A Full Toolbox
BY JOSEPH T. BARR, OD, MS, FAAO, EDITOR
A great military general once described all the assets at his disposal personnel, armaments, aircraft, sea vessels and intelligence as "the full toolbox" of battle. Each asset is used as needed based on the strategy. Similarly, the carpenter needs a full toolbox, the fisherman needs a full tackle box, the golfer needs a full bag of clubs, the traveler needs a full suitcase and the contact lens practitioner needs a complete set of assets to manage all the various patients he or she will face. I must admit the inspiration for this editorial came from Wim Aalbers in the journal Global Contact.
Long ago I asked someone what defined a true contact lens specialist, and he said modifying rigid lens material lenses. I think that's one aspect, but many other assets are needed. The full range of options would incorporate lenses made from all materials available today, including silicone hydrogel, hydrogel, GP, hybrid and cosmetic versions as needed. The true specialist would use a number of brands in each material when they are available. The most expert contact lens practitioners I know, like great athletes, never give up unless the patient just "can't wear contact lenses," a rare occurrence. These experts also have a common response when handling the most compromised eye, one with irregular astigmatism; after exhausting their long list of standard and not-so-standard treatments, they use "whatever works." This may even include a scleral lens now and then.
I never cease to be amazed by how many options we have today compared to just over three decades ago. From PMMA lenses then to the current options of daily disposable lenses, disposable and custom toric and bifocal lenses, vast variations of cosmetic lenses, all in a wide array of GP and hydrophilic materials including the ones listed above. I remember 25 years ago when you could remember each series of Soflenses and all the base curves and diameters of all the hydrogel lenses. Now you need a loaded Palm device like Dr. Jeff Krohn's or your handy Contact Lens Spectrum Contact Lenses and Solutions Summary (CLASS) just to recall all your options.
Will we see more contact lens wearers resulting from all the new options available? We should. One thing is certain: our patients wear their contact lenses with more convenience for longer hours and safer than ever.