Contact Lenses

Serve Astigmatic CL Patients: Prescribe Newest Toric Lenses

By Mike Rothschild, OD


Put astigmatic patients in the newest toric lenses on the market. The advanced lens technology will turn them into satisfied, long-term contact lens patients.

Advancements in toric contact lenses has made fitting astigmatic patients in contact lenses a much easier process for both doctors and patients than in years past. With usually no need for additional measurements and follow-ups than would be required for any other contact lens patient, the new torics allow ODs to provide contacts for nearly all of their astigmatic patients. Here are some points to keep in mind when serving astigmatic contact lens patients.

The New Toric Lenses: Easy to Fit, No Additional Chair Time Needed

ODs used to shy away from fitting patients in toric contact lenses because of all the extra steps that used to be necessary to make sure the lenses didn’t rotate too much causing the patient’s vision to blur. For that reason, many ODs used to encourage patients with small amounts of astigmatism to wear glasses, or would prescribe uncomfortable gas permeable lenses for them.

The newest toric lenses, such as Air Optix for Astigmatism, do not rotate much, if at all, and if they do, they are designed well enough that that the patient usually does not experience noticeable blurriness.

Now we can give astigmatic patients the same amount of comfort and clarity of vision that we can give any other patient in contact lenses. That is great news for patients who may have been told by eye doctors throughout their life that they cannot wear contact lenses, and good news for ODs, as well. For most astigmatic patients, fitting toric lenses requires no more chair time than fitting spherical lenses. Close to 100 percent of the time in my practice, the trial lens the patient is given becomes the lens that is ordered for them–that’s how little additional adjustment of power is necessary with new toric lenses like Air Optix for Astigmatism.

Dropout Rate of Toric CL Patients Same as Spherical CL Patients

We fit about 1,000 contact lens patients (20 percent in torics) in my practice last year, and of those 1,000 contact lens patients, only around 5 percent drop out of contact lenses. That percentage is the same for those in spherical and toric lenses. That there is no difference between the dropout rates of these two groups of patients indicates that there is no difference in comfort level for astigmatic contact lens patients when the right toric lens is prescribed.

No Specialized Instrumentation Needed

With toric lens fitting years ago such a difficult process, a corneal topographer was often needed. Today, with torics like Air Optix for Astigmatism, such instrumentation is not necessary. As long as you know the K-readings within reason–measurements which many auto-refractors provide–you can fit the patient.

Have the Conversation with Patients

One of the most common conversations you will have with astigmatic patients is with one who has low amounts of astigmatism. That patient commonly was put in a non-toric lens by an eye doctor who may not have wanted to deal with what he or she thought was the necessary extra time and effort. As a result, these patients have been living with less than superior vision. When you ask them about the quality of their vision in contacts, many will respond that it’s just OK. I then will ask: “If you could see a little better, would you like that?” Naturally, most patients will agree that they would very much like to see better. I then explain the new contact lenses that are now available for patients with astigmatism, and how I think they would be a good candidate for that type of lens. So they don’t worry, I assure them that toric lenses work the same in wear and care as their old lenses. The only difference is these lenses are designed for people with astigmatism, and for that reason, are able to provide much better vision than other kinds of contact lenses.

Another common conversation with astigmatic patients is one in which a patient with significant astigmatism is under the impression that he or she could never wear contact lenses. I might say something like: “Luckily, there have been a lot of advancements in recent years in contact lens technology, so there now are contacts designed especially for people with astigmatism that are as comfortable to wear as any other contact lens.”

With so many astigmatic patients either placed in unsatisfactory lenses by other doctors or told by other doctors that they could never wear contacts, it is worth mentioning the option of contact lenses to all of your astigmatic patients.

Happy Astigmatic CL Patients = Loyal Patients

When you successfully fit an astigmatic patient in contact lenses who was previously wearing contacts that did not offer superior vision, or a patient who was told he could never wear contacts, you have gained that patient’s loyalty. I have had patients tell me: “Why didn’t my last doctor tell me about these contacts? I’ve been wearing contacts forever, and nobody told me about these.”

Enabling a patient with astigmatism to experience visual acuity in contact lenses will dramatically change their life. Some of these patients may even call you their hero because they are not used to doctors who listen to them and then effectively provide for their needs.

Toric Contact Lenses: Action Plan

Simplify the contact lens process. If patients are experienced contact lens wearers, the new torics, like Air Optix for Astigmatism, do not require the patient to come in for a follow-up exam if they are happy with their vision and are comfortable. You also can streamline by having support staff call the patient to see how the trial lens worked out. The doctor is only notified if there is an issue.

Keep Yourself and Your Staff Educated on Latest Toric Advancements. Reps from contact lens vendors are usually happy to make presentations to you and your staff on their toric lenses, so take advantage of this under-utilized resource. Once a month we like to devote our weekly staff meeting to contact lens education. During one of these sessions, our Air Optix for Astigmatism rep visited for a tutorial on fitting his product and how to have the conversation with patients about its benefits.

Empower Your Staff. New torics are easy enough to fit that after the doctor has prescribed the appropriate lens, the support staff can often take it from there, handling the fitting and patient education process. Unless a problem develops with the patient’s wear of the lens, the staff also can become the patient’s center of communication.

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Mike Rothschild, OD, is founder and president of West Georgia Eye Care in Carrollton, Ga., and founder of LeadershipOD.com. To contact him: mrothschild@LeadershipOD.com.

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