'Current Contact Lens Practice' by Nathan Efron

[Steve Machol]

I am pleased to announce that in cooperation with Elsevier Science, Health Service Division, OptiBoard will now publish reviews of selected ophthalmic titles published by this company. The first book, Current Contact Lens Practice by Nathan Efron, BScOptom, PhD, was reviewed by a panel of OptiBoarders including Pete Hanlin, Joann Raytar and Chip Anderson. Their reviews follow this post.

For further information and pricing on this title, please visit this page:

http://www.us.elsevierhealth.com/fcg...sbn=075064690X

Please feel free to discuss this book with the reviewers and post any questions you have.

[Pete Hanlin]

Review of: Current Contact Lens Practice, ed. Nathan Efron; Butterworth-Heinmann; Woburn, MA; 2002; ISBN 0 7506 4690
Reviewer: Pete Hanlin, LDO, ABOM

In his preface, editor Nathan Efron states, “My authorship team and I have worked hard to ensure that the text is well organized, approachable, and easy to read.” Their efforts have been well spent, for these are the very words that spring to mind while scanning through the well-thought out treatment of each subject.

Current Contact Lens Practice represents a worthwhile and necessary addition to the professional library of any practitioner. The student (or novice technician) will enjoy the conversational tone, while the seasoned clinician will appreciate the attention given to modern advances in materials, designs, and modalities of wear. With more breadth than depth in its scope, the text conveys that which is essential without going into the minutiae of any one topic.

The content is supported by an excellent (and bountiful) array of illustrations and images. For example, one of the appendices contains a series of illustrations depicting the various stages of frequently encountered contact lens complications. The illustrations are enhanced by descriptive captions and extremely helpful reference marks. “A picture speaks a thousand words,” has been well heeded by editor Efron, who has included an average of at least one or two images per page of text.

Perhaps the best indicator of the relevancy to modern practice is the extensive treatment of silicone hydrogel lenses. Distinction is made between lotrafilcon-A (Ciba’s Focus Night & Day) and balafilcon-A (B&L’s PureVision), along with the advantages and disadvantages of each material. Also included are discussions of current trends in contact lens modalities and production methods, as well as relatively recent advances in bifocal designs. While no one can predict the future of the ophthalmic industry, a very current picture of the state of contact lens practice as it exists in 2002 is presented.

In conclusion, Contact Lens Practice is likely to be retrieved from the bookshelf on a regular basis as a reference tool for the questions and situations routinely encountered in daily practice. For example:

• Which FDA Group IV lens has the highest water content? (Permalens, 71%, pg. 76)
• How can the effect of soft toric misalignment when using an over-refraction be easily calculated? (The formulae are represented as an Excel spreadsheet on pg. 130)
• Is there a RGP disinfectant solution which also contains a surfactant cleaner? (Yes, Solocare hard, by Ciba- pg. 212)

In his tribute, Nathan Efron notes that 2002 marks the 100th anniversary of the first textbook account of contact lenses. In Contact Lens Practice, he has provided clinicians with a text worthy of the centennial.

[Jo]

Contact Lens Practice
Reviewed by: Joann Raytar

Contact Lens Practice edited by Nathan Efron is a compilation of
information that benefits not only professionals working in optometric practices and students of optometry but also all optical professionals who dispense vision aides. The text provides one of the more thorough overviews of contact lens basics that I have read.

Dr. Efron's chapter on the Historical Perspective of contact lenses has to be one of the most interesting that I have come across so far. Normally, historical accounts of contact lenses include the inventors' names, dates the lenses were invented, the materials the lenses were made of, a time line and a list of major manufacturers for each lens. Contact Lens Practice actually provides a bit of a pre-history of contact lenses supplying the reason why contact lenses came about in the first place and describing early attempts at improving sight through some rather unique inventions. Who knew the first contact lens spin-casting machine was made using a child's Erector Set?

