I am a CLO who passionately loves what I do and I do not hold back from letting it show.
Contact lenses literally changed my life and I truly believe they have the potential to do the same for many. My personal story is fairly typical I imagine. I was a highly myopic teenager who, after finishing and doing well in my O-levels, was finally allowed to get contact lenses. On returning to school as a sixth former I was literally transformed – no longer the awkward, lanky, spectacle wearing girl.
I was wearing what I, at the time, thought were stylish clothes (no uniform). I had had a perm (it was the 80s after all) and, most noticeable, no more specs. My life totally changed. My peers accepted me more readily, boys started to notice me (I am not sure my parents shared my enthusiasm in this) and my confidence grew in all areas of my life.
Benefits from fitting young and old
And now I have the great pleasure of witnessing that change in others whom I fit. It is true to say that, thankfully, the stigma of spectacle wearing has dramatically lessened in recent years, but still the teasing and bullying goes on. I absolutely love fitting children with lenses – it is a particular passion of mine and is so rewarding.
You witness these bespectacled children, sometimes with high prescriptions and low self-esteem, literally blossom in front of your eyes. They do not mind expressing their wonder and excitement – and this is contagious and real ‘joy spreading’ stuff. You, of course, know already how the chair time rarely differs from that of fitting adults.
These patients stay with you and your practice as they mature, bringing with them the custom of their siblings, friends and other family members. This is great for your reputation, revenue and overall business as they all need spectacles to wear too. It makes you feel valued as a practitioner giving great job satisfaction.
I am not just enthusiastic about fitting youngsters, but have some great times with the older among us too. Up until last week, my oldest first time wearer was a 78-year-old man who wanted lenses for golf. But last week I met an 83-year-old woman who wanted to wear lenses for her granddaughter’s wedding in July – and so she shall.
Worth the effort
I find, like most things in life, we get out what we put in and contact lens practice is no different. I get to work early or sometimes stay late preparing for my upcoming clinics, looking up all patient histories, ensuring I am familiar with any previous problems and advice given. This enables me to relax and enjoy my patient time, allowing more opportunity to find out how they are really getting on with their lens wear.
Time prevents me mentioning all the experiences I have enjoyed thus far in practising as a CLO but I would like to share a few with you.
I recently was lucky enough to enjoy the rewarding experience of fitting a terminally ill patient with cosmetic sclerals. Due to her illness, she had significant scleral yellowing in both eyes and was too self-conscious to venture out. So she approached me for help. I had no previous experience of fitting anything of this nature, but accepted the challenge. The result was one of the most emotionally fulfilling experiences I have ever had with a patient. She left after just a few visits with her head held high for the first time in a very long time, confident with natural looking white scleras, with hand painted tiny vessels just visible too (figure 1).1
More recently I met a gentle, kind man who is also in very poor health. He is HIV+, diabetic and two years ago had to have his leg amputated just above the knee. When I first met him his eyes were in a bit of a state. He had severe blepharitis, MGD, extensive corneal staining and many infiltrates. He had been suffering with uncomfortable, sore, epiphoric eyes for many months and just assumed it was another aspect of his health condition that could not be helped. Needless to say I did not fit him with CLs but what I did do was chat to him about my findings and set out a plan of action to help his situation improve.
After a few visits and him diligently following all advice with use of lid wipes, hot compress devices and good quality lubrication eye drops his MGD and blepharitis are much improved. His corneas are almost free from infiltrates and much less staining is evident. He is so appreciative and although perhaps not the most ideal patient to come across in a CL clinic we both view his visit as being a great success. I’m also keeping open minded about fitting him with a suitable product in the future. His condition has so dramatically improved in a relatively short period of time, it may indeed be possible for him to occasionally wear single use lenses in the coming months.
A few years ago I met a patient with phocomelia as a result of the thalidomide drug. She wanted to wear lenses but had just been told it was unwise for her. She felt they had assumed she would not be able to cope with handling. I noticed this patient was wearing eye makeup and reasoned (like most practitioners, I am sure) that if she can use cosmetics she can use lenses. I checked that the previous practitioner’s concern was not of an ocular nature by doing all the usual checks and went ahead and fitted her. Her ‘teach’ was a totally incredible experience in itself. It is quite amazing how adaptable those with disabilities are and of course her determination and motivation helped. She successfully inserted and removed her lenses and became a healthy, confident lens wearer. Another appreciative patient who bought a ‘sparkle’ to my day and was definitely inspiring.
I regularly see an SSI patient who I took over caring for several years ago who finds wearing high plus lenses enable her to appreciate her home surroundings better, giving her a little more independence. So although technically little to no improvement is seen in the room with HM or VAs this patient is extremely happy with her lenswear and yes, you guessed it, is very appreciative and always asks to see me personally which is really lovely and provides me with huge job satisfaction. Thinking out of the box is sometimes needed.
My partner is partially sighted due to extensive myopic degenerative retinal atrophy with associated field loss and reduced acuity in both eyes. He has had a few retinal detachments over the years (figure 2). Having been alongside some of his journey, this insight into the world of the visually challenged has given me a practical application that perhaps education alone cannot provide. I am truly thankful for this aspect of my life which I feel enhances my role as a practitioner and perhaps contributes to my patience and understanding.
Incidently before he had cataract surgery with post surgery complications he was another ‘unusual’ patient I saw in practice. He had worn RGPs for many years and was experiencing constant foreign body sensation with lenses in situ, dramatically reducing his wear time, so I refitted him with custom made soft torics that enabled comfortable lenswear for several years. His rx at that time was around -20.00 with a -3.75 cyl. Perhaps these days I would have tried a hybrid or suchlike. We are so blessed to have such a huge array of products at our fingertips and excellent technical support teams to educate and guide us in fitting them even if for the very first time.
Of course not every day in practice brings such delights and challenges to our doors but on a ‘regular’ clinic day I enjoy taking the extra time available to get to know my patient, have a chat, be friendly and approachable. These kinds of bonds will keep the patient returning to me year after year and enables me to truly enjoy and look forward to their visits.
You may assume from my comments that I work in independent practice enjoying lengthy appointment times. Alas, at present, like most CLOs, I work in the crazily busy world of the multiple where there is constant pressure on meeting the demands of chair time.
I personally find that by spending that extra time in clinic preparation and having great support staff enables me to give each of my patients the time they deserve in a relaxed, friendly and professional environment.
So in conclusion how do I keep enthusiastic? I try hard not to stagnate but constantly move forward and keep learning. I attend courses and conferences where possible and if circumstances do not permit attendance, I read the highlights in the journals afterwards. If there is anything I do not understand, I research it or ask my brilliant colleagues thus improving my knowledge. This keeps things interesting, keeps me motivated, brings me joy at knowing I am giving of my best and most of all this helps me to keep loving what I do.
I never say no to new experiences, doing my best to accept the challenges alongside the norm. I try really hard not to pre-judge a situation (or patient) assuming I cannot care for them because I have never done something like it before. As you can see this has led to some wonderful times and me thoroughly enjoying my patient and letting them enjoy me.
What beautiful experiences await us all in our next clinic I wonder?
References
1 Dispensing Optics, March edition, page 26.
