Contact Lens Practice Pearls

Increase Your Toric Contact Lens Prescribing

BY JASON R. MILLER, OD, MBA, FAAO

Patients drop out of contact lens wear for various reasons, including inadequate visual correction. Spherical equivalent lenses are often prescribed to mask cylinder in patients who have mild-to-moderate levels of astigmatism. Such patients' vision could be more effectively corrected with many of today's astigmatic contact lens options, including many of the daily disposable toric options.

There is significant value in correcting low-astigmatic patients. We know that uncorrected astigmatism results in distorted or blurred vision and a loss in "crispness" of visual acuity. It can also cause headaches and eye fatigue. We may be able to eliminate many of these issues by correcting even low amounts of astigmatism.

If there is any doubt, hold a trial lens with the cylinder power in front of patients' spherical-only correction and ask which they prefer. Demonstrating the astigmatic correction over their current spherical prescription, which you can also do with a phoropter, is a powerful tool.

After showing the astigmatic correction to patients, turn the cylinder axis. Explain that this lens has variable powers that have to line up perfectly to provide the best vision possible. This demonstration helps patients understand the importance of stability in their contact lenses as well as the value of your fitting process.

Why You Should Consider Maximizing Toric Prescribing

Increasing the number of new contact lens wearers is just as important as minimizing dropouts. If you can convince astigmatic patients to try contact lenses, it might result in a significant surge in revenue for your practice.

Unfortunately, not many patients have a solid understanding of what astigmatism is. Some even associate the term with a disease state. Be sure to explain that it is simply a different way of focusing images. Educate your patients about astigmatism and utilize the newest technology in contact lenses to meet their visual needs.

Many of these patients have been told that they are not good candidates for contact lenses because of their astigmatism. Some practitioners may not offer contact lenses to certain astigmatic patients because of the additional chair time needed or because they believe that patients will balk at the increased professional and material fees.

However, proactive contact lens practitioners realize that there are very few astigmatic prescriptions that cannot be accommodated with contact lenses, thanks to new lens materials and power availabilities. New materials and modalities provide improved ocular health benefits, and your patients need to be aware of this. Silicone hydrogel lenses offer improved oxygen permeability, and daily disposable lenses offer viable options for both parttime and full-time wearers. By offering patients options that may not have been presented to them in the past, forward-thinking practitioners develop stronger relationships with their patients.

Individualize Contact Lens Selection

With the many soft toric contact lens options available, you have the opportunity to offer patients a unique experience by customizing their contact lenses to suit their individual needs.

Daily disposable contact lenses offer many advantages, most particularly convenience. This may be exactly what some patients are looking for and will highlight your ability to not only correct patients' astigmatism, but also to fit them with the newest daily disposable technology.

So take the plunge and focus on increasing your toric lens prescribing. CLS

Dr. Miller is in a partnership private practice in Powell, Ohio, and is an adjunct faculty member for The Ohio State University College of Optometry. He has received honoraria for writing, speaking, acting in an advisory capacity, or research from Alcon, Allergan, CooperVision, and Visioneering Technologies. You can reach him at drmiller@eyecarepowell.com.