Contact Lens Education
Educational Materials For You and Your Practice
These contact lens educational materials can keep you and your contact lens practice current.
By Etty Bitton, OD, MS, FAAO

As contact lens practitioners, we have two lives: one as students, continually updating our knowledge on new lens materials and examination techniques, and the other as educators, teaching our assistants, patients and interns. The need for information has never been so great. With the advent of recent technology, such as the Internet and compact discs (CDs), quicker access to information and products has become part of our everyday life.

Practitioners have traditionally maintained and upgraded their knowledge by reading journals and marketing information and attending continuing education seminars and meetings with industry representatives. However, social and financial factors influence these traditional methods. Time away from the office evokes financial concerns­lost income and traveling expenses. Time away from home presents challenges with family commitments and the care of young children.

The time needed to keep up with the literature on any subject is overwhelming for any motivated researcher, let alone a busy clinician. As a result, learning how to access educational tools in a timely manner is vital to today's contact lens educator. Several available contact lens-related teaching materials are described here to facilitate, enhance and extend contact lens instruction and its related subjects. More importantly, how to access these valuable teaching resources is also described.

Computer-Assisted Education

As access to the Internet has become commonplace, the Internet has also become a very powerful resource for education. This is true in the rapidly expanding domain of contact lenses, as new products and up-to-date research information can help you to best serve your patients. Several computer-assisted educational tools, such as CD-ROMs, photo CDs and web sites, have become available. Probably the most valuable aspect of this computer-based medium is the ability to access information in a non-linear fashion, allowing for customized searches. See Table 1 for information on how to access these materials.

CD-ROMs CD-ROM technology is not only cost-effective, but can incorporate text, high quality images and multimedia (video and sound) with the ability to view the information in a non-linear fashion. Text can be masked for self-testing and images can be viewed individually or in subsets, in predetermined or random order. Numerous CDs are available today on many topics concerning the cornea and contact lenses.

The International Association of Contact Lens Educators (IACLE) has developed a comprehensive series of modules for its contact lens course. This program provides information, collected from the world's leading contact lens educators, in the form of lectures, practical sessions and tutorials for beginner, intermediate and advanced contact lens education. Seven out of 10 predetermined modules are available in hard copy. Due to the success of this program and the high demand for the high quality images incorporated in the modules, IACLE has produced some of these modules on CD (see Table 2). Using these compact discs, which include images, video clips and text, you can structure your own lectures or redesign your existing notes in a more expedient fashion for projection or 35mm slides. These modules provide an excellent opportunity to add valuable and updated teaching resources to your library and/or your presentations. Great care has been taken to insure the accuracy of the information as well as the high image quality of the photographs and video clips.

Gerald Lowther, OD, PhD, of Indiana University and The Borish Center for Ophthalmic Research with a grant from Vistakon developed a CD, Contact Lens Series, Volume 1: Introduction to Contact Lenses, Prefitting Examination, Patient and Lens Type Selection. This CD is intended for novice students or as a review of basic concepts and terminology for assistants. Text, images, illustrations, schematics and video clips cover the following topics: basic soft, rigid and RGP lens terminology, keratometry, topography, biomicroscopy, prefitting examination, lens selection, placement and removal. Because it is easy to use, this CD is popular with students, especially for reviewing topics. The CD includes a self-contained 32-bit QuickTime player to facilitate its use.

Lifelearn Eyecare's Cornea Copia: An Interactive Visual Review Tool for Cornea and Contact Lenses is another exciting educational tool designed for eyecare professionals. This CD is a slide presentation containing 218 high quality images, with accompanying text, of the cornea and contact lenses, including RGP fluorescein patterns. The text highlights important features of the selected image. Two modes are available for viewing the CD: a browse mode which allows for selection of a particular slide or condition and a quiz mode in which the text of the selected slides is hidden until requested. The slides can be viewed in a fixed or random order.

The Rigid Gas Permeable Lens Institute (RGPLI) developed RGP Fitting Evaluation and Problem Solving. This CD promises to be a valuable teaching tool, especially for those student clinicians who have not yet had much rigid gas permeable (RGP) contact lens fitting exposure. Enhancing the student's RGP fitting experience has been a challenge for contact lens educators, as fitting opportunities are often limited within a university-based population. This CD, with incorporated video clips, will no doubt bring an additional exposure to the fitting and viewing of RGP lens adjustments.

