Contact Lens Spectrum Supplements

Special Edition 2017

Contact Lens Spectrum

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22 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 INTRODUCING SPECIAL TY LENSES W hen I entered op- tometry school, I envisioned pursuing an ocular disease resi- dency and someday owning my own prac- tice. Toward the end of my years as an optometry student, however, I fell in love with specialty contact lenses and chose to do a cornea and contact lens residency at the University of Missouri-St. Louis College of Optometry. During that time, I learned a great deal about fitting and managing complex corneas and difficult contact lens fits, as well as how to successfully operate a specialty lens clinic in private practice. After completing my residency, I joined my child- hood optometrist, Stuart B. Adams, OD, in practice in my hometown of Lake Havasu, Ariz. Lake Havasu is a rural community with a population of approximately 53,000 and a median household income of about $38,000 (compared with the national average of $54,000 and the Arizona average of $50,000). The closest large city is about 200 miles away. When I joined the practice in 2012, Havasu Eye Center's patient base was mostly comprehensive eye ex- aminations, eyeglasses, soft contact lenses, and ocular disease management. I knew it would be a challenge to integrate specialty contact lenses into my new practice, because that service had never been offered. Equally challenging was the rural location of the practice along with the small population of the city. Could such a small town with a low median household income sup- port a specialty contact lens service? PLANTING THE SEEDS Initially, I performed mostly routine comprehensive eye examinations until I became comfortable with the staff, equipment, and examination flow, but I was passionate about specialty contact lenses and anxious to offer this new service to patients in my hometown. I offered specialty lenses to every patient whom I thought would benefit, and I discovered many candi- dates among our existing patients during their compre- hensive examinations. These were patients with: • fluctuating vision post-radial keratotomy • keratoconus • corneal scarring from trauma or herpes simplex • extreme dry eye who had tried artificial tears, gels, and medicated eye drops • transplanted corneas who wanted to improve their vision • normal corneas who were unhappy with their vision or comfort with soft toric lenses • high astigmatism • presbyopia, seeking the best possible vision at distance and near • irregular astigmatism, seeking the best possible vision. My partner was a huge help in referring patients re- quiring complicated contact lens prescriptions or those with irregular corneas to me. We developed a system whereby I would complete a consultation on the pa- tients he referred to me, including topography, slit lamp examination, pachymetry, and specular microscopy, and report my recommendations for treatment options. In the beginning, I would explain almost all treatment options (along with the associated costs) to each patient, but that became overwhelming, as some patients had more than 8 different options. Now, I usually discuss the top two treatment options for a particular patient based on his ocular condition, lifestyle, and any other relevant circumstances. I am happy to explain all options, but I A bl u epr i n t f o r s u c c e ss INTRODUCING SPECIALTY CONTACT LENSES IN YOUR PRACTICE S T E P H A N I E L . WO O, O D

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