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Glasses, contacts and refractive surgery should co-exist peacefully
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Do you occasionally discourage eyeglass wearers from trying contact lenses simply because of astigmatism or presbyopia? Or intimate to contact lens wearers that new eyeglasses are not necessary because their existing pair is still "functional in an emergency"? And how often have you encountered refractive surgery advertisements enticing patients to "throw away eyeglasses forever"?
It's true that these options — eyeglasses, contact lenses, and refractive surgery — are competing for a share of our nation's 140 million+ ametropes. To this end, each modality carves its niche by marketing to the exclusion of its competition. It's also true that patients are following the lead of insurers by closely monitoring personal health care expenditures. This is fostered by optical plans in which subscribers are allocated X dollars for eyeglasses or contact lenses, but not both. Undoubtedly, these trends help create a mindset among patients that prescription options are mutually exclusive. And unfortunately, this either-or mentality is not always in the patient's best interest.
I think most agree that certain eyeglass wearers would enjoy contact lenses for social engagements or recreational activities, because even our best eyeglass wearers have occasional misgivings about wearing glasses for certain activities. And what about the patient who wears contact lenses 16 hours a day, 7 days a week? Wouldn't it be nice — or even healthier — for some of these individuals to wear eyeglasses more frequently? Who knows, maybe they could even enjoy a fashionable and functional pair of eyeglasses!
And, finally, be extremely careful of promoting — or affiliating with anyone who promotes — refractive surgery as an ametropic panacea. Promising patients that refractive surgery is a means to lifelong emmetropia is misleading, results in unreasonable patient expectations and is potential grounds for litigation. Indeed, refractive surgery patients should anticipate using corrective lenses for certain activities in the future.
Yes, I know this seems intrinsic, but it is the intrinsic that occasionally escapes us. Though not always an easy task, the sage clinicians assimilate patient profile and prescription, visual tasks, budgetary considerations and refractive options into the final management plan. In doing so, they often present eyeglasses, contact lenses and refractive surgery in an integrated — not mutually exclusive — fashion. The net result? A patient perception that the doctor is knowledgeable, sensitive to their needs and providing them with choices. Imagine that!