Article Date: 11/1/2011

Potential <i>Spokes</i>patients
contact lens management

Potential Spokespatients

Meet the visual needs of bike enthusiasts.

Susan Kovacich, O.D., F.A.A.O.

Although no absolute number exists regarding the amount of Americans who ride bicycles, all one has to do is look out their car window or visit a park to see it's an extremely popular pastime for all ages. In addition, because cycling is an economical and “green” form of transportation, it can be argued that its popularity has gotten even greater in recent years. My point: You'll most definitely encounter patients who range from the after-school and weekend cyclists to the serious bikers, who conquer thousands of miles a year. And, they all have specific ocular needs that could benefit from contact lens wear. Yet these patients are an often-untapped resource of contact lens revenue because many optometrists fail to ask, via social history form and/or personally, “Do you ride a bicycle?”

The following case is an example of the patient satisfaction and financial rewards that await those practitioners who start asking this question.

Newbie cyclist

A 23-year-old male computer programmer presented for a routine eye exam at which he said he thought he needed a new spectacle prescription. The patient said he'd worn glasses full time since he was nine-years-old, and that he had no medical problems, took no medications and had no significant family history. He noted on his social history form, under hobbies, that he had begun cycling.

The patient's habitual spectacle prescription was OD -4.50D with 20/15 visual acuity (VA) and OS -4.50D with 20/15 VA with a stable refraction. All other exam findings (e.g. extraocular movement, cover test, slit lamp exam, intraocular pressure measurement and internal exam) were within normal limits. Translation: The patient was a moderate myope OU with normal binocular vision and in good ocular health.

Cycling and seeing

During the exam, I asked the patient about his interest in cycling and the accuracy of his vision during this pastime. The patient confessed he had trouble seeing upon certain head positions because the frame of his spectacles interrupted his vision. In addition, he said he experienced problems with glare and strong sunlight when cycling. I asked the patient whether he'd ever considered wearing contact lenses. He replied that while growing up his family had struggled financially, so contact lenses were never a consideration. He added that since he was now on his own and making his own money, he would be open to contact lens wear if it could benefit him.

I educated the patient that contact lens wear would preclude the spectacle-induced vision interruption he experienced while biking. I then explained that wrap-around polarized sunglasses would alleviate the varying glare and strong sunlight, enhance his peripheral vision, provide protection from debris and an additional safeguard from UV rays. With regard to the latter, I educated the patient that while the contact lenses provide UV protection to the cornea and a small area of the conjunctiva, large lens/wrap-around sunglasses cover a much larger surface around the eye.

Outcome

The patient elected to schedule a separate visit to be fit with soft contact lenses and choose a pair of sunglasses.

I fit the patient in 8.8/-4.25D/14.0 OU two-week disposable replacement soft spherical contact lenses, which moved and centered well on the eyes and resulted in 20/15 VA OU. After learning how to insert, remove and care for his lenses, the patient asked to be shown “sunglasses for biking” in the dispensary, and he found a pair that he said was “awesome.”

He returned one week later for a follow-up visit and said he was “thrilled” with his contact lenses and sunglasses. (See “Other Cyclists,” below.)

I've found that most patients are willing to spend money on products that can benefit them, especially refractive modalities that enhance their safety and enjoyment of an activity. Since cycling is a hugely popular pastime throughout the United States, and contact lenses can successfully meet the visual needs of cyclists of all ages, it's time to inquire about bike riding in your practice. And, remember: If you can satisfy one bike enthusiast, that patient will become a spokesperson for your practice, referring others for similar ocular care and products. OM

Other Cyclists
The traveling cyclist. Those who set off on extended biking tours often don't have the packing space for solutions and lens cases or the time to disinfect their lenses on a daily basis. This places their comfort and ocular health at risk. Therefore, be sure to offer those Lance Armstrong-wanabees daily disposable lenses.
The presbyopic cyclist. Once upon a time, all the presbyopic cyclist with good binocular vision and ocular health really needed were distance lenses. But as cycling mirrors (which can be attached to the patients' helmet, glasses or on the bike's handlebars) and digital bike computers (which can display speed traveled, distance, location and heart rate, among other features, and are mounted on the handlebars) have become available, the need for clear vision at the intermediate and near distances has become important for safe and enjoyable cycling. Monovision is usually not indicated for these patients, as U.S. bikers use the right side of the road and, therefore, have to turn their heads to the left. In other words, the left eye cannot be corrected for near vision. Given all these facts, multifocal lenses, which maintain binocularity, often provide the best vision correction option for these patients. The extra incentive of these lenses: Patients don't have to switch from their distance lenses back into progressive bifocals when participating in other activities, such as computer work.

DR. KOVACICH IS AN ASSOCIATE CLINICAL PROFESSOR AND CHIEF OF THE CORNEA AND CONTACT LENS SERVICE AT THE INDIANA UNIVERSITY SCHOOL OF OPTOMETRY. ALSO, SHE IS A FELLOW IN THE AMERICAN ACADEMY OF OPTOMETRY AND HAS BEEN ACTIVE IN THE ASSOCIATION OF OPTOMETRIC CONTACT LENS EDUCATORS. E-MAIL HER AT SKO VACH@INDIANA.EDU.

Optometric Management, Issue: November 2011