Contact Lens pricing

By Dr. Trevor Miranda. 

Dr. Miranda contributes his thoughts and perspectives on the topic of Independent Eye Care Practice in Eye Care Business Canada. Check out all of Dr. Miranda’s articles in Independent Insights category.

The modern consumer is egocentric. By that, I mean that they generally make purchases based on what is best for them, not what is best for the retailer.

A wise Optical Owner once told me that I wasn’t magic! How dare he dash my dreams of one day becoming a magician?! “You can’t make people buy from you.” He continued, “people will buy if they think it’s in their best interest to buy from you, so go ahead and take your shot by making your pitch.”

The Current Reality

 Today’s contact lens consumer is bombarded with online offers to purchase contact lenses directly. Clearly Contacts and other online retailers invest heavily to attract your contact lens patient into their online channel. At Kits, the online retailer’s fastest growing retail segment is a contact lens subscription that is taking your patient out of your purchasing channel for an average of 10 years (extrapolated based on European stats). Canadian studies have shown that a contact lens patient makes 2.9 purchases per year. Is this consumer using their friendly neighbourhood ECP, a convenient Big Box store, or online retailer to fulfill these purchases? Another industry statistic shows that less than 25% of patients in an optometrist office purchase annual supplies of contact lenses and the redemption rate of massive consumer rebates is less than 50%.

Contact Lens Pricing Strategies:

The Annual Supply: Many contact lens companies offer rebates and train our teams to recommend annual supplies of contact lenses. This allows the consumer to tap into “the lowest price after rebate.” There are quite a few flaws in this strategy:

  1. Most patients do not require or want to buy an annual supply of contacts.
  2. Rebates are a hassle factor and are not universally redeemed. The sticker price is artificially high and can be a shock and disincentive to purchase, rebates also require the patient to do some math to figure out if it is a “good deal” or not.
  3. Many Optometrists are compensated on a percentage of gross sales basis. The inflated price is overly expensive to the clinic owners, as that initial higher dollar amount paid potentially reduces overall profitability to the clinic.
  4. The rebates change, often quarterly, and the office staff needs to constantly update price quote sheets to keep up to date pricing.
  5. Pricing is often tiered so smaller purchase increments are not competitively priced

Per Box Pricing: The easiest way for a consumer to understand and compare pricing is on a per box basis. It is challenging for ECPs to flat price per box because of better incentives to sell larger amounts resulting in better pricing to the owners and thus better profit margins. There are, however, ways to implement this strategy in a way that is staff and consumer friendly:

  1. Negotiate with your Contact Lens Manufacturers for instant rebates or no rebates with better wholesale pricing on the lenses.
  2. Consider a small contact lens inventory where you buy “smartly” in increments that give you the best pricing and thus enabling flat per box pricing without reducing your margins.

Subscription: Studies have shown that many Canadians view contact lenses as an unaffordable luxury purchase. The sticker price keeps them from taking the plunge into full time contact lens wear. The world has moved to subscription: Services such as Netflix, gym memberships, wine clubs and, I have even heard of subscription toilet paper, are now the norm and accepted by the modern-day consumer. This allows contacts lens purchases to be considerd as “sunk costs” thus making available money to purchase other items such as sunglasses or mulitple pairs of glasses. Here are some advantages of subscription contact lenses:

  1. Affordable consistent monthly payments that reduce sticker shock
  2. The ability to consolidate a receipt to tap into insurance coverage
  3. Auto-preparation for rebate submissions.
  4. “Stickiness factor” – On average a patient stays on contact lens subscriptions for 9.9 years in Europe.

Web Stores: The pandemic drove many ECPs to develop an e-commerce strategy. While allowing the convenience of shopping at your clinic/store 24/7 is great, it has also led to some unintended consequences for some offices. Here are some e-commerce tips:

  1. Your online store offering should mirror your in-office offering. If you offer a sale online ensure you promote it in store.
  2. Inform your current patients of this convenience. Unless you spend money to elevate your search ranking, the bigger online players will  appear first.. You might be unwittingly pushing your patient to be crawled by bots on the internet and potentially taken out of your channels by Clearly and other online players.
  3. Make it easy to navigate and order online.
  4. Offer direct to patient delivery. Many manufacturers are still offering free delivery.

