Sometimes I wonder how I stuck to the optical business and profession for over forty years now. When I do reflect on this I immediately realize that it is the abundance of opportunities in all areas of our industry. There’s dispensing eye wear which includes the technical and fashion aspect of dispensing. All kinds of business models and opportunities. The fitting of contact lenses which could include orthokeratology and the fitting of the various designs of soft and rigid lenses. For me it seems that whenever I seem to be thinking things are routine someone yells “Squirrel“ and I find myself involved in something new whether it’s in my professional practice or in my opticianry advocacy world.
A number of years ago I was at a Contact Lens Society of America Conference in Tampa. I was there demonstrating the Eyelogic Sight Testing Systems which at the time was being used by quite a number of Registered Ontario opticians and opticians in other provinces. Our friend Keith Harrison introduced me to an optician by the name of Randy Kojima. Randy was demonstrating and promoting the value of using corneal topography in the fitting of contact lenses. It was a “Squirrel” moment for me when he demonstrated his corneal topographer for the assessment of the corneal surface and the virtual fitting of rigid contacts. It was the moment that “I saw it”. I finally could see the irregularities of levels or heights of the corneal surface contrary to its smooth spherical appearance. Over the years since then I have been able to use my topographer in the designing and fitting of some very interesting lenses as we can see the shape of the cornea.
Last fall one of our eye wear clients, Michelle, came into the store and asked if we would be able to fit her with scleral contact lenses as her traditional RGP lenses were no longer wearable on her 25 year old corneal grafts. “Squirrel” Of course we can fit you!
We got in touch with the lab whose design we decided to use and they sent us a fitting set for the trial fitting. The fitting of scleral lenses must include using a trial lens set. We had Michelle come in and we took maps, a history, slit lamp exam, and trial fit the scleral lenses. Over the next few months we used six lenses and Michelle was able to wear the lenses for most of her day especially for her son’s wedding. She achieved 20/20 in both eyes. Unfortunately her wearing time started to diminish after a few weeks even with our attempts to solve the problem. Enter Randy Kojima once again. Randy had sent me an invitation to a workshop a few days after I became aware of Michelle’s problem. The workshop would be on scleral contact lens fitting using the ICD16.5 IREGULAR CORNEA DESIGN. It’s from Randy and his brother Trevor’s company,Precision Technologies Services. It was being held in Toronto in conjunction with Paragon Optical, while he was in the area working at the University of Waterloo. I called Randy and asked if he would like a live model for his presentation and he accepted. I contacted Michelle and she was more than happy to participate.
We based our first trial lens selection on maps I had taken at the Eyeglass Factory. These lenses have a diameter of 16.5 mm! A far cry from the 9- 10 mm RGPs we are accustomed to. The key to fitting these lenses is to make sure there is no touch at any point on the cornea or limbus by the lens. Take into account the settling of the lens into the sclera which means don’t rush the trial. Once we were happy with the way the fluorosein patterns looked we waited another hour before assessing the lenses, over-refracting and making our final decisions on the specs of our initial pair.
Michelle was the perfect model and her presence afforded everyone in attendance a hands on experience with Randy demonstrating that this fitting philosophy makes sense and with a topographer and fitting set, we are able to offer a great service to our clients.
It turned out to be a great evening of opticians and optometrists sharing their knowledge while expanding their tool box in order to bring the best options available to our clients. Michelle was thrilled at the level of care and attention she received and very thankful; but the real thanks go to her for making her eyes available. In Part Two of this post I’ll let you know how Michelle is doing with her new lenses.
Whether you fit specialty lenses or not, this is the type of professional learning that can only encourage you to to expand your horizons within your profession, and stimulate your desire for advancing your professional knowledge and career. Share the knowledge. Those with the knowledge hold the power.
What are some of your “Squirrels” ?