The bulk of Contact Lens Practice concentrates on the anatomy of the eye, specifically the cornea; fitting contact lenses and recognizing afflictions that contact lens wearers may present with. It is in these Chapters that the information gets a bit challenging; the text is definitely written for readers who have a basic understanding of anatomy and cellular biology. This isn't necessarily a bad thing. I found it nice to read information that was a little more in depth than most introductory texts and study manuals. This is the first time I have come across information about heat exchange, the expenditure of energy and the nervous system and how they relate to the eye in any introductory text. Contact Lens Practice also does a very good job of discussing pediatric and specialty lens fitting. The editor has included some excellent graphics and photos that pull the written information together nicely. For those who don't have a background in biology, it is a good excuse to have to do a bit of research if desired. Even if readers don't seek out information about some of the terms and processes described, the text is still serves as an excellent study guide for those who wish to learn about fitting contact lenses for certification exams. The book does cover all of the typical topics from K readings and working with patients to contact lens solutions. The book also does a nice job of touching on some of the business issues contact lens fitters will face. I was surprised that the authors even mentioned current retail pricing issues.

At first glance, one might think that Contact Lens Practice would have a heavily European slant to it but Dr. Efron has done a nice job of including authors from around the globe making the information pertinent no matter where you practice. It is terrific reference for any professional or student wishing to learn more about fitting and dispensing contact lenses a great a review for those who already have abackground in working with contact lenses.

[chip anderson]

Contact Lens Practice
Review By Charles E. (Chip) Anderson, FCLSA

Nathan Efron has assembled one of the most comprehensives in depth text yet on contact lens management and technique. It is for the contact lens fitter at any level. After more than 40 years as a contact lens "expert," I thought I knew most of the aspects of contact lens fitting. It has been many years since I attended a contact lens education course and been able to glean anything more than a few pearls, but this text made me aware of how much I do not know.

Contact Lens Practice presents a marriage of anatomy, contact lens mechanics, and optics in a very well structured manner. Opposing viewpoints on the fitting and the evolution of contact lenses are presented in the most concise form yet. Unlike courses that seem to be oriented to the techniques of individual manufacturers with casual mention of those of opposing loyalties, all views seem to be very well represented in this book. The knowledge presented here can cause the expert to question his knowledge and experience. This is just the text to make experts out of the novice.

No aspect of contact lens manufacture, fitting, problems, or unusual situations has been overlooked. The special situations that you felt alone in having to confront are addressed very well. The ordinary are met, but methods of dealing with the irregular damaged cornea are also handled exceptionally well. Both rigid and soft contact approaches to special situations are shown.

I would not hesitate to refer a patient to someone who has read this book. I say this as an old independent optician who remembers when optician contact lens fitters read only those publications of medical or optical origin. This is an excellent text for every contact lens fitter, regardless of his position in the O’s. If all of us were at the levels, presented in this text there would be no bad fits and very few unhappy patients.

Spend the money, take three weeks and read the book. Your patients will benefit even with the implementation of only a small portion of the contents. Unfortunately, the future looks as though the excitement and joy of contact lens fitting will soon belong to machines and the time for old tired opticians who love the hand modification, and hands on approach will soon pass.

[YourPAL]

This sounds like a great book but does it have to cost so much? One hundred and fifty dollars, is it possible for a student be able to afford another high dollar book? Albeit, If I were to put together a small Opthalmic libary, would this book rate as being a must have with the full knowage that most Optician will never have the oportunity to dispence contacts.

[wmcdonald]

I have not seen the book Pete, but I was under the impression that it was designed more for the CL professional versus a technician. I may have a misunderstanding of the difference in professional status and technical status. Can we use this text for tech training?

Warren

[Jo]

The book might help a technician understand a bit more about the lenses they are working with and the anatomy of the eye. It has been awhile since I read the book, but I do believe a good portion of it is targeted at folks planning on running a sizable contact lens practice.

If you are putting together a library, then yes it would be an excellent reference because of how many aspects of contact lens fitting the book covered. Chip & Pete have probably had the most experience fitting contacts so they would probably be the better critics to ask about Efron's book.

[chip anderson]

Jo:


Just in case you have failed to observe. The technicians are the experts, they are the ones with enough skills left to fit rigid lenses on transplants, keratoconnus, scarred corneas, etc. The professionals slop softlenses on and hopefully have great knowledge of pathology.
The technician will benefit greatly by knowing more about just what the professional is talking about and what he is doing about a particular condition. Unfortuately, our professsionals recieve little or no training as a contact lens mechanic and or technicians recieve very little if any training as an opthalmic pathologist.
This book pretty much brings it all together. $150.00? Face it, you have spent this much on a pair of tennis shoes for your kid. I will never understand why so many "opticians" don't go to educational meetings because "they" (thier current employers) don't pay my dues. The same people think they are doing well at $25.00 an hour, while others make over $100.00 hours, to a large degree this being due to what you know. I have practioners who can't stand me, disapprove of me as a person, but have great respect for my skills and continue to send me thier ultra-difficult cases.