The Secret Sauce:

Keys to Successful Contact lens Sales:

 The doctors and ECPs need to approve the wearing of fitted contact lenses. Let the patient know that you have great pricing on contact lenses before the hand off to the optician or dispenser. A confident word from the doctor that buying from your practice really goes a long way and is in the best interest of the patient.

  1. Ensure that per box pricing is competitive. Be aware that patients will Google the brand and immediately compare pricing  from online retailers.
  2. Consider fitting brands that are ECP exclusive or “channel protected”
  3. Partner with manufacturers that give you the best margins while also making future purchases from your office more likely.
  4. Everyone approved for contact lenses should leave with a contact lens quote even if they are determined to buy from another source. The quote should include a per box price and a per month subscription price.

Good luck prescribing contact lenses and retaining your patients!

 

DR. TREVOR MIRANDA

Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices.


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Dr. James (Jim) Hoffman, shares insights on how to get former contact lens patients with presbyopia and astigmatism back into contacts and WOW them them in the process with new ULTRA Multifocal for Presbyopia from B + L.

 

 


About the Guest

Dr. Jim Hoffman graduated from the University of Houston College of Optometry in 1981 and was awarded fellowship in the American Academy of Optometry in 1985. Dr. Hoffman excels in pediatrics and advanced contact lenses and often lectures to his peers in USA and Canada.

Dr Hoffman is an independent practice owner with two practices in Orange Park Florida (south of Jacksonville), where he practices with his wife Dr. Karen Larson.

 


Episode Notes

Dr. James (Jim) Hoffman, enthusiastically shares insights on how to get former contact lens patients with presbyopia and astigmatism back into contacts and WOW them with new Bausch + Lomb ULTRA Multifocal for Astigmatism.

While multifocal toric contact lenses have been around for some time, the combination of a contact lens for presbyopia and  astigmatism in a stable, easy to fit format has been an unmet need for both practitioners and patients.

In the past Dr. Hoffman acknowledged that he had reluctantly informed patients, “there’s no contact lens for you” that could satisfy both their desire for uncompromised vision and freedom from glasses.

As an early adopter of Bausch + Lomb ULTRA Multifocal for Astigmatism contact lenses, Dr. Hoffman shares tips on how to bring back astigmatic presbyopes that had given up on contacts.

In this podcast Dr. Hoffman shares in detail:

  • how his office prepares specifically for these patients,
  • his in-office protocol,
  • patient communication strategies, and
  • follow up protocol.

Until the availability of this new lens he hadn’t realized just how frustrated the patients were. He and his patients now have the satisfaction of returning to contact lenses and regaining freedom from glasses without compromise to vision.

Key Tip: Since there’s never been a contact lens like this, he stresses the importance of following the Fitting Guide.

Resources

 

Dr. Glen Chiasson

Dr. Glen Chiasson

Dr. Glen Chiasson is a 1995 graduate of the University of Waterloo School of Optometry. He owns and manages two practices in Toronto. In 2009, he co-hosted a podcast produced for colleagues in eye care, the “International Optometry Podcast”. He is a moderator of the Canadian Optometry Group, an email forum for Canadian optometrists. As  a host of  “Eyes Wide Open”, Glenn  looks forward to exploring new new technologies and services for eye care professionals.

Dr. Chiasson enjoys tennis, hockey, and reading. He lives in Toronto with his wife and two sons.

Dr. Chiasson splits EWO podcast hosting duties with Roxanne Arnal.


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By Jaclyn Chang, OD

Residency trained optometrist Dr. Rosa Yang shares her knowledge on the ever-changing topic of specialty contact lenses in the following conversation with NewOptometrist.ca editor, Dr. Jaclyn Chang.

Dr. Rosa Yang

Jaclyn: What are the indications for scleral lens use?

Rosa: Scleral lens use has been growing and gaining more attention in recent years. The scleral lens vaults over the cornea and has increased comfort.

