CLSA Eye Witness Spring 2011 - (Page 33)

the Bottom line s the contact lens industry permanently breaking through into the therapy market? How many years have we been waiting for a true myopic reversal lens (orthoK), melting vision lens (collagen), drugdelivery system lens and/or a dry eye therapy? We might be there. The next question, how much is it worth to “cure” someone’s myopia, glaucoma, or dry eye? Certainly more than a cosmetic treatment for some form of ametropia, if you think about what a contact lens specialist is managing, it’s more than just vision correction. I think we can call it “Lifestyle Alignment.” How many patients are now able to function in everyday life thanks to our efforts. Let me present three recent examples in my practice. P.B., a 51 year old male, who came in two months ago with no prescription because no one could refract him. At 11 years post LASIK, he hasn’t seen print or objects without shadows or double vision since before his surgery. Two different fitters in the last five years have been unable to “cure” his visual handicap. What did I have that the fitters before me didn’t have? Scleral lenses that would become therapeutic vision devices. He lived over 90 minutes from our practice but our local cornea specialist referred him to me because he knew I had the therapeutic lenses that could help him. I successfully fit him with the scleral lenses and even accidentally ended up with a bifocal on one eye, eliminating the need for reading glasses for most tasks. He went back to his teaching job without headaches or double vision. He was thrilled. The next patient is D.B., a 35 year old female kidney dialysis patient, again with no prescription because no one could refract her. She did have corneal maps from her specialist that indicated large gas perm lenses. She had only one major hindrance; microscopic corneas with a narrow tight fissure. She had been previously fit with gas perm lenses that always fell out. Her k- reading in the right eye was 90D and the left was 83D. Her left eye was centrally scarred and I was expecting very little. I diagnostically fit her with my steepest, smallest eccentric keratoconus lens and it appeared about 5–10D too EyEWitnEss spring 2011 | By michael Dinapoli, fclsa, ncle-ac A Return to Normalcy I flat. Could I really fit her or was I fooling myself? I decided to create my own fitting system. The diagnostic fit indicated she needed an 8.7mm lens to satisfy her fissure and lower lid position. When I called my custom GP lab, my first question was, “What’s the steepest lens I can get with an 8.7mm diameter?” The lab response was about 4.80mm base curve. We co-developed the lens design based on diameter, then base curve, then edge and peripheral curve design. We created our own therapeutic design and it worked! Her outcome: Vision OD 20/50, OS 20/70, OU 20/40; 8–10 hours of comfortable wear. It was good enough for her to get a drivers license. Not bad for someone walking around with finger-count vision for the last several years. “Normal life” restored to a patient through my therapeutic creation. She was beyond thrilled! D.G., a 63 year old male, status post graft OU came into our practice in the winter of 2009–2010. He was unsuccessfully fit in contact lenses in New York and Florida. Both eyes were dry, allergic and watered profusely. After a GP evaluation, I told him that I could fit his right eye with a large diameter irregular cornea lens design of 11.0mm. When I informed him his left eye could only have a scleral lens his answer was simple, “NO.” At this point he let me know that a previous fitter had tried a scleral lens on him and it made him physically ill. I proceeded to fit his right eye only with an irregular corneal lens design that was much better than his simple corneal lens. He was happy, but insisted that I fit his left eye with a similar corneal design. This time, my answer was simple, “NO.” I actually refused to fit his left eye because I couldn’t improve his profuse tearing and poor vision with a corneal design. Upon his return for his final check-up for his right eye, he broke down and said, “Why don’t you stick one of those huge lenses in my left eye just to see how I feel?” I selected the best diagnostic lens I had and inserted it. He immediately had two reactions: He hardly felt it and he could see everything blacker and clearer than ever. The rest is history. When he returned from Florida in the spring he begged me to refit his right | w w w. c l s a . i n f o Mike DiNapoli is part of a thriving New York State Optical Company, DiNapoli Opticians, which has served the Capital District of New York for the past 60 years. He believes strongly in the concept of providing good customer service in a professional and efficient manner. A successful contact lens practice requires not only the skills of technically proficient contact lens fitters, but also the ability to practice in a cost efficient manner. The ability to generate revenue while saving time and reducing expenses, combined with highly trained staff, will ensure a healthy bottom line! c o n ta c t l e n s s o c i e t y o f a m e r i c a 33 http://www.clsa.info http://WWW.CLSA.INFO

Table of Contents for the Digital Edition of CLSA Eye Witness Spring 2011

CLSA Eye Witness Spring 2011

CLSA Eye Witness Spring 2011 - (Page Cover1)
CLSA Eye Witness Spring 2011 - (Page Cover2)
CLSA Eye Witness Spring 2011 - (Page 1)
CLSA Eye Witness Spring 2011 - (Page 2)
CLSA Eye Witness Spring 2011 - (Page 3)
CLSA Eye Witness Spring 2011 - (Page 4)
CLSA Eye Witness Spring 2011 - (Page 5)
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CLSA Eye Witness Spring 2011 - (Page Cover3)
CLSA Eye Witness Spring 2011 - (Page Cover4)
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