TINTED LENSES
Make the Most of Today's Colored Lenses
Newer developments in colored lens technology provide exciting practice-building opportunities for both cosmetic and specialty applications.
By Glenda B. Secor, OD, FAAO

New developments in contact lens technology have given the eyecare industry real optimism that the potential for market growth does exist. We know that contact lenses generate enthusiasm and build practices. Numerous studies and experts have touted the message that contact lens patients are more profitable, loyal and compliant with regular eye care than are spectacle patients.

With the plethora of available tinted lens options, today's contact lens enthusiasts can choose from among subtle to bold changes in both their eye color and personal statements, while specialty tinted lenses can help patients with their sports performance or improve a patient's self image following eye injury or disease.

Changing with the Times

Fortunately for our industry, the vision correction and contact lens needs of our patients increase with age and change over time. Manufacturers didn't classify the first light blue or green visibility tinted lenses as colored lenses and they didn't design them to change eye color (although some light-eyed unilateral wearers noticed a difference in their eye color with these lenses). Today's patients complain if lenses don't have a visibility tint. Obviously, this tint helps with lens handling and reduces potential loss when patients drop the lenses.

Baby boomers long ago embraced contact lenses, and now the baby boomlets (or Generation X) appear poised for a similar long-term love affair with this vision correction option. But the emotional needs of this new group of devotees has prompted progressive-thinking practitioners to realize that simply changing eye color can improve a patient's self esteem and self image, not to mention that it's affordable and fun.

Issues that discouraged practitioners from fitting this modality during the the early days of tinted lenses included higher expense, unnatural appearance, poor reproducibility and annoying fitting problems. Fortunately for practitioners and patients, manufacturers have addressed these issues. Companies have changed their designs so that the lenses fit better, feel better and look better. Such lenses are frequently available in disposable designs that are often quite affordable.

Figures 1 (top) and 2. Opaque prosthetic contact lenses helped restore this patient's confidence in her self image after her right eye was scarred by trauma.

Become Proactive

Industry surveys indicate that only 12 percent to 14 percent of current contact lens wearers wear cosmetic colored lenses. Similar reports indicate that approximately 33 percent of these lenses sold in the United States are plano. We also know that a high consumer interest in colored contact lenses exists. However, patients who would wear them often just don't know that their prescription is available in colored lenses or that a slight or dramatic change in their eye color is possible.

So why haven't the masses of providers and seekers joined to fill this unmet need? The obstacle appears to be practitioner hesitation to offer the option when discussing contact lenses. Patients typically don't know or don't dare to ask. So what can you do to change this and boost your colored lens fits?

The staff person scheduling the initial appointment should first determine a patient's desire by simply asking, "Are you interested in wearing contact lenses to change your eye color?" Asking patients about the opportunity to change eye color can enhance the message and reinforce any written information that you provide or point-of-purchase materials that manufacturers offer. Additionally, because patients have multiple lifestyles, you may also increase their interest if you offer tinted lenses for part-time wear.

Patient selection for tinted lenses can include new, existing or former lens wearers, as well as patients who don't require vision correction. Young female patients are almost always interested in colored lenses, and they ask the most questions.

Cosmetic lens wearers usually have one preferred color, but more and more they're opting to switch between two or more colors. The obvious benefit of offering multiple options of clear and tinted lenses to patients is the excitement generated. Studies have indicated that this excitement increases patient satisfaction, referrals and practice profitability. And you may often find unknown refractive errors in patients who seek colored lenses but haven't had an eye examination in many years.

Cosmetic Lens Options

Enhancement tinted lenses offer subtle color changes in light-eyed patients by slightly overlapping the iris. Some fitters lean on the steep rather than the flat fitting approach to encourage centration with these lenses. Enhancement lenses don't have a clear pupil, which can possibly influence the color perception in color-sensitive patients. But, unless this color shift professionally challenges a patient, it rarely amounts to more than just a passing comment.

Opaque lenses are ideal for dark irides. Patients who are heterochromic, who desire a more dramatic color change or who desire to lighten the appearance of their eyes require opaque lenses. Successful fitting of opaque lenses is more critical for a patient's enthusiasm as compared to fitting non-opaque tinted lenses. Patients who have corneal curvatures that are excessively flat, steep or highly astigmatic may experience more problems with lens centration. The artificial iris and pupil size of opaque lenses can adversely influence proper lens alignment in cases of large corneal or pupil diameters. The artificial pupil may also affect the peripheral field during mesopic or low light conditions. Proper education often alleviates concerns when patient symptoms occur.

