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Perspectives

Making it real for patients

Fitting contact lenses for presbyopic patients is something practitioners should no longer be shying away from, according to Dr Rachel Hiscox. The professional education and development manager for Johnson & Johnson Vision tells OT  why it is important to start a conversation

23 Apr 2018 by Andrew McClean

I have been wearing spectacles since I was 12 years old, but I was not introduced to contact lenses until my second year of university as an optometry student when I started the contact lens clinics.

I tended to take my glasses off when I was going out, which could be difficult when socialising with friends. There were some awkward moments when I had not seen someone across the room and then got a bit closer and realised I had not said hello to somebody. I don’t think contact lenses would have been introduced to me unless I had proactively sought them out and not been an optometry student at the time. Now, I wear contact lenses full time and definitely don’t see a life without them.

Patient expectations

Since joining Johnson & Johnson Vision (JJV), I have learned that patients expect their practitioner to start conversations about contact lenses. They believe that if the practitioner doesn’t proactively start the conversation, that they are not suitable for contact lenses.

It’s very easy to get to the end of the eye examination and tell a patient they need a new pair of spectacles and forget that contact lenses should be offered at that point as well. It is important that we always keep the patient at the heart of everything we do, providing them with all the information about the optical solutions that would work for them and their lifestyle.

"I think it's important to start the conversation about presbyopia before symptoms are first experienced, which means mentioning it to patients in their 30s and encouraging them to continue to come back for their eye examination because their eyes change as they mature"

More from multifocals

The profession, as a whole, shies away from treating presbyopic patients with contact lenses. We know that only about 8% of presbyopes who need visual correction wear contact lenses and only 1.2% wear multifocal contact lenses.1 Achieving good outcomes with the earliest multifocal contact lenses was challenging, often taking up lots of chair time and leaving patients rather under-whelmed. Nowadays, multifocal contact lenses have come a long way. They offer dramatically increased fit success rate, in excess of 90%, whereas previously, most practitioners would say that they were getting success rates of around 30-40% with a lot of chair time.

I think it’s important to start the conversation about presbyopia before symptoms are first experienced, which means mentioning it to patients in their 30s and encouraging them to continue to come back for their eye examination because their eyes change as they mature. We know that of those patients who try spectacles and multifocal contact lenses, 78% want a combination to suit different elements of their life.2

For university students, the science is imperative to be able to fit the contact lenses, but making it real from a patient perspective is the next level it needs to be taken to. I think if we start the conversation early when students are developing how they work as practitioners, and we get them thinking about a holistic approach to patients’ vision, with spectacles and contact lenses always forming part of their recommendation, that will stand them in good stead.

At JJV, we educate on contact lenses at local events, through online education and other methods. The biggest hurdle is the first time you fit a multifocal contact lens. We have to provide the practitioner with the confidence to give it a go and really encourage the use of the fit guide. It’s not just about the optometrist or the contact lens optician who is doing the fitting, it’s about the optical assistants as well because there are a lot of touch points across the patient journey where conversations can be started about contact lenses.

Rachel’s top tips for fitting contact lenses

  • Always follow the fit guide. Multifocal lenses are so much better now due to complex optics, so following the guide is critical to achieve the same level of success as the manufacturers’ claims
  • Use appropriate tools to assess their vision. Everyday tasks such as mobile texts are better at assessing a patient’s satisfaction than charts alone
  • Communicate positively with the patient and consider their lifestyle.

References

  1. JJV Data on File 2016. EMA Incidence, JJV Data on File 2016 EMA Wearer Map
  2. Neadle S, Ivanova V and Hickson-Curran S. Do presbyopes prefer progressive spectacles or multifocal contact lenses? Cont Lens Ant Eye, 2010;33:262-263.
Dr Rachel Hiscox is a professional education and development manager for Johnson & Johnson Vision in the UK & Ireland. Her role includes educating practitioners on contact lenses so that they are able to provide their patients with contact lenses which meet their lifestyle and ocular health needs.

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