Article Date: 9/1/2012

Learning What Patients Want

Learning What Patients Want

The NSIGHT study provides a new look at what our patients are really seeking when they come into our offices.

By Scott Han, OD, FAAO

My use of the Bausch + Lomb PureVision2 family of contact lenses began when I learned about the Needs, Symptoms, Incidence, Global Eye Health Trends (NSIGHT) study. The study influenced how I think about what patients really want and how that may differ from what we think they want or what we want for the patient.

LEARNING FROM NSIGHT

The NSIGHT study evaluated 3800 vision-corrected individuals across seven global markets to determine what motivates people to make decisions about eyecare products and identify unmet needs. This provides a framework for identifying patient priorities and recommending products and services to help them.

According to NSIGHT, the most compelling features when choosing eye-related products center around vision. Patients want us to give them the best vision possible. That means not only Snellen visual acuity on the eye chart but also quality of vision. The study also identified the incidence of glare (52%) and halos (35%) for contact lens wearers in the United States and the patients' desire for a solution.1,2 Many patients believed that no solutions existed for these problems. If patients think there's nothing that can be done, they may not bother to tell you about the problem.

IDENTIFYING PATIENTS WHO NEED HELP

So, I simply began asking my patients if they experience any glare and halos and if they would like to reduce or minimize them. I found the frequency of glare and halos in my patient population to be even higher than that found in the NSIGHT study.

For our spectacle-corrected patients, we're quick to offer anti-reflective lens coatings, but what about our contact lens patients? We didn't have much to offer them — until now.

PUREVISION2 FAMILY OF CONTACT LENSES

One of the barriers to high-quality vision and a contributor to glare and halos, especially in dim lighting, is spherical aberration. The average amount of spherical aberration in the general population is +0.18um for myopic eyes.3 Both the PureVision2 and PureVision2 For Astigmatism are designed to reduce positive spherical aberration — adjusted across the power range. The PureVision2 For Astigmatism lens does this in both the spherical and cylinder meridians. My patients consistently comment about their improved vision.

The thin lens design maintains comfort throughout the day. One of my patients said he couldn't feel any difference between the spherical lens and the toric lens. For the first time, he was able to tolerate wearing contacts and he was excited to have an option other than eyeglasses.

PUREVISION2 FAMILY DELIVERS VISION AND COMFORT

The PureVision2 family of contact lenses has enabled me to give my patients what they want — great vision and comfort. This is achieved through aspheric optics that reduce spherical aberration and thin lens designs. The toric lens adds excellent centration and rotational stability to provide consistently clear vision. The large optic zone and aspheric optics help to improve nighttime vision by reducing glare and halos. The thin lens design allows for comfortable all-day wear. The PureVision2 family of contact lenses has been an important part of building my practice and helping patients.

DR. HAN IS DIRECTOR OF OPTOMETRY AND A PARTNER IN A MULTISPECIALTY, MULTIDISCIPLINARY, PRIVATE PRACTICE WITH FIVE LOCATIONS IN THREE COUNTIES IN FLORIDA. HE IS A CONSULTANT/ADVISOR TO ALLERGAN, BAUSCH + LOMB AND MERCK.

REFERENCES

1. Needs, Symptoms, Incidence, Global Eye Health Trends (NSIGHT) Study. Market Probe Europe. December 2009.
2 Mack CJ, Merchea MM, Thomas H. A global survey reveals vision needs of highest importance amongst a vision-corrected population. Optom Vis Sci. 2010;87:E-abstract:105233. 3. Cox I, Kingston A, Vogt AKS. Wavefront aberrations of the human eye — a large population study. BCLA. Manchester, UK, 2011.

► ► DEMONSTRATING SUCCESS

CASE 1
Patient MH, a 36-year-old female, came in for an annual exam and renewal of her contact lens prescription. She reported that she was doing a great deal of night driving to visit her mother who was sick and living about an hour away. I asked if she experienced any glare and halos at night. She thought the glare she experienced with her contacts was normal. She reported sometimes wearing her eyeglasses instead because it became too distracting and tiring for her eyes to drive with contact lenses at night. Like many patients, she never complained about it because she didn't think anything could be done.
■ Rx
OD: -1.75 sph 20/20
OS: -1.50-0.50x180 20/20
■ Keratometry showed OD 44.75/45.00@089 and OS 45.00/45.75@090.
■ Medical history and ocular examination were unremarkable.
■ Fitted with PureVision2
OU -1.75 8.6 14.0
Vision was 20/20 OD+OS with good centration, coverage and movement. She was going to visit her mother that night and was excited to drive with the new contact lenses.
She called the office the next day to tell me how clear her vision was — both day and night — and how the glare was minimized during night driving.

CASE 2
Patient KS is a 29-year-old female who presented for a routine eye exam and contact lens prescription. “My contacts always move around and it makes my vision blurry,” she said. This type of complaint is common in toric contact lens wearers. It may not always be as specific. For example, many patients don't realize that the lens is rotating, but the most common complaint I hear with toric contact lenses is that vision fluctuates and becomes blurry with their contact lenses but not with their eyeglasses.
■ Rx
OD: -2.50-1.50x175 20/20
OS: -3.00-1.50x005 20/20
■ Keratometry showed OD 45.25/47.00@085 and OS 45.00/46.75@093.
■ Patient medical history and ocular examination were unremarkable.
■ Fitted with PureVision2 For Astigmatism
OD: -2.50-1.25x180 8.9 14.5 20/20
OS: -3.00-1.25x180 8.9 14.5 20/20 Vision was 20/20 OD+OS with good centration, coverage and movement.
■ The rotational markings were aligned at the 6 o'clock position OD+OS.

Most doctors are looking for ways to minimize chair time and improve efficiency.

I've found that PureVision2 For Astigmatism lenses have fast rotational alignment. With this lens, my fitting process is quick and it's simplified because I can assess the fit right away without having the patient go back to the waiting room and wait for the lens to rotate and stabilize. The novel hybrid ballasting design combines features of both prism- and peri-ballasting designs to deliver consistent and stable vision.

When KS returned for her 2-week follow-up visit, she said she no longer had to manually move the contact lenses in her eyes to sharpen her vision.

CASE 3
Patient JS, a 25-year-old male, came to me for a new patient exam. During the exam, I asked if he'd ever considered contact lenses. He said that because he had astigmatism in one eye, contact lenses had been too uncomfortable in the past. I told him about the new options and encouraged him to try again. He agreed but was not very enthusiastic.
■ Rx
OD: -4.50-0.25x165 20/20
OS: -4.25-2.00x015 20/25
■ Keratometry showed OD 45.50/45.75@080 and OS 45.25/47.00@104.
■ Patient medical history and ocular examination were unremarkable.
■ Fitted with PureVision2 OD and PureVision2 For Astigmatism OS
OD: -4.25 8.6 14.0 20/20
OS: -4.00-1.75x010 8.9 14.5 20/25
With these lenses, we found good centration, coverage and movement with rotational marking at 6 o'clock OS.
The thin lens design maintains comfort throughout the day. JS said he couldn't feel any difference between the spherical lens and the toric lens. For the first time, he was able to tolerate wearing contacts and he was excited to have an option other than eyeglasses.


Contact Lens Spectrum, Volume: , Issue: September 2012, page(s): 5 6