Resolving To Fit Torics

BY THOMAS G. QUINN, O.D., M.S.
JAN. 1996

Doesn't it give you a warm and fuzzy feeling when you hear, "My vision has never been so clear, Doc!"? So why do many of us shy away from fully correcting the vision of our astigmatic patients?

We have two great tools to help us serve this population: gas permeable lenses and toric soft lenses. I've talked about the gas permeable lens candidate (Spectrum, Mar. '95). Here's how I approach the soft toric candidate.

ESTABLISH A BALANCE

Educate your patient without overwhelming. The process begins while the patient is behind the phoropter. After completing the refraction, I demonstrate the deleterious effect of removing the astigmatic correction. This clearly shows the patient the benefit of correcting astigmatism. Astigmatism is no longer just a strange word but a very real and personal condition.

A professionally done schematic depicting light entering an astigmatic cornea and focusing at disparate points will help you illustrate that astigmatism is a shape issue, not a health issue. It also helps the patient understand why he needs a specially shaped contact lens to correct vision.

PRESENT FEES

Now that the patient understands the need for and the benefits of a special lens design, he's prepared for the greater expense of toric lenses.

We provide the patient with a handout illustrating toric soft lens options (see Table 1). This table lists the advantages, disadvantages and cost of each option and shows the patient the growing list of advantages compared to disadvantages for frequent replacement lenses. Before you discuss this handout, make sure the patient's refractive correction is available in the more limited parameters offered in toric frequent replacement designs.

SET EXPECTATIONS

You've convinced the patient that a toric soft lens is the best option and he's agreed to foot the bill. But what about the increased chair time? What about the possible need to reorder numerous lenses?

Make sure you both know what to expect. Be prepared to spend more time with your astigmatic patients and set your fees accordingly. You'll be more willing to take the time to optimally serve these patients when you know that your time is covered.

Let the patient know that due to the more sophisticated nature of toric lenses, reorders are often necessary to arrive at the best contact lens prescription. Since astigmatic patients want to see well, they'll be very willing to work with you to achieve this goal. CLS

Dr. Quinn has served as a faculty member and research associate at The OSU College of Optometry. He's in group practice in Athens, Ohio.