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THESE TECHNOLOGIES AID IN CONTACT LENS SELECTION AND MONITORING

CONTACT LENS technology has come a long way, allowing O.D.s to fit more patients than ever before. But finding the right contact lens for each patient can be tricky. With the availability of lens materials and designs formulated for eye health, we must look deeper into the intricate details of our patients’ corneas and anterior segments to ensure a healthy fit.

Are you investing in and utilizing the available technology needed to properly select a lens for a patient? Here, I outline three technologies to help you do so.

CORNEAL TOPOGRAPHY

Corneal topography is not just for specialty contact lens fits; it can be beneficial for regular contact lens wearers as well. Today’s topographers can detect corneal irregularities, such as irregular astigmatism and corneal ectasias. They also enable O.D.s to assess whether a patient’s current contact lenses are reshaping the cornea or harshly bearing on the corneal surface.

For example, I had a patient who is affected with astigmatism and was also a contact lens wearer. Every year, I would use topography after he removed his contact lenses. Eventually, he decided he wanted to proceed with refractive surgery.

In preparation, he refrained from wearing his contact lenses for two weeks. After those two weeks, I utilized topography again, which revealed he had a significant amount of irregular astigmatism, thereby nullifying his refractive surgery candidacy. Throughout the years, his soft lenses had molded and reshaped his corneas. Had it not been for this technology, the outcome of his refractive surgery could possibly have been poor.

In addition, topography can also aid in detecting early anterior segment diseases, acquire tear film break-up time, tear interferometry and, to a certain extent, the oxygen transmissibility of soft contact lenses.

SPECULAR MICROSCOPY

Specular microscopy is a valuable tool to care for contact lens patients. This technology allows O.D.s to measure corneal integrity. It often yields pachymetry readings, and provides measurements of corneal thickness. Specular microscopy can be used to help diagnose corneal disease, as well as other anterior segment diseases.

With these results, O.D.s are able to assess the corneal health of their patients and prescribe more appropriate contact lens materials. For example, using this technology, O.D.s can determine whether a patient would do just as well in a hydrogel lens as he or she would in a silicone hydrogel lens.

LIPIVIEW

Finally, assessment of the eyelids and eyelashes are paramount to contact lens wear. Without proper monitoring of the meibomian glands, the lens surface and its surface treatments become broken down and may cause contact lens intolerance and discomfort — and lead to contact lens dropout.

The LipiView Interferometer (TearScience) allows for the analysis of the tear layer supplied by the meibomian glands, which is an essential meibum to help prevent evaporation of the tears. Further, with contact lenses, it is a component to the biofilm that interacts with the contact lens surface to keep it smooth and clear as the wearer blinks. Although not routinely accepted yet, this technology is essential to keeping my patients happy and satisfied in their contact lenses.

AHEAD OF THE CURVE

By staying abreast of the latest contact lens innovations we have at our disposal and utilizing the available technology outlined above, we, as O.Ds, are better able to retain our patients through thorough and innovative care. OM

KEVIN GEE, O.D., practices in Houston and is an assistant clinical professor at the University of Houston College of Optometry. He is a Fellow of the American Academy of Optometry, an ABO Diplomate and an OCRT member. Also, he’s on Allergan’s advisory board and is a consultant for Solution Reach. Visit tinyurl.com/OMcomment to comment on this article.