Previously, the primary indication for scleral lenses was corneal ectasia; the main one being keratoconus. Now we have learned about other benefits of scleral lenses, for example, patients with dry eye. Scleral lenses provide constant lubrication to the ocular surface. While dry eye is a multifactorial disease and scleral lenses aren’t for every patient with dry eye, there is a specific subgroup of patients who would benefit from them. These include patients with exposure, such as with a facial palsy.

Jaclyn: What equipment is necessary for fitting specialty contact lenses?

Rosa:  Topography is essential to the fitting of specialty contact lenses. When you think about managing glaucoma, you think about how important OCT is to glaucoma specialists. The analogy for a contact lens fitter is topography.

It is an effective method to assess ortho-K treatment, for example. While the patient may have optimal vision and the lens may appear well-fitted open-eye, this may not always correlate with optimal ortho-K treatment overnight. The treatment may be decentered but provides enough treatment through the optical center to give good vision. However, this does not equate to optimal treatment.

There is also value in topography with scleral lens fits. The amount of time needed to select the initial lens can be minimized. The topography can aid us in determining the initial sag of the lens. We have also learned that many scleras have toricity. Some topographers can map out scleral contour to help us decide if the patient would benefit from a toric peripheral design.

Jaclyn:  Can you talk a little bit about specialty soft contact lenses?

Rosa:   Sure, there are specialty or customized soft contact lenses for high prescriptions outside of range. For example, I had a patient whose prescription was -22D. We put this patient in a soft contact lens called Intelliwave. Keep in mind that this lens lasts for three months so the patient has to be diligent with cleaning.

Jaclyn: What is new in the world of fitting specialty contact lenses?

Rosa:  Profilometry is fairly new. With this, the topographer and the software are linked to the contact lens manufacturer. Normally, we would do a diagnostic fit, where you put a lens on the eye, check the fit, and then specify the change in parameters. Profilometry is a method in which the contact lens manufacturer can generate a lens with a specific parameter based on the topography itself.

Aberrometer is also a relatively new technology being implemented. Higher order aberrations (HOAs) can lower best corrected VA and quality of vision. HOAs can be measured and neutralized to improve vision in scleral lens wearers.

Jaclyn:  Great, thanks so much for that refresher and update!

 

Previous discussions with Dr. Rosa Yang: 

Perspectives on Myopia Control
Pursuing a Contact Lens Residency

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.


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Dr. Jocelyn Leung is passionate about contact lenses. Here she discusses how she implements multifocal contact lenses into her everyday practice to provide patients with vision that fits their lifestyle.

Jaclyn:  How do you identify successful candidates for multifocal contacts?

Jocelyn: Once patients reach presbyopia, possibly getting eyestrain and headaches, you can have the conversation about multifocals.

If the patient is already a contact lens wearer, fantastic. Patients who wear contact lenses are used to not wearing glasses and want to maintain this lifestyle. Glasses are inconvenient for any athletic activity, traveling, especially nowadays with the masks causing constant fogging!

I discuss the options with the patient: glasses over contacts, monovision, or multifocal contact lenses.
Before a multifocal fitting, I set expectations and let the patients know that they won’t necessarily have 100% clarity of vision but will get convenience. I usually say that they can achieve about 80-90% of what they would be able to see with glasses and gauge the patient’s response.

Patients who prioritize convenience over perfect vision are ideal candidates. It is important to make sure that the patient understands the way multifocal lenses work and what is optically possible.

Jaclyn: How is the conversation different if the patient is not a previous contact lens wearer?

Jocelyn:  Multifocal contact lenses are a good option for presbyopic patients whose end goal is to be glasses free, even if they have not previously worn contact lenses. The process does take a little bit more time, with teaching insertion and removal and educating on contact lens hygiene.

It really depends on the patient’s personality and visual demands. Last week, I fit a patient who has never worn contact lenses but did not want to wear glasses anymore due to the mask and fogging. She was very, very happy with her lenses right off the bat and I finalized her prescription with only one more visit.

Jaclyn: Can you walk us through your process of fitting multifocal lenses?

