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With a new corporate identity and a series of packed roadshows throughout the UK, CooperVision is a company intent on raising its profile. The speakers at the events included some of the best-known academics and clinicians in the contact lens arena and, despite the heavy schedule, none showed any sign of fading at the final roadshow event in Savoy Place, London earlier in the year.
Introducing the event, professional relations manager Karl Aberdeen outlined the theme for the day by reminding delegates that contact lenses are suitable for people at all stages of life and it is up to practitioners to ensure the public is aware of this.
This led perfectly into a presentation by Professor Bruce Evans (City University and Institute of Optometry). Evans has been known for many years as an expert in paediatric binocular vision but, in the flesh, is keen to point out his practice has a significant contact lens business and children should never be excluded from this. The CooperVision roadshows include an opportunity to spend some time in a more informal setting with the speakers and this sort of opportunity represents a big step forward in CET events.
Kids and communication
Contact lenses can make a big difference to a child's life, Evans pointed out, and the motivating factors are similar to those for adults: cosmesis, sport and improved visual function. But each of these factors is more likely to apply to a child than to an adult.
In particular, the word 'cosmesis' underestimates the impact contact lenses can have on children's self-image and confidence. Spectacle wear can trigger bullying and poor self-esteem. Contact lenses can liberate children from these problems. Indeed, research has shown that, among eight-year-olds, spectacle wearers are 35 per cent more likely to suffer bullying.
Next up was current BCLA president Shelley Bansal, who, in his own inimitable way, explained how communication is the key to maintaining a satisfied and loyal patient base.
Tips included summarising the information you collate during initial questioning before starting the clinical examination. This not only ensures a focused clinical approach but emphasises to the patient that you have been listening. Also, at the conclusion of the examination, make a point of saying when you want to see them again and ensure that they hear you making any recommendations to other colleagues.
The ageing debate
Asymptomatic hydrogel wearers appear to have normal corneas. However, research shows the cornea changes with age and with contact lens wear, even in asymptomatic patients. Proposing that the corneas are normal were Craig Wilcox and Professor Evans, while arguing against normality were Dr Phil Morgan and Professor Noel Brennan.
The afternoon continued with Brennan expanding on his description of how age changes the eye. The ageing eye undergoes a number of changes, such as decreased accommodation and increased risk of certain diseases, such as cataract, glaucoma and age-related maculopathy.
While less dramatic, changes to the ocular surface may play a significant role in an older person's ability to wear contact lenses. Decreased tear flow, leading to dry eye symptoms, is one prominent example and the relation to contact lens discomfort has been the subject of considerable research leading to improvements in materials.
Other changes include those of an optical nature, leading to increased against-the-rule astigmatism, an altered aberration profile and decreased transparency. Physiological changes include decreased endothelial cell density and increased polymegethism, a trend toward reduced stromal keratocyte density with age and a reduction in the number and complexity of corneal nerve fibres.
Safety with contact lens wear tends to increase with the age of the wearer in the incidence of infection and inflammation. The reasons for this are uncertain but may relate to risk-taking behaviour in the young or exposure of the immune system to a wider range of micro-organisms over time.
Wilcox gave an excellent review of how different styles of communication improve presbyopic management. A major challenge to successful multifocal fitting has to be clinical communication.
Trend towards toric
The final speaker of the day was the ever-entertaining and informative Dr Phil Morgan, who described how the number of patients fitted with soft toric contact lenses has increased dramatically in recent years. Currently, about 30 per cent of all soft contact lenses fitted in the UK are torics.
However, this is still short of the number of astigmats who would benefit from a 0.75DC correction, suggesting there remains some reluctance to fit these lenses, perhaps especially in the low cyl category.
Most delegates to these events are familiar with VRICS-style CET exercises. The CooperVision events included a video-based exercise, a definite improvement on stills images for this subject area. This was the second year CooperVision has run such events. I can only look forward to more to come. ?