Bausch & Lomb with the assistance of Nathan Efron, PhD, et al., has put together a photo CD, Premier Contact Lens Slide Collection. The CD holds the 100 best clinical photographs from the B&L European Symposium Slide Collection between 1987 and 1994. Subject categories include tear film; corneal epithelium, stroma and endothelium; limbal, bulbar and palpebral conjunctiva; lids and lashes; rigid and soft lenses; and a section on related pathology. For a quick reference, the insert holds a pictorial index of the 100 images with a description and slide author. This format provides quick reference for in-office use to educate patients, staff and students and easy transport for conferencing. Slides can be viewed serially or by subject matter. This non-linear viewing capability offers a diversified teaching format.

CDs have become so popular that many books are now available in this format. Other books, such as Dr. Efron's Contact Lens Complications, have CD complements. Contact Lens Complications' CD features the Efron Grading Morphs. These schematic representations enhance the clinical assessment of different contact lens complications, varying from grade 0.0 to grade 4.0 in 0.1 increments. Eight complications are depicted in a progressive scale fashion so that the viewer can slide up or down the scale to view the progression or resolution of the complication. Depicted complications include epithelial staining, epithelial microcysts, stromal neovascularization, stromal edema, endothelial blebs, endothelial polymegathism, papillary conjunctivitis and conjunctival hyperemia. It is also a valuable teaching resource to demonstrate to patients the consequences of noncompliance, such as the progression of a giant papillary conjunctivitis.

Web sites The traditional didactic teaching format fails to maintain student attention and does not promote active participation. Using web sites for course materials allows you to incorporate text, images, video clips and sound. The ability to link and search for material in a non-linear manner also allows students to customize information and reduce research time. Using web sites can also give students access to work sheets, problem sets, quizzes and updated course notes. This interactive format of learning is sure to be more efficient and more interesting for the student, which may contribute to enhanced retention of information. The use of computer-assisted independent study formats allows scheduled classtime to be dedicated to increased discussion and interpretation. Educators using this modality of instruction report that it is well received by students and makes for a more interactive class session.

Contact lens educators, like other healthcare educators, require constant information in order to provide the latest technological advances to their students, assistants and patients. To this end, the Internet has proven to be a powerful resource tool. Many professional organizations, contact lens-related manufacturers and publications have web sites which feature valuable resources such as patient and practitioner education and CE. Table 3 lists a few of these informative sites. This list is by no means comprehensive. New sites are created at a rapid rate as the need and demand for information has peaked the professional and the public's growing interest.

Information Retrieval Systems Educators, students and patients need to be informed of the latest developments in their respective areas of interest. Many do not have access to university or hospital libraries to stay current with the latest periodicals. The Internet allows remote searches with or without the full abstract of selected articles; however, many eyecare journals are not indexed by the major sites, such as Medline, leaving many worthy articles unavailable for online searches.

A huge undertaking on behalf of the library staff at the Southern College of Optometry in Memphis has addressed this problem and amalgamated into what is now referred to as VISIONET. VISIONET is a computerized comprehensive index for vision science, contact lenses, optometry and ophthalmology literature citations dating from 1976. VISIONET is updated weekly and includes all of the journals pertaining to contact lenses, whether they are on Medline or not. VISIONET offers literature searches and photocopying of articles. This vast resource is now accessible worldwide through the web. One can search by topic or keywords and obtain basic citation information such as title, journal and publication date. The educational benefits of such a resource cannot be calculated, and remote access of such useful information is an exciting and valuable resource for educators and practitioners.

Living Library The Association of Optometric Contact Lens Educator (AOCLE)'s web site features a section called Living Library. This dynamic resource on the presentation and management of various corneal and contact lens-related topics is intended for practitioners, student clinicians and educators. Each topic is condensed and presented by two contact lens educators who stay current on new developments in their particular areas of expertise and update information as the need arises. A list of key resources is included to direct the reader toward more in-depth information. This quick online reference is a convenient educational tool to help you stay current on contact lens-related topics.

Offline Educational Tools

Posters, Pocket Guides, Picture Cards How many times have you sat in your examining room, trying to explain a cornea and/or contact lens-related condition to a patient or student and wished you had a picture? You can, of course, search through atlases or web sites for the condition you are trying to illustrate; however, a more expedient way is to have a poster or card, illustrating some of the more common conditions, available right in your examining room or in a contact lens fitting area. The need for high-quality images in the form of posters or picture cards remain a valuable teaching aid because many offices are not equipped with computers or have computers that are solely dedicated to front office duties and not readily available for teaching of interns or patients.