Jocelyn: I first discuss the process and fitting fees with the patient. On average it is going to take three visits and some time to find the right prescription. I let the patient know that it’s very likely they won’t be fit on the first try, and then if they are fit earlier, they’re even happier.

I look at the prescription and what lenses the patient has worn in the past. Using a brand or modality similar to what they’re currently wearing can help ease the transition. I usually stick with DAILIES TOTAL1 as my number one go-to option for multifocal lenses.

The fitting guide, which is individual to every brand and contact lens, is very important. My tip is to find two or three multifocal lenses that you like and memorize those fitting guides. Then if you need to pivot, you can look up the fitting guide for the other tertiary lenses.

Grab your first trial lens and have the patient try the lenses on in the office. It does take some time for the lens to settle and for the patient’s brain to adjust, so let the patient know that you do not expect perfect vision right now.

Make sure that the patient is functional before they leave the office: meeting the driving standards, comfortable seeing far away, and can read their phone. Then you can send them home with some lenses.

I do a one week follow up, but the patient can take two to four weeks to adapt. I like to see the patient at least every week, maximum two weeks, for a follow up to get their feedback. Otherwise, the patient may try the lens, forget about their vision, and not be able to provide you with comments. If there’s something the patient isn’t happy with, they need to vocalize that to you. You need to ask the right questions and be able to adjust from there.

At the first follow-up appointment, I get feedback on the comfort and vision at distance, intermediate, and near. I do use a reading card for a metric number at near, but I do not base my success on a number. I am not aiming for a certain visual acuity. I am aiming for what the patient is happy with because everyone has different visual demands.

We see if the patient wants to improve their distance or near vision and make sure that the comfort of the lens is good. We can then do an over-refraction to see what adjustments need to be made.

After a few appointments, if we find a lens that the patient is happy with, we can finalize the prescription. If the patient still is not getting comfortable vision, we can give it another shot for a few more weeks before switching to monovision or back to glasses if necessary.

Jaclyn: Can you give us some insight into your discussion on fitting fees with the patient?

Jocelyn: I always discuss fees first so there are no surprises. If financials are a deciding factor, then we only discuss options within their absolute cutoff budget.

We can always educate and bring awareness to our patients on the options available. However, if the patient is very happy with over-the-counter readers or taking their glasses off to read, they likely won’t be convinced to try multifocals. It’s what they’re used to and that’s what they’re happy with. To try multifocal lenses, you have to be enthusiastic and engaged in the process.

If the patient is willing to give multifocals a try, that’s when we can add the most value. I’ll explain that a contact lens fitting is a process, and the fitting fee is a one-time fee that covers trial lenses and multiple appointments.

As long as the patient understands that we are putting in the effort to try to get them the best vision possible, they will be more open to that fitting fee. Depending on the clinic, fitting fees may also cover appointments for any sort of infections or emergencies related to contact lenses. This gives the patient reassurance that we’re going to be there every step of the way.

Jaclyn: Great, thank you so much for all your tips on being more successful with our multifocal fits!

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.


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By Jaclyn Chang, OD

I recently had the chance to discuss how myopic control can benefit our patients with contact lens residency trained optometrist, Dr. Rosa Yang.

Here is the conversation.

Dr. Rosa Yang

Dr. Yang pursued a post-graduate residency program in Cornea and Contact Lenses at the University of Waterloo.

She is the recipient of the Sheldon Wechsler Contact Lens Residency Award from the American Academy of Optometry and was awarded First Place in Clinical Poster from the Global Specialty Lens Symposium.

Dr. Yang has particular interests in myopia control (including ortho-K), dry eye and corneal disease management.

 

Jaclyn:  What myopia control options are available?

Rosa:  There are several options including the MiYOSMART spectacle lenses by Hoya, MiSight soft contact lenses or off-label use of soft multifocals, Atropine, and ortho-K.

As a clinician, I think it is good to be aware of all the options so you can choose the most appropriate option for your patient.

Jaclyn: How do you choose one myopia control option over another for a patient? Is it very individual to that patient’s comfort level and particular case?  

Rosa: I don’t want to oversimplify, but, yes, there are selection criteria where we weigh one option over another. These include prescription, the parents’ budget, and the underlying eye condition.

