View from the High Street: Not just a soft option
Judy Lea ponders the difference contact lenses can make to patients
Author: Judy Lea
Contact lenses have always been an integral part of our offer to patients. Over the years that I have worked in optometry, they have changed and developed incredibly. I always remember my first exposure to contact lenses was fitting scleral lenses on fellow students. It certainly made us have empathy with our patients, having experienced that discomfort for ourselves. Maybe it is an experience that current optometry students miss out on? The first-choice lens was always gas permeable then, as it was the far safer and more healthy option, but thankfully now with the innovations of soft lens materials, the first-choice lens for patients and practitioners has moved towards the newer soft lens. Our pre-registration students, searching for that elusive gas permeable lens fitting experience, may be the only ones who wish GP lenses were still popular with patients.
There does seem to be a change though in our patients – not just that they don’t want to wear gas permeable lenses unless they have to. As spectacles have become much more fashionable, patients aren’t concerned about being seen out in public in them and do not want to wear contact lenses at all costs. They now see lenses as an additional option and will often just wear them for social events, with spectacles being part of their outfits during the day. This means that we have seen a trend towards more sales of daily lenses rather than those on monthly schemes.
However, there are still some patients who feel restricted by spectacle wear, whether in sport or social situations. We recently had a very shy eight-year old, who was very hyperopic with a convergent squint when he didn’t wear his spectacles. His mum was convinced that he would be a different child if he could wear contact lenses. I didn’t feel that he particularly wanted the lenses, so was a little reserved about his motivation and whether he would persevere. With the encouragement of his mum we went ahead with the fitting and the change in him was amazing. He returned for follow ups and became a very confident child, who started to experiment with trendy clothes and haircuts. His mum reported that his schoolwork had improved so dramatically that he had moved from the second to bottom set to the top set of seven! It may have been coincidence, but I’m pretty certain it was the magic effect of contact lens wear.
The other patients who get the wow effect from contact lenses are those who suffer from severe dry eye and are fitted with bandage lenses in the hospital clinic where I work once a week. Having suffered with dry eyes and severe discomfort for so long, usually the last thing they want to consider is having a foreign body inserted in their eye, but the immediate relief when you persuade them to try them gives such job satisfaction.
In practice we have always encouraged our practitioners to offer patients the option of contact lenses if deemed appropriate, along with the various spectacle lens options that may be suitable for them. We may know about contact lenses, but that doesn’t mean that our patients do. We have certainly been supported by having a contact lens optician working for us over recent years. By doing nothing but contact lenses they have far more knowledge of products and the experience to deal with the more challenging patients who I would probably accept as being unsuitable if I was dealing with them alone.
I remember a discussion with colleagues about whether we would rather have someone who did a little bit of everything dealing with our specific medical needs or have someone who did it all day, every day and therefore became an expert. I know what the answer is for me and as our practice grew, particularly located in an area where optometrists are still in relatively short supply, it made sense to employ a contact lens optician. They can concentrate on recommending the best contact lenses for each patient and seem to be better at upgrading patients to better lens materials by having the time and experience to explain the benefits. For patients with more complex needs, they will usually have come across similar cases previously and know what was and what was not successful.
As a practice, our strength is in teamwork. We work together as a team, but we use one another’s strengths and skills for the benefit of our patients so that they get the most expert advice and service possible. I certainly hope that our contact lens patients realise that, particularly the many who we have been able to successfully fit with contact lenses, even though they thought that they ‘couldn’t wear contact lenses’. I await the seasonal increase in requests for ‘Halloween lenses’ and will leave the inevitable discussions about hygiene and not sharing with friends to our ever-able contact lens optician.
Judy Lea is optometrist director of Specsavers, Longton, Staffordshire.