Keeping Our Patients in Soft Contact Lenses

Dear colleagues,

Successful soft contact lens wearers are happy patients and  profitable patients for our practices.  More purchases, more regular examinations, more word of mouth referrals are all benefits of keeping patients happy in their soft lenses.  Over the last few decades, soft lens wear has evolved into more frequent replacement, which is great for reducing complications of lens wear.  We also have better materials that make lenses less dry and more comfortable to wear.  Soft torics are more stable and provide better vision than ever before.  We have a wide arsenal of multifocal lenses with cleaner optics than ever before.   Despite all the improvements, contact lens utilization is much lower than it could be. 

As practitioners, many of us are not incentivized to offer soft lenses as it is not part of our pay structure, or it simply adds time to an encounter when we don’t get paid any more or less for doing the extra work.  This is a down side of being an employed doctor who has no stake in the profitability of the office as a whole.  But more significantly, many patients simply choose not to wear them or stop wearing them at some point.  This is an area that we can address, but it will take a change in our mindsets.  We need to stop thinking that all soft lenses fit all eyes equally well and individualize our fitting both in terms of fit and material.  

One of the biggest concerns I have for the current soft lens offerings is how tight / deep lenses are being made currently.  A loose-fitting lens is usually just fine as long as the patient is comfortable with it.  More movement only enhances tear exchange and long-term comfort.  When a lens is TOO loose, it will be obvious.  A bigger concern are tight fitting lenses.  They are often quite comfortable at the outset, and a patient will rarely complain at the fitting of a lens being too tight.  But in many cases a tight fitting lens will manifest over time with dryness and lack of long-term comfort.  This insidious issue will often end up creating dropouts, refits into lenses that are more premium do to the belief that the problem is inherent dry eyes, or reduced satisfaction with lenses in general.  It is my hope that over time, we have better ways to assess when a lens is a proper fit and move away from the one size fits all approach.  In the meantime, fitters can use the tools at their disposal, such as corneal topography and published sagittal depth tables to make sure that every patient has properly fitted lenses.

Best wishes and happy fitting!!

Jason Jedlicka, OD, FCLSA, FAAO
President, CLSA