a frustrating pattern: stronger glasses year after year. But myopia is more than just blurry distance vision.
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As prescriptions become higher, the eye grows longer, increasing the lifetime risk of serious eye conditions such as retinal detachment, glaucoma, cataracts, and myopic macular degeneration. Because of this, modern eye care has shifted from simply correcting vision to actively managing myopia progression.
The exciting news is that myopia control technology and treatment strategies continue to evolve rapidly. Today’s options are more advanced, more customized, and more effective than ever before.



At Kirkwood Eye Associates, we continue to expand our myopia management technology and treatment approaches to help children preserve clearer vision and healthier eyes for the future. Myopia Control has evolved. Just a few years ago, most children with myopia simply received stronger glasses each year. Today, we now understand that slowing the progression of myopia early can have meaningful long-term benefits for eye health.

Recent advancements in myopia management include:

• Better understanding of how eye growth progresses in children
• Improved corneal mapping and elevation-based technology
• More advanced Orthokeratology lens designs
• New specialty spectacle lenses designed specifically for myopia control
• Enhanced soft multifocal contact lens optics
• Better methods to monitor axial length and treatment effectiveness over time

Rather than a one-size-fits-all approach, modern myopia management is now highly personalized.


Current Myopia Control Options
Specialty Myopia Control GlassesNew generations of myopia control spectacle lenses are specifically designed to help reduce the visual signals that stimulate eye growth while still providing clear vision. These lenses look very similar to regular glasses but use advanced optical designs to help slow progression.
Benefits include:

• Easy adaptation
• No contact lens handling
• Great option for younger children
• Helpful for children not yet ready for contacts

These lenses continue to improve and are becoming an increasingly important part of modern myopia management.


Low-Dose Atropine Eye DropsLow-dose atropine remains an important tool in myopia management and has become more refined over the past several years. These nightly prescription eye drops are used in very low concentrations to help slow the progression of myopia. Advancements in atropine therapy now allow doctors to better customize:

• Concentration strength
• Treatment timing
• Combination therapies with other modalities

For some children, atropine works especially well when paired with optical treatments such as Ortho-K or myopia control glasses.


Soft Multifocal Contact LensesSoft multifocal contact lenses have also improved significantly, with newer optical designs specifically intended for myopia control rather than simply standard multifocal correction. Benefits include:

• Comfortable daytime wear
• Clear vision during sports and activities
• Effective slowing of myopia progression in many children

These are often a great option for children who want contact lenses but may not yet be candidates for overnight lens wear.


Why Orthokeratology (Ortho-K) Continues to Be Our Favorite
While multiple treatment options are available, Orthokeratology — commonly called Ortho-K — remains one of our favorite approaches to myopia control because of both its effectiveness and the freedom it provides children.
Ortho-K uses custom-designed lenses worn only during sleep. Overnight, the lenses gently reshape the front surface of the eye so children can often see clearly all day without glasses or daytime contacts. Recent Advancements in Ortho-KModern Ortho-K is far more sophisticated than it was even a few years ago. Today’s advancements include:

• More precise corneal elevation mapping
• Improved toric and customized lens designs
• Better centration technology
• Enhanced comfort and lens stability
• More advanced monitoring of eye growth over time

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At Kirkwood Eye Associates, we utilize advanced corneal imaging and diagnostic technology to customize Ortho-K treatment for each child’s individual eye shape and visual needs.

Why do families love Ortho-K?

Freedom from daytime glasses and contacts.Children can participate in sports, swim, and stay active without worrying about glasses or daytime lenses.
Excellent Vision During the DayMany children achieve crisp daytime vision without needing correction while awake.
Proven Myopia ManagementResearch continues to support Ortho-K as one of the most effective methods for slowing myopia progression and eye growth.
Highly Customized TreatmentModern mapping technology allows for more precise and individualized lens designs than ever before.


One of the most exciting developments in eye care is that myopia management continues to evolve quickly. Ongoing research and technological advancements are helping doctors better customize treatments and improve outcomes for children.
The earlier myopia progression is identified and treated, the better opportunity we have to help protect long-term eye health.
If your child’s prescription continues to increase each year, it may be time to explore newer myopia control options beyond traditional glasses alone.