A big factor is also how comfortable the patient is with handling contact lenses. Do they want to handle the contacts themselves or is it something that the parents might want to be more involved with? For the latter, ortho-K might be the better option because it’s mainly done at home at night.

For a patient who doesn’t want to wear hard contact lenses or glasses, and if the parents are hesitant about putting their kids on a medication (Atropine), soft contact lenses are the option we would be considering.

The only FDA approved soft contact lens for myopia control is MiSight, but it is limited by the fact that it is not available with astigmatism. In patients who have astigmatism, multifocal soft contact lenses can be used to implement the peripheral defocus effects.

Jaclyn: Under what circumstances might you select specifically designed spectacle lenses (like  MiYOSMART) for the patient?

Rosa: Some patients have been wearing spectacles and would like to continue wearing them. For them, it makes sense to keep them in myopia control lenses like MiYOSMART.

There are also patients who are uncomfortable pursuing contact lenses (i.e. they have trouble handling CLs, they are poor CL candidates) or the parents are uncomfortable having their kids on long-term atropine drops, then we would consider spectacles.

MiyoSmart lenses may also have larger prescription ranges than the contact lenses.

Jaclyn: When would you initiate myopia control treatment? Do you monitor until you see progression or initiate at the onset of myopia?

Rosa: Currently there is no consensus amongst clinicians, but when I see evidence of fast progression, then I initiate myopia control. Average progression is -0.50D per year, so anything above that might urge me to start myopia control; sometimes you may want to monitor a little bit more to see.

There are also clinicians that see myopia control as a preventative treatment that should be used more widely, especially considering the global myopia pandemic, so it’s a grey area.

Jaclyn: Are there certain things that we can say to our patients to help them better understand the importance and benefit of myopia control treatment? How can we help them understand the health implications associated with myopia?

Rosa: This is a very good question, because this is a topic that I discuss with every parent when we talk about myopia control. I tell them that the reason we pursue myopia control is not just the high prescription itself, it’s not just the inconvenience of having really thick glasses, it’s the ocular health implication.

“When you have a high prescription, the eyeball is usually more elongated, which means that the tissues in the eyeball get stretched out and are thinner; this predisposes them to certain ocular health complications, some of which are vision threatening. There is a higher risk of retinal detachment, maculopathy, and glaucoma.”

When I emphasize this, parents usually understand. With myopia control, it’s very important that parents understand what you’re doing, why you’re doing it, and how you’re doing it.

Jaclyn: Thanks for that – hearing the way that other doctors counsel always helps me with how I counsel my patients. Education makes such a big difference to patient care. 

Rosa: Yes, exactly, with myopia control, sometimes parents wonder why their child’s prescription still increases. That’s why with myopia control, it’s very important to have a consultation.

The management we’re doing is not to stop myopia, it’s to slow down the progression of myopia; regardless, the child is still going to progress.

Another thing to realize, for example, with ortho-K, is that some parents may think that once you wear the ortho-K lenses, that the prescription is completely gone, so explaining the process and treatment is very important.

Jaclyn: Thank you so much Dr. Yang! This gives our audience some things to think about and implement into everyday practice. 

Previous discussions with Dr. Rosa Yang: 
Pursuing a Contact Lens Residency: 

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.


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Young Optometry residents in conversation

By Jaclyn Chang, OD

As graduates approach the final stretch of optometry school, the decision to spend an additional year immersed in a residency program might come into view for some near-to-be optometrists.

Dr. Rosa Yang

While a residency provides the advantage of specialized training in a unique clinical setting, it may also defer the process of landing a job or starting your own practice.

Dr. Rosa Yang graduated from the University of Waterloo School of Optometry in 2019.  She interned at various clinics in Canada and in the USA, including Houston Eye Associates in Texas, where she worked closely with ophthalmologists specializing in cataract, glaucoma, and corneal diseases.

Dr.Yang pursued a post-graduate residency program in Cornea and Contact Lenses at the University of Waterloo.

Dr. Jaclyn Chang discussed Dr. Yang’s residency experience.

