Corneal Topography and Contact Lenses

JOSEPH T. BARR, O.D., M.S., EDITOR
DEC. 1996

Sometimes it's difficult to integrate new technology into contact lens practice. There are barriers -- resistance to change, unproved utility, challenged reimbursement. And there are questions -- Where does this technology fit in an efficient examination sequence? How will my technicians adapt to it? How can I justify the cost?

I'm fortunate to have worked with computerized videokeratoscopy for years and to have been educated by some of the top scholars in the field of corneal topography. I believe this technology is invaluable. A few years ago we wondered if it would replace the keratometer, now we're sure. Each day we need it to evaluate a long-term contact lens wearer for corneal irregularity, to fit a contact lens on a highly toric or irregular cornea, to monitor orthokeratology, to evaluate a keratoconus suspect or to assess a refractive surgery patient. Even for someone from the 'old school' who appreciates peripheral keratometry, enjoys reading the fluorescein pattern of a rigid lens, and likes using a hand-held keratoscope or an old-fashioned safety pin reflected off the cornea at the slit lamp, I just can't imagine life without a computerized corneal topographer.

In this issue, we describe corneal mapping, how to use it to fit contact lenses, and the practice management aspects of the modern corneal topographer. Here's one more basic question to think about. Do you want to use your old keratometer and qualitatively evaluate corneal distortion with a retinascope or ophthalmoscope? Or would you rather show your patient a color corneal contour map of his condition like the other eye doctor down the street does?

In other words, if you want to provide the highest standard of care for your patients, give yourself and your staff a sense of pride and satisfaction, or even ensure your legal position via photo-documentation of your at-risk contact lens or refractive surgery patients, then get a corneal mapping system. Sure, reimbursement is a challenge. It is for everything! But this technology makes you a better, more efficient doctor with a better, more efficient practice. Read on. We'll show you how. CLS