Dry eye disease has become one of the most common complaints we see in modern eye care. Patients often describe:
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• Burning
• Fluctuating vision
• Redness
• Tearing
• Irritation
• Contact lens discomfort
• Heavy or tired eyes

For years, many treatments focused mainly on temporary symptom relief with artificial tears, gels, or medications. While those treatments can still play an important role, newer technologies are allowing doctors to better address the underlying causes of dry eye — particularly meibomian gland dysfunction (MGD).

At Kirkwood Eye Associates, we are excited to offer the InMode Envision platform featuring Lumecca-I and Forma-I technology as part of our comprehensive dry eye treatment approach.

What makes this platform unique is that it was specifically developed with the eye area in mind — not simply adapted from general cosmetic devices.


Designed Specifically for the Eye Area

One of the biggest advancements with the Envision platform is that the treatment applicators and protocols were designed specifically for the delicate anatomy around the eyes.

Traditional IPL devices were often developed primarily for dermatology or cosmetic applications and later adapted for dry eye-related treatments. The Envision platform takes a more specialized approach with eye-focused treatment design and precision around the periocular area.

This allows for:

• More targeted treatment around the eyelids
• Improved comfort during treatment
• Better integration into comprehensive ocular surface care
• Enhanced customization for individual patients

The eye area is uniquely sensitive and anatomically complex, and specialized technology matters.


Understanding IPL and the Ocular Surface

Intense Pulsed Light (IPL) technology has become an increasingly important part of modern ocular surface management.
Lumecca-I uses pulses of light energy applied around the eyelids and surrounding skin. In ophthalmic and optometric settings, IPL is commonly incorporated into treatment plans focused on meibomian gland dysfunction and ocular surface inflammation.

Potential benefits often include:

• Improved tear film stability
• Reduction in inflammatory lid margin changes
• Better meibomian gland function
• Reduced eyelid redness and telangiectatic vessels
• Improved contact lens comfort for some patients

Many patients are surprised to learn that dry eye symptoms frequently originate from oil gland dysfunction within the eyelids rather than simply “not producing enough tears.”


Why RF (Radiofrequency) Is Such an Important Addition

One of the most exciting advancements in modern ocular surface care is the combination of IPL with Radiofrequency (RF) technology.
Forma-I utilizes controlled radiofrequency energy around the eyelids and periocular tissues. The addition of RF can provide a powerful complement to IPL as part of a broader treatment strategy.


Why the Combination Matters

IPL and RF work differently, which is why many patients may benefit from using both technologies together.
IPL Helps Address Inflammation and Vascular ComponentsIPL is commonly used to target inflammatory contributors and abnormal blood vessels associated with eyelid disease and meibomian gland dysfunction.

RF Adds Gentle Therapeutic HeatRadiofrequency technology delivers controlled warming to the tissues around the eyelids. Heat plays an important role in softening thickened meibomian gland oils and supporting gland expression.


The Synergy Can Be Significant

When combined appropriately, IPL and RF may help create a more comprehensive approach to eyelid and tear film management than either modality alone.
Patients often describe improvements in:

• Eye comfort
• Contact lens wear time
• Vision stability
• End-of-day eye fatigue
• Dryness symptoms

A More Comprehensive Approach to Dry Eye

Dry eye disease is complex and multifactorial. There is rarely a single “magic treatment” that works for every patient. That is why modern dry eye care increasingly involves combining technologies and therapies such as:

• IPL
• RF
• Lid hygiene
• Prescription medications
• Tear supplements
• Meibomian gland expression
• Nutritional support
• Contact lens modifications

At Kirkwood Eye Associates, we believe advanced diagnostics and customized treatment plans are essential for long-term success.


Important Treatment Considerations

While IPL and RF technologies are increasingly utilized in ocular surface management, treatment plans are individualized based on each patient’s findings and symptoms.

Patients should understand that:

• Results can vary between individuals
• Multiple treatment sessions are often recommended
• Maintenance treatments may be needed over time
• These technologies are typically part of a broader dry eye management strategy

Our goal is to evaluate the underlying causes of symptoms and determine which combination of therapies may be most appropriate for each patient.


The Future of Ocular Surface Care

One of the most exciting developments in eye care is the continued advancement of technology designed specifically for the ocular surface and eyelids.
The Envision platform represents a newer generation of eye-focused treatment technology that allows for more specialized care around the eyes than ever before.

As our understanding of meibomian gland dysfunction and ocular surface disease continues to evolve, advanced combination therapies like IPL and RF are becoming increasingly important tools in comprehensive dry eye management.