Jaclyn:  I really admire anyone who has done a residency and I’ve never heard anyone say they regret doing one. Can you comment on the opportunity that residency provides? 

Rosa:  For sure! Residency gave me the platform to meet people and experience a variety of opportunities. I was able to connect with eyecare specialists not just in Canada, but on an international level. Some of them became my mentors and friends. Now, when I need help to tackle a difficult case, they are my go-to people.

I have always loved teaching and residency allowed me to TA in labs and provide clinical supervision for students. I got to write case report, oral presentations, and conference posters. Through the process of preparing for them, I feel like I became a stronger critical and independent thinker – these are important traits for a clinician to have. I also travelled to so many places to attend conferences – I think I flew to five difference places in half a year, imagine how many more places I could have gone to if COVID did not happen.

Overall, it is such an enriching year with memories that I will never forget!

Jaclyn: That’s awesome! How did you feel about jumping in and doing things that we didn’t necessarily have a lot of experience with? For example, teaching, being a clinical supervisor and presenting at conferences.

Rosa: Of course, I was nervous. I am the type of person who thinks I need to be 100% prepared and execute with perfection.  That is not how real life works. More often, you learn along the way, but only if you have a good attitude and put in the hard work. I feel extremely lucky and thankful of my residency mentors. They have always believed me even when I doubt myself. Their encouragements have meant a lot to me and I think have been monumental for my growth!

Jaclyn: Can you talk a little bit about why you decided to go into residency?

Rosa: In my fourth year, I worked with a corneal ophthalmologist. Many of his patients had dysfunctional lives because they had corneal diseases and saw very poorly. With surgeries, many of them saw vision improve, but I wondered “I don’t do surgeries, is there anything that I can do for these patients?” The surgeon often told his patients “I do surgeries, but there are these special contact lenses that will probably make your vision even better. I don’t do them, but I will send you to the right people.” The surgeon was referring to us – optometrists, and he reminded me that specialty contact lens is a niche thing that optometrists do.

Then, I was mentored by a specialty contact lens optometrist. We saw a patient who had keratoconus. He started out desperate and very hopeless – he was struggling with his vision and he was told by several doctors that the only option was corneal transplant. We told him about scleral lenses and I can never forget the change in his facial expression the moment he looked around the room after we inserted the lens. The change was a total 180. I thought, this is something I really want to do.

Jaclyn: It’s cool how people who we encounter throughout our school, especially our supervisors in fourth year, really influence us on where we want to go.

Thank you so much for your insight. It’s always great to learn more about residency and your experience is very encouraging to other prospective students. I can’t wait for you to share your expertise with us on how we can better incorporate specialty contact lenses into our practice with our next talk!

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.


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Dr. James (Jim) Hoffman, an early trialist of B+L’s new ULTRA Multifocal for Astigmatism contact lenses, shares his experience and best practices with this new contact lens for presbyopes with astigmatism.


About the Guest

Dr. Jim Hoffman graduated from the University of Houston College of Optometry in 1981 and was awarded fellowship in the American Academy of Optometry in 1985. Dr. Hoffman excels in pediatrics and advanced contact lenses and often lectures to his peers in USA and Canada.

Dr Hoffman is an independent practice owner with two practices in Orange Park Florida (south of Jacksonville), where he practices with his wife Dr. Karen Larson.

 


Episode Notes

Dr. James (Jim) Hoffman shares his experience with the new ULTRA Multifocal for Astigmatism Contact Lens from Bausch + Lomb. Dr Hoffman was among the earliest ODs to work with the lens. He’s been impressed with the lens and explains how it has helped him maintain an innovative edge in a competitive market environment.

He reveals his pre-marketing strategy for the lens including identification of which specific patient types are best, and which to avoid. Jim relays his experience in fitting the lenses and offers up advice to get the most out of this innovative new product, particularly for patients that have been frustrated with the challenge of finding a great solution for presbyopes with astigmatism.

He explains why the B+L fitting guide is important and shouldn’t be ignored.

Jim explains his approach to different patient types, including CL drop-outs, in the exam room conversation and shares his experience with adaption and patient follow ups. He reveals his “go-to” question to open the conversation on contact lenses in general.

