editor's perspective

The Dumbing Down of Contact Lenses

BY JOSEPH T. BARR, OD, MS, EDITOR
May 2000

When I was coached into this job as editor of Contact Lens Spectrum over 10 years ago, I was told that it was best to keep it written at a very low level to make sure all of you could and would read it. Before you get upset, let me tell you that this is common in journalism. I have learned that this is true, and it works. And yet, we do have very high regard for our readers. Our surveys show us that you know your stuff. In the past couple of years, with some many good exceptions of course, we've actually tried to get a little more sophisticated and detailed. But I can't help wondering which direction is best for you, your colleagues, your staff and your patients. (Oh, and I need to make sure the publisher is not unhappy with what we do.)

We hear from most practitioners that we're doing it about right, and I work with a lot of great minds in this field who keep us on course and write what you read. But I also hear from industry sources that there are many people calling their consultation lines who, quite frankly, don't have a clue. It's hard not to believe that there are a lot of really naive people out there trying to sell contact lenses. In fact, we've known for over 20 years, even back into PMMA days, that many lenses are fitted over the phone when practitioners call the laboratory with only K readings and a refraction finding. Imagine fitting a bifocal contact lens with only this information. Imagine your primary care physician calling your pharmacist with a BP reading and a pulse, then asking for them to send the MD some medicine to sell to you. Literally thousands of contact lenses are "prescribed" this way.

Recently, bifocal contact lens manufacturers have found it increasingly necessary to dumb down their fitting directions for those who expect the first lenses to work like they do on most spherical soft lens patients. Just imagine the wide expanse between the practitioners who can do cross-cylinder problems in their heads and the ones who have to call the consultation line every time they order a lens. Even with the various levels of licensing, this field has so many levels of expertise that it certainly resembles free enterprise more than many others.

I know our sophisticated colleagues say, "no problem, those people who really want contact lenses will end up in my chair and then I'll fit them right." They're probably correct, if the patient ever gets there. If the patient persists and gets from a novice to an expert, he has a fighting chance. I see little hope that this situation will improve, what with more eye care practitioners being produced than current demand requires.

Nevertheless, we at Contact Lens Spectrum will try to help in all the ways that we can. We'll help the novice improve while challenging the expert, as we tell the ongoing story of contact lenses. Please let us know how we can help you.