If you struggle with burning, fluctuating vision, redness, irritation, or contact lens discomfort, a comprehensive dry eye evaluation may help identify underlying causes and treatment options beyond artificial tears alone.

     Myopia – or nearsightedness – is a condition that affects nearly one-third to one-half of the population in the United States. The nearsighted individual can see objects close but has difficulty seeing objects farther away. This can happen if the eye is longer than normal, from front to back, or the cornea is too
steeply curved. The eyes are intended to grow from birth until the teenage years, and then stabilize, but in myopia, the eyes may grow too much and/or too fast. When the eye length grows too quickly, it may lead to vision deterioration, requiring a progressively stronger prescription. This lengthening or
stretching of the eyeball could lead to an increased risk of vision threatening eye diseases later in life, such as retinal detachment, myopic macular degeneration, glaucoma, and cataracts. 

     Myopia is generally not reversible, so today’s treatments are directed toward prevention, compensation
(using glasses or contact lenses), or slowing its progression - a process called myopia control. Myopia control treatment is not a guarantee for any individual child, but the research indicates that it offers the likelihood of success in slowing the progression of nearsightedness.

Myopia Management Options

Spectacles – standard, single-focus spectacles do not slow myopia progression. Specialized myopia control spectacles have been shown to, on average, slow down the progression of myopia by nearly 70%. 5 The FDA has authorized marketing of the first spectacle lens to slow down the progression of
pediatric myopia; we expect approval soon!


Contact Lenses – standard, single-focus contact lenses do not slow myopia progression.

     Soft myopia control contact lenses – these are daily disposable contact lenses to be worn during waking hours. The FDA has approval for myopia control was granted up to an indicated prescription.
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     Soft multifocal contact lenses – these contact lenses may be daily disposable or reusable up to one month and are worn during waking hours. These are not FDA approved for myopia control but have been used off-label and has widely studied for safety and efficacy.

     Orthokeratology lenses – these contact lenses are gas permeable lenses worn overnight and removed upon waking. These lenses are custom to each wearer and therefore require more measurements and appointments. This option is desirable for those where soft lens or spectacle wear may be inconvenient during the day (i.e. swimmers). Orthokeratology lenses are not specifically FDA approved for myopia control.


Atropine Eye Drops – lower concentrations (0.01% to 0.05%) of this pharmacological eyedrop are used for myopia control. There are fewer risks and side effects associated with the lower concentrations and has been widely studied for safety and efficacy. Vision correction, with spectacles or contact lenses, may
still be needed to help with blurry vision.


Other things that you can do:

 Limit screentime and near work
 Utilize optimal lighting – natural light is best!
 Promote outdoor time
 Increase your knowledge
 Schedule regular eye exams

Kirkwood Eye Associates offers all the myopia control options, provided by our contact lens specialists. Contact us today to see if your child may be a good candidate.
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Scleral lenses are life changing devices for people with irregular corneas from conditions like  keratoconus, corneal transplants, failed LASIK, corneal scarring and dry eye disease.  They offer significant improvements in visual acuity and can give patents with these conditions the ability to see and function normally with comfort and consistency.  They act as a prosthetic that can be worn during the day to greatly reduce blur, glare, and light sensitivity.  

Patients with these conditions suffer from excessive amounts of what are known as higher order aberrations (HOAs).  Aberrations exist in virtually every eye.  Typical aberrations (lower order aberrations) include myopia (near sightedness), hyperopia (far-sightedness) and astigmatism, can be easily corrected with glasses and soft contact lenses.  People with eye diseases like keratoconus have additional higher order aberrations (trefoil, coma, etc) that cause significant blur, glare at night, star-bursting, haloes, and “ghosting” of letters and images.  These HOAs cannot be corrected with typical vision correction devices like glasses and soft contact lenses.  

Rigid lenses like traditional scleral lenses and corneal gas permeable lenses can correct a significant amount of HOAs and greatly improve vision for these individuals, but often there are still residual HOAs that can persist and prevent clarity. 

Kirkwood Eye Associates is now the first and only practice in Missouri with the ability to detect these residual HOAs with the help of the XWAVE system from OVITZ, and the ability to incorporate the proper correction onto a number of scleral lens platforms.   The process involves using the XWAVE aberrometer to measure the amount of HOAs present in an eye wearing a traditional scleral lens.  The measurements can then be used to design a wavefront guided optic zone on a scleral lens to further reduce presence of HOAs and improve visual acuity and clarity.  