Key Advice: “Don’t use your past experience to fit a lens that’s never been made before.”

Resources

 

Dr. Glen Chiasson

Dr. Glen Chiasson

Dr. Glen Chiasson is a 1995 graduate of the University of Waterloo School of Optometry. He owns and manages two practices in Toronto. In 2009, he co-hosted a podcast produced for colleagues in eye care, the “International Optometry Podcast”. He is a moderator of the Canadian Optometry Group, an email forum for Canadian optometrists. As  a host of  “Eyes Wide Open”, Glenn  looks forward to exploring new new technologies and services for eye care professionals.

Dr. Chiasson enjoys tennis, hockey, and reading. He lives in Toronto with his wife and two sons.

Dr. Chiasson splits EWO podcast hosting duties with Roxanne Arnal.


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COVID-19 Support from Industry

Optical companies are unveiling new initiatives to help eye care practices deal the the difficulties of COVID-19.  Here is a recap of what some of the companies are doing:

Bausch + Lomb Canada
Bausch + Lomb Canada are providing free home delivery of Contact Lenses direct to patients.  This initiative will assist practice staff and patients in social distancing.  All B+L Territory Managers will be working from home until further notice but will remain available to assist ECPs including handling sample requests of PreserVision® and Bepreve®.
View the company’s COVID-19 Statement here.

ESSILOR Canada
Essilor Canada is providing a measure of financial relief by providing flexible case-by-case payment terms, immediate late fee suspension for all iECP customers, and pre-authorized payment suspension (lens purchase accounts only) for a period of 90 days.   Click here to view the Essilor’s statement.

Company initiatives to support ECPs during the COVID-19 difficulties will be updated on this page.


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Canadian Eye Care Business Review and Clinical & Refractive Optometry are pleased to announce a COPE approved (2 credit hours) live CE webinar on Monday, October 29 at 8 PM (EDT):
Myopia Management:  New perspectives. New Opportunities.  
Registration for the webinar is now open.

COPE Course ID: 59812-GO      Qualified Credit: 2 hour(s)

Speakers and topics for the webinar include

  • Scott Mundle, OD, President, World Council of Optometry
    • The Challenge of Myopia 
  • Debbie Jones, FCOptom, DipCLP FAAO, CORE/Univ. of Waterloo,
    • Myopia Management from Research to Clinical Practice 
  • Jeff Goodhew, OD, Chief Co-editor Canadian Eye Care Business Review
    • Myopia Control in Practice 

Myopia can no longer be considered a benign condition. It must be addressed as a potentially sight-threatening treatable disease.  Dr Mundle will share the WCO perspectives and plans for a global Myopia awareness week in 2019. All optometrists will understand the coordinated effort toward raising awareness of Myopia as a treatable condition. Dr. Debbie Jones,will review some of the interesting research and clinical studies, and Dr Jeff Goodhew will provide pointers on how optometry can integrate myopia control to patients in the optometric practice.

Presentations will be followed by a panel discussion. Dr. Farrah Sunderji, Calgary, Alberta and Dr. Thomas Gosling, Colorado will join in a panel discussion moderated by the hosts Drs Tina and Jeff Goodhew.  Questions from the audience will be addressed.

The webinar is made possible through the generous support of CooperVision Canada,  Carl Zeiss Vision Canada and HOYA Vision Care.

Pacific University, School of Optometry is the COPE sponsoring organization and administrator for this course.

 

REGISTER


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How would you explain to your patient the synergistic performance of the two significant design innovations delivered by ACUVUE OASYS® Brand Contact Lenses 1-Day for ASTIGMATISM lenses? Like wine and cheese, that’s how! Often times when you take one great idea and pair it with another the sum is greater than the parts. It takes the more consistent visual performance of BLINK STABILIZED® Design and combines it with the reduced frictional energy profile of HydraLuxeTM Technology, and the result is a lens that is even more consistently clear and comfortable than anticipated.  With each blink, the world is brought back into sharp focus and because of the tighter crosslinking meshwork the lens slides back into optimal position more effortlessly than ever before. Voila! What a magnificent pairing and what a remarkable way to share performance and innovation with your patients.
Kent Prete, OD, Calgary Alberta

ACUVUE OASYS® Brand Contact Lenses 1-Day for ASTIGMATISM combine two unique technologies to deliver excellent comfort and clear, stable vision, with the widest parameter range.

