editor's perspective
Options, New Products and Commentary

A former student recently told me that he believed he was taught to offer patients options. I firmly told him that we now make recommendations. Now, before my legal colleagues say that patients need options or we'll be in greater legal liability, let me be clear. I'm saying, make a recommendation but say there are options. Most patients expect us to tell them what's best for them. You get paid for being a trained practitioner, and you need to be so confident in your recommendation that you're willing to write it on a prescription form, even if it's an over-the-counter product. If the patient chooses the recommendation, great! If it doesn't work, offer an option.

We have great new products to recommend. Silicone hydrogels, better hydrogels, solutions and specialty lenses. Here are some recent observations:

• Silicone hydrogels offer many benefits for most patients, and we have a number of them. If one doesn't work due to deposits or GPC or whatever, try another. They're not all the same. If you try a couple and they don't work, there are new hydrogels that dehydrate less, are very biocompatible and work well for daily wear. Also keep in mind that new daily disposable lenses help wet the eye while they're worn. All of these lenses can be comfortable all day long if you match each patient to the right lens and solution.

• Pay attention to the solutions your patients use. Make sure that you understand from solution manufacturers about product and material compatibility. And by all means, make sure patients are compliant with lens care cleaning, rubbing, rinsing, fresh solution and a clean — even antimicrobial — case.

• Many of you want to know what multifocal works. They all do — and don't. Choose a multifocal and a bifocal and learn how to use them well. Use a lab you can communicate with. Pick your presbyopes wisely and you'll have great success.

Finally, I wrote a commentary in the July 30th issue of our Internet publication CLToday (www.cltoday.com) about the possible introduction of a lens made by a lab owned by a well-known Internet/mail-order company. I said that a new lens, made of unknown material, in a unique package, would increase competition and be good for the contact lens field. A few members of a popular message board made what some of my colleagues felt were derogatory comments about me. Frankly, I thought they were just naive, uninformed and paranoid remarks and I didn't want to engage in such controversy, but I've been persuaded otherwise. They said these things on-line and not to me. They said I'm an academic. Correct, guilty and proud of it. They said, "What would an academic know about competition?" To those who made these remarks, if you want to comment about me, my e-mail is cltoday@lwwvisioncare.com. Please also understand that I'm responsible for an academic clinic that competes in a very overpopulated eyecare practitioner city, and we compete very well. We don't lose money because we recommend the best new products and we have smart people in our organization, like most other academic clinics. We code well and we market ourselves very productively. I hope you do, too.