This process requires perfect scleral lens stability to properly align the optics to correct these imperfections in the visual system.  The scleral lens experts at Kirkwood Eye Associates utilize cutting edge technologies like scleral mapping and impression scleral molding to design lenses with the optimal fit necessary to align these precision optical corrections.  

It is important to note that likely every human eye has some detectable level of HOAs and it is impossible to get that level to zero with current technology, but the OVITZ software can often help people with corneal disease bring their HOAs to a level at or below what we would expect in a non-diseased eye.  

HOA correction is not currently covered by any vision or medical insurance.  If you do have a plan with “medically necessary” coverage, please note that HOA correction will still be an out-of-pocket add-on feature.  

Contact Kirkwood Eye Associates today to see if HOA-correcting scleral lenses can help improve your vision.   

​Valued Patients, 

       At Kirkwood Eye Associates, our goal is to deliver exceptionally personal patient care in a welcoming setting. Continuing with this tradition, we are excited to announce we are expanding our practice with a second location in downtown Eureka, MO.

We have acquired the practice of Dr. Gregory Boschert who has practiced in St. Louis for nearly 50 years. The practice, now known as Eureka Eye Care, sits right along the very same railroad tracks that run in front of our Kirkwood office, symbolically connecting the two practices. You'll find the same friendly care and much of the same technology that makes the experience in Kirkwood so efficient and unique.

Please note that all scleral lens, keratoconus, and ortho-k patients will be serviced exclusively in Kirkwood at this time.

With a second doctor on our team, we will be able to expand our weekday hours at Kirkwood Eye Associates to better meet your needs. I will see patients in Kirkwood Monday through Thursday. A new doctor will be joining our staff to take over in Kirkwood on Fridays. Eureka Eye Care hours are available Monday, Tuesday, Thursday, and Friday.

Please feel free to reach out to us with any questions or concerns. Thank you for trusting your vision care to us and we will work every day to exceed your expectations. As always, thanks for supporting local.

Sincerely,
Dr. Biondo

Scleral lenses are life changing devices for a wide variety of patients.  These custom devices help give crisp vision to people suffering from keratoconus, post-LASIK, corneal transplant, corneal scarring, high astigmatism and much more.  They are extremely comfortable, stable, and easy to wear.  They also offer relief from severe dry eye syndrome.  This relatively new technology continues to evolve at a rapid pace and there are new options that utilize technology to improve fit, comfort and vision.  

​These options range from: good (diagnostic fit), to better (custom scan fit,) to best (impression mold design).

Diagnostic Fitting (Good)
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This is the traditional method for fitting scleral lenses.  Diagnostic (trial) lenses are placed on the eye in the office to determine the best fit and power for the patients eye.  These designs continue to improve and are becoming more customizable each year, but still have limitations on how “fine-tuned” the fit can be based on manufacturer specifications. 

​Custom Scan Fitting (Better)
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Thanks to a new piece of equipment here at Kirkwood Eye know as the Pentacam Corneo-Scleral Profiler, we can now scan the entire front surface of the eye including the cornea and surrounding sclera (the white part of the eye).  Traditional topographers only measure the  cornea. This is important because scleral lenses rest completely on the sclera.  This technology allows us to scan the scleral topography (shape) and custom design a lens to match the unique curvature of each patients eye for an exacting fit in all meridians.  This not only improves comfort and vision, it also reduces the need for remakes and additional office visits to “fine-tune” the design.

​Impression Molded Design (Best)
This technique is similar to the process used for a dental mold.  A bio-compatible compound is loaded in to a tray and placed against the ocular surface for about 90 seconds.  There is no pain and it feels similar to wearing a contact lens.  The compound hardens and is gently removed, leaving a perfect impression of the surface of the eye.  The impressions are sent to a lab where scleral lenses are designed in a 3D environment to perfectly match the patient eye down to 2 microns of tolerance (a micron is one millionth of a meter).  This design is great for anyone looking for a perfect fit from day one and is especially useful for people with scleral irregularities like glaucoma shunts or other elevations.  
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​Orthokeratology (also know as ortho-k or corneal reshaping) is a safe and effective overnight treatment for myopia, or “near-sightedness.”
Myopia, or near-sightedness, is on the rise in a big way.  Not only are more children than ever developing myopia, the severity is also increasing rapidly.  The prevalence of myopia has increased 66% in this country since 1971 and it’s estimated that half of the world's population will be myopic by 2050.  Higher levels of myopia have a number of negative health consequences.   Risks include an increase likelihood of glaucoma, early cataracts, and retinal detachments.  Higher amounts of myopia also impact quality of life as they result in and increase dependency in vision correction devices and a reduction in refractive surgery candidacy.




