SOCIAL

  the way i see it

A New Approach

Don’t ignore the obvious with your contact lens patients

MARC R. BLOOMENSTEIN, O.D, F.A.A.O.

Often times, I read or hear about something that is intuitively obvious but somehow escapes my limited cerebral capacity.

Case in point: A Buzzfeed.com article highlighted the apparent need for some female TV characters, who are in life-threatening peril, to still take the time to shave their underarms. Aside from Mary Ann and Ginger from “Gilligan’s Island,” modern-day damsels, such as Kate from “LOST” and all the women from “The Walking Dead” take the time to shave! (I know, right?)

Another obvious and yet seemingly ignored detail is the notion that contact lenses are medically controlled devices that can cause significant damage to that precious little organ: el ojo.

My friends, I am not saying anything more than what we all know. Yet, we seem to look the other way in regard to our contact lens patients. I am not implying that we are negligent with respect to these patients. However, you have to admit (or you are lying!) that we are not aggressive enough in our approach to managing the eye that has a corrective plastic wrap on the cornea.

Out with the old

The fact that we still see the same dropout rate with contact lenses as the last few decades — 23%, according to Eye and Contact Lens — even though the materials and disinfecting solutions have advanced is a telling statistic. We also know that contact lens wearers are at greater risk for experiencing ocular dryness and dry eye-type symptoms. And where there is dryness, there is inflammation. Moreover, a poor ocular surface can affect vision and, thus, affect the vision of our contact lens patients. Don’t even get me started on those patients who have significant MGD. Where is all that sludge ending up? On the contact lens, on the epithelium and clouding the very nature of what we are trying to do — make our patients see better.

New view

We have to start adopting a new way to approach this species of patient. Simply doing business as usual is in short time going to be not doing business at all. The new view on contact lens management should be derived from a response to the medical nature of this FDA-controlled device. This is a refractive medical device that needs attention, before and after the prescription is written.

In 2015, we should stand together again and say, “Stop the Insanity” (a common theme with me)! Placing this transparent refractive miracle on the cornea comes with responsibility, one that, frankly, our patients should not be expected to adhere to.

In the same way we treat our glaucoma patients, we should establish a protocol for medical follow-ups two to three times a year. Utilizing osmolarity, meibography, inflammation evaluation and, most importantly, checking vision, we can then objectively see how the medical device is affecting our patients.

Much like the bare-skinned pits of our heroines, these are images that are not easily unseen. We have seen what contact lenses can do, and it is obvious at this stage of the game that we need to do something different. Our patients deserve our medical attention. Contact lenses deserve more. And hairy armpits are not bad. OM

DR. BLOOMENSTEIN CURRENTLY PRACTICES AT SCHWARTZ LASER EYE CENTER IN SCOTTSDALE, ARIZ. HE IS A FOUNDING MEMBER OF THE OPTOMETRIC COUNCIL ON REFRACTIVE TECHNOLOGY. E-MAIL HIM AT MBLOOMENSTEIN@GMAIL.COM, OR SEND COMMENTS TO OPTOMETRICMANAGEMENT@GMAIL.COM.