Contact Lens Spectrum Supplements

Special Edition 2017

Contact Lens Spectrum

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C O N T A C T L E N S S P E C T R U M S P E C I A L E D I T I O N 2 0 1 7 c l s p e c t r u m . c o m 18 PRACTICE BUILDING pared to the extra steps necessary when making soft lenses. If you are really keen on differentiating yourself, consider becoming familiar with lens design software, which will enable you to custom-design your own lenses (Figure 4). There are different options of these pro- grams. Some are built into a topographer, others can download the topography files into the design software, and still others stand alone. Regardless of the program you choose, knowing how to use this software puts you in the driver's seat for determining what is best for your patient's ocular situation. 6. TAKE THE QUICKEST PATH TO BECOMING A SPECIALIST: PRESBYOPIA Frankly, I believe you could position yourself only as a presbyopia contact lens specialist and be as busy as you want to be. It is the largest specialty lens category, yet one where many patients have remained somewhat dissatisfied, particularly with the visual results. To do this correctly, you need to have access to a multitude of lens products and be aware of the different optical principles applied with each one. In the soft lens arena, you will want to have every major brand of disposable soft lenses available, as each one has its place, and you will need to understand the optics of the individual designs. Are the lenses center-near or cen- ter-distance? Are multiple add powers available? Are the optics spherical or aspheric (Figure 5), or are they in the newest category, extended depth of focus? Which design works best for distance, intermediate, or near vision? When should you consider mixing brands to achieve the best vi- sual result? Remember, there is no rule that states a patient must wear the same brand or even the same add power on each eye. In fact, the creativity of certain combinations can often be the difference between visual success and failure. Do not forget about GP and hybrid lenses for pres- byopic patients. Both provide the sharp acuity that will meet the needs of certain patients. GP bifocal designs of- 4. USE VARIOUS METHODS TO CAPTURE ON-EYE IMAGES Everyone in eye care is employing more imaging than ever before, mainly because today's slit lamps have photo capabilities along with the relative ease of storing images in the patient's electronic health record. A specialty con- tact lens practice must be able to acquire numerous types of images in white and cobalt blue light with and without fluorescein and utilizing many different types of illumina- tion. Diffuse and retro illumination as well as the use of optic section provide images that document various lens fitting characteristics. High quality video is also important, particularly if you want to participate in venues where you can share interesting cases with your peers. Imaging is an excellent method for sharing difficult cases with your lens labora- tory to allow them to weigh in with possible answers to fit- ting challenges. Video can be captured with HD cameras or simply by holding or attaching your mobile device to the slit lamp oculars. 5. BECOME A LENS DESIGN EXPERT To develop your specialty lens presence, you must first understand lens design. This is best achieved sim- ply by asking your laboratory consultant many questions about the various lens parameters. You should know the optical zone sizes and whether they use radius or angles in the lens periphery and what the overall thickness pro- file is. While some laboratories treat this information as proprietary, most are willing to share it with you, be- cause they realize the more you understand a particular product, the better chance you and your patient have of being successful. Visiting your laboratory to watch how lenses are fabri- cated is also extremely helpful. You will gain an apprecia- tion of how well contact lenses are manufactured today. In addition, you will gain insight into how surface treat- ments, such as plasma and PEG (polyethylene glycol), are applied. You will also learn the differences in the manu- facturing processes for corneal and scleral GPs as com- Figure 5. High add, center near, spherical multifocal optics. Figure 4. Screenshot of GP lens design software.

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