Striking a Balance
BY JOSEPH T. BARR, OD, MS,
We held a workshop last
month for our students to learn bifocal contact lens fitting and talked about the
balance between distance and near vision. We decided not to say "compromise between
distance and near" because it sounds negative, and although presbyopia correction
is all about compromise, "balance" is true as well. Just as I insist to our students
that the balance between the two eyes is critical, so too is balance helpful for
best stereoacuity in presbyopic correction. Life is full of balancing and handling
imbalance, and even though I and many other contact lens practitioners prefer bifocal
or multifocal lenses to monovision, our April article "Use of Presbyopic Contact
Lens Corrections in Optometric Practices" by Harris et al shows that many other
practitioners still consider monovision and modified monovision a preferred modality.
As Robert Mandell, OD, PhD, has pointed out, you can have balanced, somewhat imperfect
vision in each eye with bifocal and multifocal lenses or you can have monocular
blur at distance in one eye and at near in one eye with monovision. You'll have
to choose your own balancing act as the monovision vs. multifocal debate continues.
recently had a conversation with an industry leader who discussed the balance that
manufacturers try to obtain and maintain with material properties (oxygen permeability,
surface biocompatibility, modulus, thickness, lens design...the list goes on). This
too is the subject of much debate these days. Is more oxygen transmission better,
and can a contact lens have higher oxygen transmissibility and still have all of
the other factors that comprise a good contact lens? This debate is occurring in
marketing departments and in the courts, if not in the minds of practitioners. They
just want happy patients who perceive that their contact lenses are in harmony with
their eyes and meet their visual needs based on their lifestyle demands.
My colleagues often compliment
me on my balance in my life, yet those closest to me tell me that I work too much.
But that's when I'm most in balance: When I'm working hard and playing hard, whether
it's at the office wearing my PALs or at the beach wearing my bifocal contact lenses
or sports vision sun lenses. Balancing patients' vision and lifestyle needs, whether
they're presbyopic or physiologic, is manifold in our world today and is a challenge
with spherical and specialty contact lenses. But we're performing this balancing
act better than ever.
Have a great summer, and don't
be afraid to send us a letter or an e-mail about your own balancing acts to email@example.com.
Contact Lens Spectrum, Issue: July 2005