Don't Pigeonhole Your Contact Lens Patients
Lifestyles are forever changing at a dizzying pace. Each patient has different visual demands and time constraints during work, vacation and leisure. Why do we pigeonhole our patients into a single modality ? Why can't they benefit from the a single modality? Why can't they benefit from the advantages of different modalities at different times?
I can already hear your pessimism. Patients are confused enough, why should we confuse them even more? Following are a few examples that may encourage you to propose different modalities for selected patients.
A young woman came in for an annual examination. She had never worn contact lenses and was interested in them mainly for her upcoming wedding day and honeymoon. Once we established that there were no contraindications to lens wear, we discussed the different modalities. Monthly frequent replacement lenses were most attractive to her, as they best suited her lifestyle. She was equally attracted to daily disposables for their simplicity, but found them somewhat costly.
I suggested that she can benefit from the advantages of daily disposables on her wedding day and honeymoon (she was going backpacking in Asia for three weeks) and then return to a monthly replacement modality thereafter. She asked, "I can do that?" and was thrilled at the prospect. Since then, she has returned to purchase daily disposable lenses for every vacation she takes to make her life a little less stressful. I've had similar success with patients who have seasonal allergies and have benefited from daily disposable wear at the peak of their symptoms.
The Dusty Environment
Another patient was undertaking major home renovations while still living in his house. The dust was everywhere and was causing lens-related discomfort that he had never before experienced. He had worn two-week replacement lenses problem-free for the past five years.
I suggested that he wear daily disposables during the period of renovations. Although they didn't relieve all of the symptoms related to the increased dust, they alleviated some because he wore fresh lenses every day. He returned to his usual modality after the work was complete. He continues to use a two-week lens, but has incorporated daily disposables for his weekend getaways and water sports.
The New Mother
A first-time mother came to the office to improve her vision at all times of the day and night. Her newborn had a three-hour feeding schedule and she couldn't function without her prescription (OD –8.25, OS –9.25/–0.50 X 180). She was a seasoned soft lens wearer in a monthly replacement modality. She was interested in continuous wear during the nursing months with her newborn.
We tried continuous wear for the first six months. She was pleased that she could function in the middle of the night without having to feel for her glasses or struggle to apply her lenses. In addition, once she understood the benefits of silicone hydrogels for her ocular health, she was more than convinced to upgrade.
Prescribe for Patients' Needs
Getting to know your patients is key to understanding their visual demands and their lifestyles. We tend to pigeonhole our patients into one modality, but suggesting more than one is practical for some patients who have specific demands. Keeping abreast of what's new and prescribing more than one modality when appropriate will allow you to offer your patients what best suites their lifestyles and will identify you as a caring, attentive practitioner.
Dr. Bitton is an associate professor of Optometry at the École d'optométrie, Université de Montréal and is the Externship Director. She is also Secretary of the AOCLE.