​How does orthokeratology work?

Orthokeratology (ortho-k) is a process that involves wearing an overnight contact lens device.  The device gently molds the cornea to correct myopia and thereby eliminates the need for any daytime contacts or glasses.  The treatment also help to stop or significantly slow the progression of myopia, making it ideal for children and teenagers.  The treatment effects are reversible by simply discontinuing the devices.


Is orthokeratology safe?
Ortho-k was FDA approved in 2001 and is a safe and effective treatment for myopia.  It’s myopia control effect makes it far more beneficial for younger patients than traditional contacts and glasses.  The risks associated with orthokeratology are the same as those for any contact lens wearer and can be mitigated with proper lens hygiene.


Who should have ortho-k?
Anyone with a prescription under -5.00D and with minimal astigmatism is a good candidate for orthokeratology, but it is especially beneficial for children and people under 21 years old, since they will have the highest risk of myopic progression with traditional contacts and glasses.  There is no minimum age under the FDA approval, and we at Kirkwood Eye Associates have successfully treated patients as young as 6 years old.  The earlier you start ortho-k, the better you can control the myopia.  Typically, we offer to move patients into traditional vision correction devices or consider refractive surgery after 21 years of age, but some patients elect to continue ortho-k through their 20’s and beyond because of its convince.


How much does ortho-k cost?  Is it covered by insurance?
Cost can vary depending on the extent of treatment but it typically is around $80 a month.  Some more advance and high risk patients might require atropine therapy that can slightly increase the fee.  The treatment is not covered by vision or medical insurance.


Are there alternatives to ortho-k?
There are other myopia control options offered at Kirkwood Eye Associates.  Atropine drop therapy is a compounded medication that can help slow eye growth.  MiSight soft daily disposable soft contact lenses are FDA approved to slow down myopic progression as well.

Keratoconus is a progressive corneal disease that effects roughly 1 in 2000 Americans according to the national institute of health.  It causes blurred vision that may not be correctable with standard spectacles or soft contact lenses.  Other symptoms can include glare, haloes, and rarely, pain.  Keratoconus is not an inherently blinding condition, but in its severe forms it can result in the need for a corneal transplant.  Scleral lenses offer keratoconic patients significant visual rehabilitation and are comfortable and stable.  They can be successful for nearly any patient, even those who have failed other contact lenses in the past like corneal gas permeable lenses and hybrid lenses.   They are also shown to reduce or alleviate the need for a corneal transplant.


Dry eye disease patients can do exceptionally well with scleral lenses.  Because these devices hold a layer of moisturizing tears against he ocular surface all day, they can offer relief from dry eye symptoms and improved quality of life.  Many studies highlight the reduction or discontinuation of the need for eye drops and medications, as well as improved visual acuity and visual stability.


Post corneal surgery patients (LASIK, Corneal Transplant, RK, PRK) can be left with corneal surface irregularities that prevent them from seeing as crisply as they would like, especially at night.  These irregularities cannot be corrected with spectacles, soft contact lenses or other surgeries.  Scleral lenses can give back the crisp 20/20 vision that allows you to see clearly at night or follow a golf ball off of the tee.


At Kirkwood Eye Associates, we have invested in the latest technology to fit scleral lenses.  We are one of the only practices in the state to offer Eyeprint custom molded scleral lenses that accurately match the ocular surface down to 2 microns.  We are one of the first to have a machine that utilizes complete scleral surface mapping to design lenses that are accurate down to 10 microns.  Both of these options far exceed the ability to fit with diagnostic lenses alone.  Call today to see if scleral lenses can change your life.

Attention scleral lens wearers! We at Kirkwood Eye Associates are proud to be national leaders in scleral lens fitting for dry eye, keratoconus, and irregular cornea patients.  We are excited to announce the addition of the EyePrint Pro Scleral Device System to our practice.  This highly customized scleral lens fitting utilizes a compound that is inserted onto the surface of the eye and makes an impression of the globe.  That impression is 3D analyzed and a perfectly molded scleral device is produced for your eye.