I don' think knowledge is power, but knowledge with application is power.. No one should pay you for what you know, but they should pay with a smile for what you do with what you know.

Chip

[YourPAL]

Thanks Chip for clearing up the benefits of the book "Contact Lens Practice". I will be adding this book to my collection.

Being able to diagnose complications while fiting contact is of great concern to me. The ocular health of my paients will always have my utmost considerations. Now, if this book could only talk and tell me how to pronounce thoses dam latin words it would be marvelous.

Do you have anymore suggestions as to what books would be a must have for my libary that is not on the NCLA list.

I am also very interested in anti reflective coating and have not found much information on them, like what wave lenght are you breaking, what index is used to brake what ect.. When I speak to a company that sells AR coats my questions are answered with a quick silence or we do not give out that information. I must come to the conclusion that AR coats are a closely guarded secret, and if so how much trial and error do we need to go throught to find what works for what.

Many Thanks,
YourPal

[wmcdonald]

Chip,
My comment about technicians was to make a point. I those who fit CLs, especially those experts you ddescribe, are selling themselves short using the term technician. Reading the definition of technician in a variety of dictionaries will lead one to believe that they have little professional knowledge or skill, and only go through rote steps to accomplish a task. I hope to see CL professionals like you titled a bit more appropriately. That is the reason for my comment and I knew somebpody would respond as you did.

Warren

[YourPAL]

I agree that to call a Contact Lens Fitter, just a fitter is a misnomer. If they do have the immediate care of a patient and are responcibile for diagnoses are they not indeed a practitioner. If you can be sued, you are a practitioner. However, due to the fact that the medical community and its supporting institutions have allied politically they can ditate the naming of a profession and indeed control all fractions of the industry exspecilly the allied health fields. How will we then act with this understanding of our position, as an allied health member. Should we not work to strengthen our position in this process? If we all had an alike understanding of the inevitable changes forth coming, could we not advocate for our avocation?

Have you ever wondered about the name "allied health", sound condescending doesn't it? To be exact the wording means in support of, but not a part of, this one little word "allied" says it all, there aint no hiding it anymore boys, and that's the rest of the story.:hammer:

[Jo]

Chip,
I hope to see CL professionals like you titled a bit more appropriately.

Warren

I agree with that. I will openly admit that while most of the CL prescriptions we fill are for soft lenses, every now and then someone wearing RGP's comes in and if there are issues with fit I am not as comfortable with RGP's as I am soft lenses. I suppose it might be from lack of exposure but a big part of it is education. While we have to be trained in RGP fit and wear, most of our training and testing involves soft lenses.

I respect folks like Chip and others, including yourself, who could run rings around most CL dispensers.

[wmcdonald]

Isn't that what I get my shaving cream from each morning......?

[eromitlab]

I just got this book yesterday and I am blown away at how well it is written. Everything is well-written and clearly defined, something you don't see very often with textbooks (believe me, I have a bookcase full of music theory and analysis books that would be more useful to start a bonfire than to read).

I was a little shocked at the price, but after a trip to amazon.com, I got a new copy at half the price (including shipping) than what Elsevier has it listed at (looks like it may have been in a damaged lot, but hell, it still reads the same).

As an optician that was more or less 'thrown to the wolves' as a contact lens technician, this text is going to be my bible for the next few months as I prepare for the NCLE exam, and attempt to become a more competent and educated contact lens professional.

Thanks again for your recommendations and insight, Optiboarders like you folks are the reason I have chosen to stay in the field and inspired me to become a more complete optician.

[HarryChiling]

Sounds like a lot of priase for this book, I just added it the the http://books.onlineopticianry.com home page's slide show and the directory.

[Aadil]

Hello every one
Well no doubt the book is very nice and I am sure bout its content that every one is going to like it…..as the Author is having a great grip on this topic, anyway thanks for the Link….