An industry first for both light and dark eyes are illuminating lenses that allow for more definition of the existing iris color without changing the natural eye color. These lenses feature a clear center, an inner starburst sparkle pattern and an outer charcoal outline. Patients who have peripheral arcus changes that have reduced the natural coloration of the limbal cornea especially notice an improved cosmetic appearance with these lenses.

Specialty Uses for Tinted Lenses

Tinted contact lenses are available that are purported to help athletes improve their performance and gain an advantage over their competitors. Improving contrast and reducing glare can motivate these patients to try tinted contact lenses for sports such as tennis, baseball or golf.

Incorporating a red-tinted lens on one eye may potentially reduce color deficiencies. X-Chrome lenses have had varying amounts of success depending upon a patient's level of color deficiency and the practitioner's enthusiasm. Use the red lens from your conventional trial lens set or the red filter end of conventional cover paddles when color deficient patients view a standard color vision test to determine the potential for success.

Novelty lenses strongly attract a youthful audience, whether of mental or chronological age. Although these lenses may not appeal to mainstream patients, wearers may now choose to proudly wear their favorite animal eyes, alien eyes, football team logo and many other designs as eye "blink blink," or jewelry. Remind your patients that these, like all contact lenses, are medical devices that require care and solo ownership.

The most rewarding tinted lens experience that I've had is working with prosthetic lenses. Patients who have scarred corneas or irregular pupils can feel much more confident when they wear opaque tinted lenses on one or both eyes (Figures 1 and 2). Existing options for prosthetic needs include single- or double-colored print designs over a black or gray background. Clear or black pupil designs are available to match or create matching eye colors. If you are unable to match an existing iris color, then simply fitting a similar opaque tinted lens on the non-affected eye can achieve a balanced appearance.

If current commercially available prosthetic lenses are unacceptable for a patient's needs or desired outcome, then you can turn to several companies that offer custom tinting for unique color hues, diameters and pupil needs. A variety of lens materials and designs are available. A photograph of the fellow eye helps ensure a better match and improves the cosmesis of the ultimate lens.

Black pupil tinted lenses can also act as occluders. You can use an opaque black pupil contact lens to reduce double vision because the tint eliminates all light entering the eye. Opaque pupil contact lenses also help eliminate patient compliance issues related to traditional conventional eye patching or occlusion therapy in infants, children and vision therapy patients.

Streamline Your Fitting Process

Incorporating tinted lenses into a mainstream contact lens practice is easier than you may realize. You can simplify the color trial by limiting the choices that you offer to patients. You can also narrow your choices by asking patients if they want a lighter vs. darker eye color or a subtle vs. bold appearance. A time-efficient process for your staff guides patients to a choice without allowing them to "shop."

Because diagnostic lenses rarely come in a patient's prescription, prescribe a visibility-tinted lens first to ensure success with the fitting aspects of the lens. To help patients get a sense of how a colored lens will appear on their eyes, try piggy-backing a tinted diagnostic lens over a powered lens so that patients who have high ametropias can see the difference. Manufacturers have outstanding sales aids such as color paddles to virtually view the appearance of tinted lenses. Also, companies have incorporated unique ways to identify diagnostic lenses to reduce pilferage and lost sales.

For patients who have several different colors in their contact lens wardrobe, recommend different colored cases to help them easily locate a particular pair of lenses and so reduce unnecessary contamination from mishandling. Multiple pairs also make it more challenging to remember replacement schedules. Encouraging patients to replace their disposable tinted lenses on a routine basis regardless of the number of times that they've worn the lenses may reduce infection risk from soiled lenses. Disinfecting lenses before wearing may also help reduce infection risk, and I recommend simply replacing the soaking solution each night or within 24 hours of lens wear.

Don't Miss a Great Opportunity

We realize that contact lens patients love options, and with today's availability of tinted lenses in many new designs and colors, the opportunity has never been greater. The biggest obstacle is getting practitioners to offer the option when discussing contact lenses. The diagnostic process is easy, especially if a patient already wears a design that offers tinted lenses. Practitioners can then quickly verify the fitting aspects and reinforce the compliance requirements.

Cosmetic contact lenses are definitely a practice builder. They can entice people into our practices, encourage them to try contact lenses and promote multiple options. The enthusiasm that tinted lenses bring to a patient and a practice is contagious and benefits everyone.

Editor's Note: To see the many colored lens options currently available, visit www.clspectrum.com/CLASS.