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Thread: Chip and contact lenses

  1. #1
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    Chip and contact lenses

    Chip
    You are completely obsessed with contact lens correction of refractive error.You seem to think a good fitting cl is the answer to every high ametropes refractive needs.Have you never had any ocular complications to the contact lenses you have fitted?Do you fit extended wear?Did you ever see a corneal ulcer particularly before the advent of silicone hydrogels?Have none of your pxs ever had neovascularisation?The ideal way to wear cls is a combination of specs + cls.Many high ametropes want asthetically pleasing eyewear so it would be helpful if you give your experienced opinion on that instead of "this px needs a good fitting pair of cls"

  2. #2
    Bad address email on file John R's Avatar
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    Question Not that Chip need help..

    Chip is just expressing his views on what he thinks is the best soluition from his years of experience in the optical industry. We all have views on what is best, which is what makes things so good here as you dont get sucked into one view alone.

    I take it you are refering to the person with the +11.00 script in another thread here, and i have to say even though i have nothing to do with contacts, Chips answer added an extra element to the thread and brought up the fact the person already wore them, something we didn't know and proberly never would have either. In a lot of ways chips soluition was around the best going, but as the person seemed dead set on big specs made in glass. Nothing we were adding was going to make any diffrence.

  3. #3
    OptiBoardaholic sarahr's Avatar
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    I don't like the idea of a thread dedicated to criticising another member. It makes me very nervous of speaking my mind. Chip is entitled to his views and comments, ( I don't always agree with them;) !), but I think it's unkind to single out any one member in this way. I'm sure Chip will take your comments 'on the chin' and defend himself adequately, but just my opinion for what it's worth.

  4. #4
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    Pete: I have been around when PMMA lenses were the only thing available (Retail fitting since 1961 to be exact) and I do feel that everyone needing visual correction should have a pair of spectacles, the best that they can afford for whatever their condition is. I have seen most problems that can be caused by contact lenses both well and poorly fitted. However after decades of fitting high myopes, keratoconnus, hyperopes, aphakes (the non-pseudophakic type) and penetrating keratoplasties. It is my feeling that even if PMMA were the only material available, all patients with high Rx requirements would be better served by a well fitting, well supervised pair of contact lenes. Unfortunately due to the decline in the number of skilled fitters (and even the definition of skilled fitters) today, I can understand your leaning toward spectacle correction as the modality of choice.

    Chip

    For these people contact lenses (if well done) provide no decrease in peripherial vision, no ring scotomas, no distortions away from the center of the lens, and conciderably less image size discrepancy. You just can't say this for spectacles.

  5. #5
    Master OptiBoarder Joann Raytar's Avatar
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    :cheers:

    Cheers to Chip for offering advice on a corrective alternative to spectacles. Chip has been fitting contact lenses for quite some time and offers valuable advice. He isn't saying patients should rely on contact lenses exclusively but offering his opinion on the device that will offer patients the best vision.

    We often say ask patients about their lifestyles and fit them according to the understanding that one pair of glasses won't do everything. Why wouldn't contacts be a good choice for a second pair if best acuity is what the patient wants most?

  6. #6
    Master OptiBoarder
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    Fact is, Pete, everyone on this board knows glasses exist. 99% of us make a living from them. But not everyone deals extensively with contact lenses. When someone has a query, there are quite a few members able to give expert advice on glasses, but we pretty much only have Chip for the contacts. So we like that he tells us about them. If he was going to tell us about Essilor lenses all day, we'd have to get rid of Pete Hanlin :)

  7. #7
    sub specie aeternitatis Pete Hanlin's Avatar
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    Chip,
    Impressive answer...