Astigmatic patients achieve their best vision when both sphere and cylinder are corrected. However, toric contact lenses have historically been underprescribed relative to the prevalence of astigmatism. Barriers to prescribing toric lenses include limited parameter availability and difficulty achieving stable vision and comfort.

Among those who have been fit in toric lenses, 58% report declining lens performance over the course of a day, with those who experience more activities or more environments during the day being the most prone to declining lens performance.¹

A new daily disposable toric lens, ACUVUE OASYS® Brand Contact Lenses 1-Day for ASTIGMATISM, has been specifically designed to provide exceptional comfort and performance in challenging environments. It combines BLINK STABILIZED® Design, which works with the natural movements of the eyelids to settle the lens quickly and maintain stable vision, with HydraLuxe™ Technology, comprising an enhanced moisture network of tear-like molecules and a highly breathable, hydrated silicone that integrates with the patient’s own tears to help maintain tear film stability.

A subject-masked, one-week dispensing study of 162 habitual toric soft lens wearers (324 eyes) was conducted in the U.S.² Within just 3 minutes of lens insertion, almost all lenses (97%) settled within 10° of nominal orientation (toric lens markings exactly vertical at 12 and 6 o’clock). At 15 minutes, all 324 eyes showed less than 5° movement on blink, which is a key factor in providing stable, predictable vision.

Clinical performance

In a busy practice, I’m looking for a lens that stabilizes quickly. But what is even more impressive to me than fit and stability in the office is how well the lens performs in the patient’s world, during everyday tasks that can challenge vision. In the study, 99% of eyes were successful at one week in the first lens fit, and visual acuity was excellent, with 97% seeing 20/20 or better monocularly.

My patients also loved the comfort of these lenses. They have busy lives and spend a lot of time on digital devices, which tend to reduce the blink rate and increase discomfort. Because it works with the tear film to stay lubricated, ACUVUE OASYS® 1 Day for ASTIGMATISM helped my patients stay comfortable throughout the day.

ACUVUE OASYS®  1-Day for ASTIGMATISM

  • First-fit success rate of 99%
  • Settles within 10˚ of nominal orientation in just 3 minutes
  • All patients achieved 20/25 or better monocularly, and 97% achieved 20/20 or better
  • Available in 2,260 parameters–40% more than any other daily disposable toric lens

Widest parameter range
The parameter range, the widest of any daily disposable toric contact lens, makes this lens very easy to fit. In the past, the lack of oblique axes or plus powers meant that some patients had to accept a level of visual compromise, or forgo the benefits of a daily disposable lens.

With ACUVUE OASYS® 1-Day for ASTIGMATISM, all three cylinder powers (-0.75DC, -1.25DC and -1.75DC) are available in axes around the clock for sphere powers plano to -6.00DS. For patients with higher astigmatism, an additional -2.25DC option is available in the most common meridians. This allows us to bring the benefits of daily disposable toric lens wear to more of our astigmatic patients.

References
1. Mathews, K., et al. AAO poster presentation, Nov 2016. Market research survey on performance throughout the day with toric soft lens wearers. US, n=208, 12% daily disposable toric, 88% reusable toric.
2. Straker B, et al. Global Specialty Lens Conference Poster presentation, January 2017

ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information. Complete information is also available from Johnson & Johnson Vision Care division of Johnson & Johnson Inc., by calling 1-800-267-5098 or by visiting acuvueprofessional.ca.

ACUVUE®, ACUVUE OASYS®, HydraLuxe™, BLINK STABILIZED®, and EYE-INSPIRED™ are trademarks of Johnson & Johnson, Inc.
©Johnson & Johnson, Inc. 2017

 

This article is sponsored by J&J Vision Care Canada.

 

ROXANNE ACHONG-COAN, OD, FAAO, FIAO

Dr. Coan received compensation for her work on this article.


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