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Made to Measure

By Kelly Waterhouse

Contact lenses offer patients flexibility, ease and an alternative to traditional eyewear frames. The choice comes down to getting the right fit for the patient, considering their health issues and lifestyle choices. For eyecare professionals (ECPs), it’s about making sure the contact lens measures up.

“Thanks to today’s technology, almost every patient could be declared eligible and be educated on the possibility of soft contact lenses as an option for vision correction, even if their reason for the visit was an comprehensive eye exam and new eyewear,” says Michael S. Mayers, O.D., FAAO Manager of Global Strategic Medical Affairs for Vistakon, Johnson & Johnson Vision Care, Inc.

ECPs understand the range of contact lens products available and making the best recommendations for patients comes from asking the right questions.

“For an existing patient, many factors go into deciding which type of contact lens is most suitable, such as lifestyle and comfort,” Mayers said. “Questions like, “How do you compare the beginning of day comfort to end of day comfort?” and “Do you work in front of a computer?” may help optometrists better judge what type of lens would be best.”

Rick Leroux, Director of Marketing and Communications (Lens Division) for Centennial Optical says, “Daily disposable lenses have increased in popularity due to the convenience and safety of this wearing modality.”

Mayer adds, “The eye measurements impact what lenses will be fit. The eye [prescription and curvature], discussing patient lifestyle and current contact lens experience are all factors to decide the type of contact lens to prescribe. Each brand of contact lens may fit differently.”

Whatever the trend, the knowledge and experience of ECPs are key for consumer support and safety. It begins with ensuring patient’s get the right fit.

“In order to determine the right fit, the most important thing to achieve is an accurate subjective refraction for the patient,” said Mayers.
“Once the right prescription is chosen and the lens is placed on the eye, the overall evaluation of the lens fit is the next step,” he said. “Ensuring the lens centers – aligns properly on the eye and provides acceptable movement is critical in order to deliver acceptable vision, comfort, and eye health.”

The initial patient trial is the best indicator of how the contact lens feels and fits.

“When a patient first tries on a new contact lens, they immediately evaluate ease of handling/insertion, initial comfort, and vision upon insertion. Listening to the patient feedback is critical during this time period,” Mayers said.

Certain eye health conditions present obvious challenges for ECP’s, such as astigmatism.

“For patients with astigmatism, a common challenge is the location/rotation of the lens. Most astigmatism patients know if their lenses aren’t ‘seated’ correctly then their vision may be blurred,” Mayers said.

“The Blink Stabilized Design used by ACUVUE harnesses the natural pressures of a blinking eye to help keep the lens in place and quickly realign the lens if it rotates out of position, providing wearers with consistent, all-day vision,” Mayers explains. “This also provides a marked advantage for practitioners because the lens settles and aligns very quickly, usually within one minute, thus reducing chair time and the need for further progress evaluations.”

Giroux points another eye health concern: presbyopia. With Canada’s significant aging population, this is an issue ECPs are facing.

“This translates to a rapid decrease in the number of contact-lens wearers and a correspondingly large increase in the number of spectacle wearers. Unsurprisingly, this group of over-40 contact lens wearing patients experiences the largest drop-out rate, mainly due to the fact that their existing contact lenses no longer meet their lifestyle and vision needs.”

Giroux says the current marketplace has a limited selection of silicone hydrogel multifocal lenses available to patients.

“Clariti 1Day Multifocal is the world’s first daily disposable silicone hydrogel multifocal. As such, it offers presbyopic patients great vision in the healthiest lens material and the safest wearing modality. They can wear a fresh pair of lenses every day, or whenever they choose to wear contact lenses, that will provide natural near, intermediate and distance vision, without the fuss of cleaning and storing their lenses,” Giroux said. Clariti Multifocal offers patients a reusable silicone hydrogel multifocal, combining the features and benefits of Clariti lenses with the ground-breaking Clariti 1Day Multifocal optical design.

Mayer notes that while the technology for fitting soft contact lenses has not changed drastically over the years, the technology for measuring the properties of contact lenses has changed.

“One of these properties is known as coefficient of friction (CoF),” explains Mayer. “CoF is the ratio of frictional force acting between two surfaces as one of those surfaces moves over the other one – such as the lid blinking over the contact lens surface. A lower coefficient of friction means there is very little resistant for the lid to travel across the lens. New contact lens materials that incorporate lacreaon and hydraclear technologies lower the coefficient of friction providing a more lubricious surface, potentially improving end of day lens comfort for the patient.”

According Leroux, silicone hydrogel has been the most widely prescribed contact lens material largely due to its higher oxygen transmissibility, which contributes to eye health.

“One downside of silicone hydrogels is it is a stiffer material than traditional hydrogels and it is hydrophobic, repelling water,” Leroux said. “Clariti lenses solve these problems with a low (0.5 MPa) modulus, high water content (56 per cent) and AquaGen non-surface treatment technology which makes the lenses hydrophilic, attracting water molecules to the lens surface and providing continuous “wettability.”

What hasn’t changed is the vital role of ECP’s in providing patient care and education about contact lens options. Follow-up patient care is the best way for ECPs to guarantee customer satisfaction, building that relationship of trust.

“It is up do the ECP how often to schedule regular follow up. However an annual comprehensive eye exam and lens evaluation is recommended for most patients wearing contact lenses,” Mayers said.

It comes down to listening to what patients want and helping them make the right choice.

“With today’s soft contact lens technology, meeting and exceeding patient needs has never been easier,” Mayers said. “Start the conversation!”

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