    Pete Hanlin

    PS- Buy more Essilor/Varilux products! :D
    Pete Hanlin, ABOM
    Vice President Professional Services
    Essilor of America

    http://linkedin.com/in/pete-hanlin-72a3a74

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    I have been reading this thread with much interest . I respect the views of everyone who has posted, they are all valid.
    I agree with Chip in that everybody would benefit from a good pair of glasses even if they can wear contact lenses successfully. I would say that many times they complement each other.
    But there are situations in which some patients will achieve much better vision with a pair of well fitted contact lenses than with the best pair of spectacles, for example patients with keratoconus, corneal grafts, extremely high prescriptions, severe anisometropia or antimetropia, irregular astigmatism etc.
    For many patients, glasses might serve as a "backup" but would not give them the best possible visual acuity. Take for example a very high myope, (like myself when I was a -11.00) even with the excellent high index, thin and lightweight materials we have today, which make eyewear more comfortable, we still have the problem of excessive minification (or magnification in the case of the high plus), loss of depth perception and loss of peripheral vision.
    Patients with keratoconus, especially the advanced cases, cannot achieve optimal vision with glasses, same can be said about people with corneal scars, corneal transplants and anything that could cause irregular astigmatism, like refractive surgery for example.
    These people can only be corrected with a rigid gas permeable lens. Problem is what someone here already mentioned, there are not enough skilled people to do this so patients are missing on more options that could provide them with the best possible visual acuity.
    Going back to the eyeglasses, there will ALWAYS be a market for those. Not everybody is a candidate for contact lenses and even if they were, there are times when the use of contact lenses should be avoided or restricted for a while (like when we have an eye infection, a cold, etc.)
    When we reach the age of presbyopia not every contact lens wearer can adapt to or get a good fit on a bifocal CL so a pair of reading glasses on top of our contacts could be the best solution for many of us (myself included in this group)
    Many older people (and even young people too) simply have eyes that are too dry to use contact lenses. With our senior population there will always be a market for bifocals, trifocals and progressive lenses!!!
    And what about those who need prism, we know that in contact lenses we only use prism to stabilize the lens by preventing rotation but it doesn't help at all with diplopia. For those patients glasses are the only option as far as I know.
    So the need for eyeglasses will NEVER disappear. On the other hand contact lenses are the ONLY option for many people and I think that the value of contact lenses has been underestimated by many. In my opinion (and please don't take me wrong) too much emphasis has been placed on the "lack of profitability" from contact lenses to make them an option that many professionals don't want to pursue beyond the one size fit all lens approach.
    Contact lenses are view by many as nothing much more than a cosmetic device, more so since the soft disposable lenses are in the market. Very few professionals are interested in exploring the potential of specialty contact lenses such as custom made rigid gas permeable lenses, bifocal lenses, toric lenses etc. as a very valuable option for many patients out there.
    In summary, there is a market for both, eyeglasses and CL, they don't need to "compete" against each other. Each one satisfy a specific need and we as opticians should be well prepared to offer the patient enough information about all the options available for their specific needs.

  9. #9
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    Chip,
    I would almost drive from Reston to MS to get an appointment with you - or fly. I really, really, really want to get back into contacts. Are you aware of anyone in the state of VA or Washington DC whom you feel is a professional as described below as a dying breed?

    MUCH THANKS
    Abby

    "Unfortunately due to the decline in the number of skilled fitters (and even the definition of skilled fitters) today"

    "Very few professionals are interested in exploring the potential of specialty contact lenses such as custom made rigid gas permeable lenses, bifocal lenses, toric lenses etc. as a very valuable option for many patients out there."

  10. #10
    Optimentor Diane's Avatar
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    Abby,

    Contact the Contact Lens Society of America for an excellent referral for a great contact lens fitter in your area. I have some suggestions, but you may actually do better speaking directly with CLSA. Their number is 1-703-437-5100, and actually you may find a member on the website www.clsa.info. What you will need to look for is a Fellow member of CLSA. Under member search, look for the credentials FCLSA. That way you will have a better chance of getting what you are looking for. I still think a phone call to CLSA would be best. They are actually located in Reston, VA.

    If you want a suggestion from me, directly, e-mail me directly. I know a few great fitters in your area.

    Diane F. Drake, FCLSA
    Anything worth doing is worth doing well.

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