editor's perspective
Across the Pond
BY JOSEPH T. BARR, OD, MS, FAAO, EDITOR

The British Contact Lens Association Clinical Conference and Exhibition held May 24-26 in Birmingham, England, was excellent as usual.

David Ruston reiterated that presbyopes who try bifocal lenses will like them about one-third of the time, while approximately 40 percent prefer monovision and the remainder prefer spectacles. He astutely noted that, when they translate, center-distance lenses help near vision, and center-near lenses make near vision worse.

Lyndon Jones suggested that a fifth material group (beyond the current four-group FDA system) may be needed to classify silicone hydrogel lenses. Ralph Stone recently suggested a similar proposal.

Trusit Dave pointed out that spherical aberration correction in aspheric lenses is specific to the lens power, not to the patient. He suggests that wavefront analysis may be used over trial diagnostic lenses in the future to specify front surface aberration correction the eye and lens may need. He later demonstrated a case of reduced aberration on a keratoconus eye with a flat GP lens fit as compared to a steep fit.

Jane Veys' study of contact lens dropouts indicates that using new technology to refit all dropouts in the UK market could result in one million new wearers. This would translate to over 10 million successful former dropouts in the United States.

Hikaru Hamano reviewed his career work investigating contact lenses and ocular physiology. At age 80, Professor Hamano impressed the audience with his vast array of contributions to the field.

Fiona Stapleton's study of personality and contact lens success indicates that people who need control may be less likely to succeed.

In one of the wittiest presentations, Brian Tomkins and Shelly Bansal, mimicking the famous British comedian talk show "Baddiel and Skinner Unplanned," presented a practical patient management of GP multifocal lenses. They discussed making sure the patient understands the value of your service and quoted Pat Caroline's three R's of multifocal lens fitting: Refit, Refit, Refund. But seriously, some of their comic tips are worth considering, such as not fitting patients who fold their pajamas or have creases in their jeans. They reviewed how to efficiently perform the chat and fitting visit - order empirically. At the collection visit, put the lenses on and have the patient look at a park, at a newspaper and then send him home. Don't worry about corneal distortion from these lenses, it's just like having tight knickers.

You can find good contact lens CE and research presentations in the United States, but consider the BCLA meeting for a real contact lens extravaganza.