Why You Should Be Fitting Specialty Contact Lenses

When I first opened my specialty contact lens practice, I was focused on providing my patients with the highest quality scleral and rigid gas permeable (RGP) lenses. These were patients with irregular corneas due to corneal scarring, post-corneal transplants, and conditions such as keratoconus. The lenses I fit them with vastly improved their vision, which made them incredibly happy.

My practice is now 4 years old, and I have expanded my contact lens offerings. I am blown away by the number of patients who have benefitted from specialty lenses that aren’t scleral or RGP lenses (see Patients Who May Benefit From Specialty Contact Lenses). You too can reap the benefits of fitting patients with specialty lenses. Keep reading to learn how.

GETTING STARTED

Below are a few simple steps to help get you going with specialty lenses in your practice.

Watch Free Recorded Lectures Online

You can find free recorded lectures on the websites of the Scleral Lens Education Society (sclerallens.org), Gas Permeable Lens Institute (gpli.info), and Woo University (woou.org), to name a few.

Reach Out to Specialty Contact Lens Manufacturers

Call the manufacturers of specialty lenses that you are interested in and speak with them about the products they offer. You can also request a list of offerings to be sent to your email. Knowing the types of lenses that are out there is half the battle.

Introduce One Type of Lens at a Time

Discuss the lens type, its benefits, and the types of patients it would help at your next staff meeting. The more your staff can inform patients about what is available, the easier it will be to introduce new lenses to your patients during their examination.

UNDERSTANDING EYE ANATOMY IN RELATION TO LENS FIT

Because patients with high myopia tend to have steeper corneas, whereas those with high hyperopia tend to have flatter corneas, neither category qualifies for the one-size-fits-all base curve and diameter combination of commercially available soft contact lenses. For this reason, an adequate fitting lens could be much more comfortable if it were custom fit.

This is also the case for patients with smaller or larger horizontal visible iris diameters (HVIDs), also known as white-to-white measurements. These measurements are used to determine the ideal sagittal depth of a contact lens. Patients with larger HVIDs need a contact lens with a deeper sagittal depth (steeper base curve and larger diameter), whereas patients with smaller HVIDs need a lens with a shallower sagittal depth (typically flatter base curve and smaller contact lens diameter).

In my practice, when I see a patient with an HVID of < 11.5 mm or > 12.00 mm, I recommend they be fit with a custom soft lens (see An Example Case). Many times, I have ordered both custom soft lenses and commercially available soft lenses for the same patient, and they always end up preferring the vision of the custom lenses.

OTHER BENEFITS OF SPECIALTY LENSES

Patients who have had complicated surgeries or trauma are sometimes left with pupillary abnormalities, and in my experience, even the smallest pupillary change can induce life-altering light sensitivity. Using specialty contact lenses to reduce light sensitivity has also been a huge winner in my office. Prosthetic contact lenses (either plain black or color) that block out light and recreate a spherical pupil, can increase a patient’s quality of life tenfold.

Colored prosthetic contact lenses can also be incredibly life-changing for the self-esteem and confidence of patients with disfigured eyes or diffuse corneal scarring. One patient with a keratoprosthesis device (an artificial cornea that makes the eye appear blue in color) said, after being fit with his brown prosthetic contact lens, that his life and confidence dramatically increased and that choosing this lens was “the best thing he’s done all year.”

Patients who need prismatic correction in their glasses may also benefit from specialty contact lenses. Contact lenses with prism are one of my favorite topics to discuss because not a lot of doctors know about them. Custom soft contact lenses can incorporate up to 4.00 Δ of base down prism, while a scleral lens can incorporate 4.00 Δ in any direction.

A WISE DECISION FOR YOUR PRACTICE

Now that you’ve heard what specialty contact lenses have done for my patients, know that adding them to your practice can benefit you as well! Your patients need you to offer this option.

With customized lenses, we get to stay on the cutting edge of technology, offering not necessarily what is easiest and most routine, but what will truly enhance the lives of our patients. Doing so leads to more patient engagement with our practices and better patient retention. Referrals will come in from patients who believe we have gone above and beyond the status quo to solve their visual issues. When patients believe that you are acting in their best interest, their trust in you will grow, and they will tell others about the service and offerings at your practice.