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    3 tips to upgrading astigmatic contact lens patients

    New technology looks great and is exciting to touch, feel, and experiment with. Unfortunately, many optometrists routinely forget about new technology and fall back into our comfort zone with contact lens fits.

    Consider taking a step back to look at how you are attacking certain contact lens situations. You may find there is a better way of doing things.

    Patient education first

    Many patients do not have a solid understanding of astigmatism. Some patients even associate the word with a disease state.

    Previously from Dr. Miller: Contact lens commoditization: Looking forward and back

    When talking with patients, do not assume they understands astigmatism—explain that astigmatism is simply a different way of focusing images. Educate your contact lens patients that having astigmatism requires them to utilize a contact lenses designed to meet their visual needs.Figure 1A and B. Look across the parking lot. If upon exiting your practice, a patient experiences poor vision with contact lenses (Figure 1A—Top) as compared to a sharp image (Figure 1B—Bottom), she may lose confidence in your abilities.

    Our astigmatic patients often receive spherical equivalent lenses prescribed in order to mask their cylinder. This practice began back in an era when not many toric lens options were available and those options were not stable on the human eye. Uncorrected astigmatism results in distorted or blurred vision and a loss in “sharpness” of visual acuity. This can lead to headaches and eye fatigue.

    Fortunately, we work in a different contact lens era with better material and design technology. For astigmatic patients previously wearing a spherical lens, consider upgrading them to a toric contact lens.

    Following are three tips to help.

    1. Minimize masking

    When patients are judging the care we provide, they do so based on how well they see with their vision correction, whether it is eyeglasses or contact lenses. When they walk out the door and look across the parking lot, they want to see the best the possibly can.

    If there is a technology that provides better vision, our patients will desire that option. You may want to mention the time period for their contact lenses to settle and for their vision to stabilize so your patient does not grow frustrated with the fitting process.

    Related: Top toric contact lens fitting tips from the experts

    Due to the success of today’s toric contact lens designs, there is no longer a good reason to mask astigmatism. Masking cylinder with spherical contact lenses does not allow the best visual outcome. If there is any doubt with those 0.75 D cylinder patients, demonstrate the cylinder correction in the phoropter and ask which the patient prefers to have in his contact lenses. Additionally, demonstrate the cylinder axis. Explain that this contact lens has variable powers that have to be perfectly lined up in order to provide the best vision possible.

    Jason Miller, OD, MBA, FAAO
    Dr. Miller is a partner in a three-doctor private practice in Powell, OH, and he is an adjunct faculty member for The Ohio State ...


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