Optometric Management

FEB 2017

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40 F E B R U A R Y 2 0 1 7 • O P T O M E T R I C M A N A G E M E N T . C O M CLINICAL CONTACT LENSES T HERE HAVE been many discussions about de- termining the differ- ences between contact lens-induced dry eye vs. clinical dry eye. In fact, we have previously discussed it in this column. (See July's "Con- tact Lens.") Here's a new approach: Instead of focusing on the cause of contact lens-related discomfort, why not look at ways to improve the ocular surface? It is a small reversal of thought. Here's what it would look like: 1 SET YOUR EXPECTATIONS First, assume everyone has some sort of underlying dryness — un- til proven otherwise. Consider that many of our patients have de- manding visual days with the high use of digital devices, just one of the factors contributing to dry eye discomfort. Americans spent about 8 hours and 25 minutes per day using various forms of digital media — TV, smartphone, com- puter, according to e Nielsen Total Audience Report for the second quarter of 2016. ese pa- tients likely have a reduced blink rate, incomplete blinking and in- termittent dryness throughout the day. Second, expect that your pa- tients are going to wear their lenses for long hours during the day. I would not expect someone to take his or her lenses out mid- day or immediately when arriv- ing home from work. at wear time is more than 8 hours. With this knowledge, look for specific contact lenses that have the potential to enhance the corneal surface, and make this your go-to lens. 2 REPROGRAM YOUR WAYS With this way of thinking, your first approach is no longer to as- sume contact lenses are inducing dry eyes when presented with com- plaints or clinical signs. Continue a step further, and consider that contact lenses can provide a valu- able tool, when used correctly, for treating dry eye conditions. Here are a couple examples of ways this can happen. 1. As a bandage. Bandage con- tact lenses have the potential to provide a smooth ocular surface over a corneal abrasion. ey can help protect the corneal surface during the healing process and al- low for faster recovery. 2. As a treatment. Consider whether the cause of your pa- tient's moderate dry eyes and the condition itself can be improved utilizing one of the contact lens- es on the market that have been specifically designed to main- tain moisture and wettability throughout the day. MAKE THE CHANGE ere are ways we can improve the ocular surface, VA and grow our contact lens-wearing popu- lation. Perhaps a mere tweak in your thought process will help you unlock one of those ways and increase patient satisfaction at your practice. OM ADJUST YOUR APPROACH PRESCRIBE CONTACT LENSES TO TREAT OCULAR DRYNESS JASON R. MILLER, O.D., M.B.A., F.A.A.O. DR. MILLER is a partner at Eyecare Professionals of Powell, in Powell, Ohio, on the board of the Ohio Optometric Association and is an adjunct faculty member for The Ohio State University College of Optometry. To comment on this ar- ticle, visit tinyurl.com/OMcomment. Corneal abrasion before, left, and after 12 hours of bandage contact lens.

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