Guide to Corneal Infiltrative Conditions Seen in Contact Lens Practice is a handy laminated fold-out guide developed by the Cornea and Contact Lens Research Unit (CCLRU) in Australia and the LV Prasad Eye Institute in India via an educational grant sponsored by CIBA Vision. This guide illustrates and tabulates eight different infiltrative conditions: microbial keratitis, contact lens-induced peripheral ulcer, contact lens-induced acute red eye, infiltrative keratitis, viral keratoconjunctivitis, superior epithelial arcuate lesion, asymptomatic infiltrative keratitis and asymptomatic infiltrate. Each image is accompanied by a description of the lesion, a severity rating, a signs and symptoms section, etiology, associated risk factors and a recommended course of management. The high quality colored photos demonstrate the extent and depth of each lesion along with a schematic diagram on how to document the condition.

CCLRU, with an educational grant from Vistakon, developed CCLRU Grading Scales to provide clinicians with a set of photographs depicting common lens-related anomalies in a poster format. Most schools/colleges of optometry in North America have these in their clinics and pre-clinic areas. These grading scales have recently become available in a laminated 8-by-11-inch card format. The following conditions are depicted and graded 1 to 4: bulbar redness, limbal redness, lid redness, lid roughness (white light and fluorescein view), corneal staining (type, depth and extent) and conjuctival staining. See this month's RGP Insights column for more information on RGP educational tools.

Videos Videos enhance and facilitate teaching of contact lenses. Available topics include fitting and evaluation, problem solving, care and handling and advanced fitting techniques. RGPLI created a video, RGP Bifocal Fitting and Troubleshooting, which uses slit lamp images to highlight important prefitting factors and aspheric multifocal and segmented translating fitting and troubleshooting. Videos are a good way of learning or reviewing material at your own pace, alone or in a group. The multimedia (visual and auditory) format of videos has made this medium a very appealing, cost-effective educational resource. The limiting factor of videos is that the information can be viewed only sequentially. Contact your sales representative for more information on videos.

Audio Tapes Vistakon made a series of audiotapes that cover several topics of interest to contact lens practitioners (see Table 1). These audio tapes offer clinical pearls by leading eyecare professionals on topics such as fitting and problem-solving for the presbyopic patient, new products, etc. These audio tapes are a relaxing way to benefit from the clinical experience of recognized guest speakers and to gain motivation to try a new product or a new approach with your patients.

Workshops Most contact lens companies offer hands-on workshops for students, faculty and staff to complement or reinforce concepts taught in the classroom. This teaching modality is very appealing to students, because they benefit from the expertise and clinical experience of eyecare professionals, other than their own faculty. The most valuable teaching tool is the hands-on experience, which complements the more traditional didactic teaching. The students can be exposed to a variety of fitting and troubleshooting cases in a very short time and benefit highly from the experience. Although this teaching modality is popular, it requires some advanced planning, but nonetheless, the benefits of hands-on experience are unmeasurable.

Academic Programs The contact lens industry has put together different academic programs to support education. These programs can help educators better teach interns and patients both the background, clinical care and management of cornea and contact lens practice. These programs are available upon request and often include a combination of the following:

• Hands-on contact lens fitting workshops
• Lectures
• New practitioner program
• Educational support materials (i.e. newsletters, web sites, chat-rooms, pamphlets, slides, videos, CDs, marketing materials and programs, etc)
• Scholarships/awards
• Contact lens residents program
• Research and association support

At the annual Association of Optometric Contact Lens Educators (AOCLE) workshop, a significant amount of time is dedicated for reviewing academic programs. This annual event is attended by educators from the nineteen North American schools/ colleges of optometry, and these academic programs are very valuable as they often complement and reinforce existing concepts. The AOCLE continues to use this resource and the contact lens industry should be congratulated for its continued innovation and support of these programs.

Conclusion

In this explosive field, educators must stay in touch with the industry and the latest research and developments. This may take many forms, from attending conferences and workshops to subscribing to newsletters and journals to connecting to the Internet for online updates. CE courses, networking and industry organizations are also invaluable resources. Becoming an active participant in contact lens-related organizations provides you with a sense of belonging and personal accomplishment and allows you to give back to the contact lens community.

Access to updated contact lens information has never been so easy. As computers and the Internet gain more penetration, computer-assisted educational tools and information retrieval systems are simplifying the research process. Web sites, CD-ROMs, photo CDs, videos, posters and pocket guides are just a few examples of the educational tools available to the busy contact lens educator. These educational tools will no doubt be part of the future of contact lens education.

To receive references via fax, call (800) 239-4684 and request document #79. (Have a fax number ready.)