Contact Lens Practice Pearls
New Options in Specialty Lenses
BY JASON R. MILLER, OD, MBA, FAAO
This is a great time to be an eyecare professional as there are many positive changes happening in many areas within the eyecare industry. Specialty contact lenses are one area creating a buzz, and they may become a focal point in more of our practices.
Why Specialty Lenses?
Many patients who require specialty contact lenses need them mostly for either vision or comfort reasons. They are valued for their ability to mask corneal irregularities associated with various diseases, such as keratoconus, as well as trauma, a history of penetrating keratoplasty or refractive surgery, Stevens-Johnson syndrome, neurotrophic keratitis, and severe dry eye syndrome. In addition, recent specialty designs have been developed for other possible uses including myopia control, drug delivery vehicles, and there’s even a possibility for virtual reality lenses (Choi, 2012).
This year at the 2012 Global Specialty Lens Symposium (GSLS) in Las Vegas, I had the opportunity to learn about new technologies and upcoming research associated with multiple areas in specialty contact lenses.
There is much research associated with this topic, some of which is very compelling. During the conference, I was asking myself: what amount of myopia reduction would cause me to change my prescribing habits? Furthermore, what percentage of myopia reduction would create a situation in which I was obligated to offer this as a treatment to my younger patients? Is it 33 percent, 50 percent, or even more? If I could tell an emerging myope’s mom and dad that I could reduce their child’s projected vision impairment by 50 percent—that is a significant number to me. What about reducing an “expected” 8.00D myope down to a 4.00D myope just by using a specific treatment that interrupts his predicted axial elongation?
What is causing an increasing frequency of myopia? Is it nature or nurture? Many researchers are evaluating the role of genetic predisposition, amount of near work, lag of accommodation, levels of Vitamin D, and even the amount of time spent outdoors. Accelerated axial length growth associated with myopia development has been evaluated for many years, and many theories have been proposed. Newer models and contact lens designs are attempting various ways to aggressively halt that change. Stay tuned for upcoming research aiming to optimize the various designs.
When fitting GP lenses, larger diameters—often greater than 10mm—may be a viable option for those who have difficult-to-fit corneas. Many lenses are available in corneal-scleral, semi-scleral, mini-scleral, and scleral lens designs. Large-diameter GPs can vault the central cornea and land on the peripheral cornea or sclera without bearing on the central cornea. This will result in superior comfort while protecting the integrity of the corneal surface.
In addition, hybrid lens technology allows you to provide the benefits of GP optics along with the benefits of a soft skirt surrounding the GP lens center, thus creating less lens and edge awareness compared to standard GP contact lenses.
Always More to Learn
Many technological advances have occurred in the contact lens industry, and specialty contact lenses are growing in popularity because of their many uses. From fitting keratoconus to controlling myopia, it is important to stay up-to-date with the newest technologies available. Being comfortable with the multiple designs and their uses may open up your practice to new groups of contact lens wearers. CLS
For references, please visit www.clspectrum.com/references.asp and click on document #197.
|Dr. Miller is in a partnership private practice in Powell, Ohio, and is an adjunct faculty member for The Ohio State University College of Optometry. He has received honoraria for writing, speaking, acting in an advisory capacity, or research from Alcon, Allergan, CooperVision, and Visioneering Technologies. You can reach him at firstname.lastname@example.org.|