For those who are interested in starting to wear custom lenses or returning to them as an option for the patient, the process can be challenging

The threat and impact of patient retention, rejection, and online offerings dominate our thinking about contact lenses. Even with a lot of innovation, the market remains relatively stagnant. One area to look into to help you grow your contact lens business and retain your patients is offering customized products. For some practitioners, self-doubt, limited experience, equipment problems, or lack of focus on optics training can be barriers to fitting custom lenses. It can also be misunderstood that they are time consuming and not worth the effort. However, wearing custom lenses can enhance your professional image and increase job satisfaction.

Multifocal Contact Lenses
For those who are interested in starting to wear custom lenses or returning to them as an option for the patient, the process can be challenging. This seven step guide will help you succeed.
The first time we thought that fitting non-standard lenses might be due to high correction, whether spherical or cylindrical, but that’s only part of the chance.
The category of presbyopia with astigmatism continues to grow, and although their correction may not be particularly high on any meridian, their options remain limited due to the large number of articles needed to facilitate successful lens wear. In fact, mass-produced lenses may not meet their requirements.
The next category are those users who currently use multifocal contact lenses but are not completely satisfied with them, for whom “functional vision” may not be enough and a more personalized option may be better. Then some people experience ghosting or halos, so a design with increased depth of field may be needed to address these issues.
Finally, we have a group of often overlooked patients who had fairly simple corrections that often resulted in them being fitted with standard off-the-shelf products but with a smaller or larger than average corneal diameter or their corneas being flatter. or big. Normal case is cooler.
Start with the most recent dioptric assessment, corneal assessment, and biometric measurements of k-reading and HVID (Horizontal Visible Iris Diameter), as is customary for fitting contact lenses. These measurements will help determine which patients should wear custom lenses.

Multifocal Contact Lenses

Topographers provide more information, such as the degree of flattening around the cornea (eccentricity), but for those who don’t, a keratometer and PD (interpupillary distance) rules suffice for HVID. If we want to fit multifocal glasses, then eye dominance is also required.
We must consider which material is the most appropriate for the patient and the modalities. With the exception of patients with dry eyes, patients requiring temporary wear may be best served with a hydrogel, while those requiring long-term wear may benefit from silicone hydrogels. Also, consider choosing materials for presbyopic patients who are more prone to dry eye symptoms.
At this point, we should have all the information we need to order a lens. Please refer to the manufacturer’s installation guide, which can be supplemented with an online calculator. If you’re unsure, they may have a technical support service that can help you select materials and specifications.
Wait at least 20 minutes after donning for the lens to stabilize and then evaluate the fit. Over-refraction should only be done when the ophthalmologist is satisfied with how the lens fits the eye. If fit and vision are satisfactory, continue with the appropriate fitting period.
In the event of an unsatisfactory fit, the beauty of custom lenses means we can adjust them and get the best results. Excessive movement can be reduced by increasing the diameter and/or decreasing the base curvature, while insufficient movement can be reduced by decreasing the diameter and/or increasing the base curvature.
As a guideline, if the lens is rotated more than 20 degrees and hyperreflexia is significantly higher than normally expected, or visual acuity (VA) does not improve with hyperreflexia, then the fit is unlikely to be optimal and we will need to re-evaluate the base curve and diameter.
If you encounter unexpected results, such as VA not improving due to over-refraction, and you don’t know how to proceed, the manufacturer will be happy to help you.
When both you and the patient are satisfied, proceed with prescription lenses, ideally involving the patient in a current care plan. For those who are unable to offer or enroll in such a program, calling them every three months to remind them of the order will ensure good compliance and minimize problems and subsequent dropouts.
Carol Maldonado-Codina talks about her career, CL materials and being recognized as one of the IACLE Contact Lens Instructors of the Year.
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