Article

CLINICAL: Contact Lenses

Implement Contact Lens Technology

Technology can help take care to the next level. One example: topographers

Contact lens technology is an area that has continued to advance rapidly. Equipment developments in topography can aid us in both diagnostics and specialty lens care. We should take inventory of what contact lens technology we have and what purchases may help in the strategic growth of our contact lens business.

For example, here is a look at two areas in which topographers can aid in contact lens patient outcomes.

Topography results shown above verify ortho-k lens placement.
Image courtesy of Dr. Jason Miller

1 ORTHOKERATOLOGY

To offer advanced orthokeratology and specialty contact lens fits, I’ve found that a good topographer is a must. We want to identify a brand and model that provides quality topographical maps to aid us in placing and assessing the effectiveness of the lens.

For example: A 10-year-old female patient recently jumped in myopia from -1.00 DS OU to -1.75 OU over 11 months. We discussed the advantages of orthokeratology and potentially slowing the myopic shift and axial length elongation. The patient and her parents agreed this would be a great option for her. I captured the images (one below) before and after the fit. It was evident the lenses were centered and flattening the central cornea, which was the goal.

2 DRYNESS

When it comes to determining whether a patient has true dry eye disease (DED) or contact lens-related DED, software within the topographer can provide advanced information about the patient’s tear film. Specifically, objective measurements of the patient’s tear film meniscus, non-invasive TBUT and a meibomian gland evaluation may reveal underlying advanced DED.

When a patient presents with dryness symptoms during contact lens wear, this information is valuable in deciding whether to have the patient remove the contact lens, initiate a DED treatment protocol or simply use a different contact lens.

Take this case for example: A 38-year-old male new patient presented with intermittent blurriness and contact lens discomfort. He was wearing daily disposable lenses and had been on the computer more often throughout this pandemic. Upon evaluation of his ocular surface, he had a reduced TBUT and moderate meibomian gland disease. I discussed with the patient that, instead of re-fitting him into a different contact lens, I would like to treat his underlying DED first, as it is important to get that under control because he will most likely have the same symptoms with any type of contact lens.

EVALUATE TECHNOLOGY

Topographers also help in troubleshooting and fixing clinical concerns, as advanced information allows us to improve outcomes. With more and improved information as a foundation for treating a patient, an improved treatment plan will result.

These are a few examples of how technology can improve outcomes. Let’s evaluate our technology and look for ways to take our care to the next level. OM