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Does Patient Comfort Guide Your Contact Lens Fitting Decisions? Reply

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Do you ever stop and think about how fortunate our specialty contact lens patients are?  Technology has made so many strides that now allow us to assist patients who previously only had surgery as an option.  Having said that, how do you decide on the best treatment option for your patients?  When looking at an irregular cornea, are there findings that push you closer to a soft, hybrid, scleral or standard gas permeable contact lens design?  How much does patient comfort play a role in your decision process? Read more

[Mar 18, 2014]
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Scleral Contact Lens Filling Solutions 1

Off label use of 0.9% Sodium Chloride Inhalation Solution for Scleral Contact Lenses

(See the Video Here:  Video Quick Tip)

Is it just me, or is everyone fitting scleral contact lenses now a days?  Why not, technology has come quite a long way in recent years. When fit correctly , these designs can now allow us to offer our patients an incredible option in both comfort and acuity. Read more

[Dec 31, 2013]
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Gas Permeable Contact Lens Staining Patterns Reply

Diffuse Corneal Staining

(See the Video Here:  Video Quick Tip)

How many of you fit rigid lenses?  The truth of the matter is, if you are not doing these fits on a regular basis, it can be very easy to forget the techniques.   Having said that, we can’t avoid it completely.   There is always the possibility that a patient currently using gas permeable contact lenses, ends up in your chair with a problem, and expects you to fix it. Read more

[Dec 15, 2013]
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Specialty Contact Lens Vocabulary Reply

apical touch

When learning to fit rigid contact lenses, a practitioner must first familiarize themselves with certain terms. Whether using these terms for documentation purposes or for speaking to a fitting consultant, using the approved vocabulary will greatly enhance the learning process. Below are a few terms that you should be familiar with. Read more

[Jul 04, 2013]
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Specialty Contact Lenses for the Irregular Cornea Reply

ScleralStandardRGP

Fitting an irregular cornea is a challenging but rewarding task.  The ability to take a patient who would otherwise require surgery and provide them with remarkable vision is truly an art.   Thankfully, technology has brought us to a place where this fitting process is becoming more and more mainstream allowing a greater number of patients to benefit from this technology. Read more

[Jun 04, 2013]
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Posted in Gas Permeable Lenses, Scleral Contact Lenses, Soft Lenses, TheRightContact.com | Tagged , , , , , , ,

6 Tips To Find The Best Contact Lens Lab Reply

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So you are a new or expanding ‘specialty’ contact lens fitter.  Great!  So what is the next step?  You need to find the right manufacturing lab.  Making a decision is not an easy task.  After just a little research, you can quickly find that there are literally dozens of labs to choose from.  You can easily ask around, but it might be tough finding an unbiased opinion.  Within this post we are going to take a quick look at key factors you should consider when making your decision.  Follow these steps, and you will definitely find the best contact lens lab for you and your practice. Read more

[Apr 04, 2013]
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Flexure Revealed 1

flexure

Flexure could be defined as the bending of a contact lens in an effort to conform to the corneal shape. This is a concern gas permeable lens fitters come across when monitoring their patients. The reason it becomes problematic is because an initially, perfectly fit lens, now presents with new fitting characteristics and new power requirements.

So why do we see flexure or the reshaping on these lenses? Put simply, the amount of flexure is dependent on various factors including lens thickness and flexibility. Did you know that thin lenses can flex a third of the corneal astigmatism?

Flexure is noted on follow up and is reported by the patient as CONSTANT blurred vision. Your diagnosis is confirmed by obtaining keratometry measurements over the lens. If the anterior surface of the lens was originally spherical or another noted parameter, alterations in shape will be detected here.

There are certain lens characteristics that will increase the likelihood of flexure. These factors include a high amount of astigmatism, steep base curves, thin lenses or large optic zones. Once diagnosed alterations to lens designs are your only option.

The key to addressing flexure is understanding the underlying mechanism.

Is the lens thin? Solution: Get a more rigid material (i.e. increase center thickness, lower dk, etc.).

Are we correctly aligned to the cornea? Solution: Adjust the fit (i.e. consider toric curves, use a flatter base curve, decrease optic zone, etc.).

Troubleshooting is a part of the job description for a specialty contact lens fitter. Flexure is just one of those issues we might find ourselves contending with. Understanding the potential impact of this finding will save you both time and money. Learn it well, and this will be yet another factor that puts you ahead of the rest.

[Feb 02, 2013]
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Having difficulty with that RGP fit? 4

Contact Lens Fitting

While in optometry school, we definitely received a good foundation for specialty contact lens fitting.  I have to admit though, I didn’t take full advantage of it back then.  My success with specialty lens fits didn’t come until I made the personal decision to “jump right in”.

Nowadays, there are many resources available to the practitioner.  You have online tutorials, Vimeo, YouTube, and webinars.  There are even sites , like the one provided by the Gas Permeable Lens Institute (www.gpli.info/) that are dedicated to simple and advanced contact lens training.  There is certainly a lot to choose from, but at the end of the day, remember these contact lens companies want your business.  I have yet to find a company’s consultation department unwilling to walk you through the most basic to the most advanced fitting questions.

Just starting out and unsure if you want to commit to purchasing a fitting set, there is a good portion of lenses that can be fit empirically.  If you can provide your refraction and keratomety, that’s all they really need.  You don’t have to worry about back toric vs. bitoric or SAM/FAP.   Most manufacturers will be able to create a lens from just those readings.  They will actually do the calculations for you.  You can even email images or videos.  They can literally walk you right through the fitting process.  Companies such as Art Optical and Blanchard Contact Lens are pretty good about return policies and modifications.  Once again, there is your safety net.  Get your feet wet.

When you decide to take it a step further and consider a fitting set, you have a lot of options.  My recommendation would be to do your standard GP’s empirically and to invest in a scleral lens kit.  To me this is giving you more BANG for your BUCK!  Think about it, the scleral fitting philosophy is vaulting the cornea.  A sclera lens can manage just about any irregular cornea.  Whether you are talking about keratoconus, pellucid marginal degeneration, post graft, etc., you are vaulting over the irregularity.   My personal favorite is the MSD by Blanchard Contact Lens but there are many others with varying options.

Those more comfortable with soft lenses have the next generation soft lenses for keratoconus.  Designs such as the KeraSoft IC as well as the NovaKone (the one I use) have taken a new look at the way practicioners are treating keratoconus.  Unfortunately these cannot be fit empirically but the success of these lenses is well documented.

[Aug 22, 2012]
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