Article

CONTACT LENS PRACTICE PEARLS

DON’T BE A DECLINER

“The enterprise that does not innovate ages and declines. And in a period of rapid change such as the present, the decline will be fast.”—Peter Drucker, author, management consultant (1909-2005)

In looking back over the past 20 years in the eyecare industry, the contact lens industry has evolved quickly. When I graduated from optometry school in 1999, I rarely fit multifocal contact lenses because, at that time, it was a challenge to achieve adequate vision with the designs available. Daily disposable lenses were an option, but they were not mainstream and were mostly used for part-time wearers who wanted a 30 pack. Orthokeratology lenses were just in their infancy, and the idea of slowing the progression of myopia with any type of contact lens was nearly nonexistent. Furthermore, scleral lens options were rarely considered for any type of cornea.

Most of these lens options and applications are now mainstream—or are quickly becoming mainstream—in the contact lens industry, even myopia control, for which contact lenses are currently an off-label use. They have also all evolved rapidly over that 20-year period of time. This continual advancement has opened the door for practitioners to fit patients into contact lenses who would never have been candidates 20 years ago.

For example, consider the following case. A 32-year-old new male patient presented for a comprehensive eye exam and corneal evaluation. He has a history of herpes simplex keratitis and corneal scarring OS only. It has not flared up in the past 15 years. The patient reported that he used eyedrops when the condition was active, but he has not used any since then and has maintained daily use of 400mg acyclovir since.

His best-corrected visual acuity (BCVA) was 20/40 with a prescription of +2.75 –5.50 x 090 in that eye. Figure 1 shows the topography maps of his right and left corneas.

Figure 1. Corneal topography maps of our patient OD (A) and OS (B).

Think Outside the Box

At first glance, many would not even consider fitting this patient with contact lenses. He was not asking for contact lenses, and he did not even consider them an option after the herpes simplex keratitis happened to his left eye.

But with the innovation of scleral contact lenses, eyecare professionals have an option to possibly improve this patient’s vision and irregular astigmatism with contact lenses that vault this thin area of his cornea. By thinking outside the box and offering an innovative option for this challenging patient, we may now have the opportunity to change his visual life.

Keep Up with the Times

I have no doubt that technology will continue to evolve in the contact lens industry. It is imperative to remain up-to-date with the latest advancements and to offer innovative products for your patients’ visual demands.

So get out there and attend some conferences, workshops, and lectures, and read about the latest technologies in journals and on manufacturers’ websites. Without making a conscious effort to do that myself, I would not have had the confidence to fit this patient with contact lenses. I can’t wait to see what the next 20 years will bring to this industry! CLS