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Contact lens practice: Anything but disposable
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As clinicians, we often define new contact lenses in a variety of ways. First, there are physical attributes: Dk/L, water content ionicity and modulus. Then there are classifications according to wearing habits: daily vs. extended, and replacement schedules: frequent vs. disposable. Interestingly enough, some of these same descriptors apply to our contact lens practices as well! For instance, how would you rate the "modulus" of your contact lens practice?
In a sense, we use the term modulus to define a contact lens material's ability to resist external forces, to avoid deformation and to maintain a constant. When applied to contact lens practice modulus serves as a gauge of one's ability to weather a variety of external market forces and yet maintain some semblance of normality.
In this respect, it is easy to see how the contemporary contact lens practice has had its modulus tested in recent years. For starters, consider that the largest group of contact lens wearers — baby boomers — are entering mid-life. Many have forecasted the demise of contact lenses as this group enters presbyopia, develops dry eye and grows weary of the hassles of contact lens care. However, contact lenses have risen to the occasion with monovision, more bifocal options, moisture-retaining materials and dry eye adjuncts, and patient-friendly multipurpose lens care systems.
Then, there's the resurgence of spectacles. Naysayers are quick to question the ability of contact lenses to compete in the increasingly fashionable and popular world of eye wear. The contact lens industry has responded with more tinted options for the fashion conscious, daily disposables for those who desire occasional lens wear and aggressive marketing to the teenage population.
And what about refractive surgery? After all, radial keratotomy, photorefractive keratectomy, laser in situ keratomileusis and a multitude of other procedures are making tremendous strides in correcting a variety of refractive errors. Could this be the ultimate downfall of contact lenses? I doubt it.
As contact lens manufacturers offer more prescriptions, simpler lens care systems, daily disposables and longer extended wear, these devices become even more patient friendly. Additionally, at present, contact lenses are easier (and less costly) to titrate in the face of ongoing prescription change.
Finally, there is the nagging belief that contact lenses are no longer a cost effective use of professional time. Many claim that managed care plans are out of sync with the contact lens wearer's needs, offering minimal coverage at too infrequent intervals.
The solution? Position contact lenses as a "non-plan" service. Remember that most health care plans do not cover cosmetic oculoplastic surgery, refractive surgery or even "high-end" eye glasses. To succeed in this strategy, optometrists need only be fair with their patients. Be competitive and equitable in providing materials, operate efficiently by delegating where appropriate and charge for your professional services accordingly.
Indeed, the contact lens industry has faced a great deal of adversity in recent years. With each challenge it has responded by evolving into something larger and stronger.
So, what is the prognosis for today's contact lens practice? For starters, it's got a great modulus. It is also assuming an extended role within the contemporary eye care practice. Finally, today's contact lens practice is anything but disposable!