Pat Caroline shares wisdom on presbyopic correction

At the ninth meeting of the CIBA VISION sponsored Specialist Club^® world renowned presenter Pat Caroline gave valuable tips on maximising success in presbyopic correction. Delegates enjoyed a full days programme which attracted 4 CET points at the Thorpe Park Hotel near Leeds on October 17th 2006.

The day started with a key note lecture on “How to Optimise Presbyopia with Contact Lenses”. Pat Caroline is Associate Professor of Optometry at Pacific University College of Optometry in Forest Grove Oregon and Assistant Professor of Ophthalmology at the Oregon Health University in Portland Oregon. The presbyopic patient offers a huge opportunity as only 4% of those over 50 requiring a prescription are wearing contact lenses. Professor Caroline reminded us of the challenges of fitting an aging eye and how important patient motivation is.

In a review of monovision he suggested a useful tip on using a +1.50 blur test for dominance as opposed to preferential sighting. Pat described a technique of hyperopic corneal reshaping with RGP lenses which is using ortho-K to induce a reading add in one eye. There followed a review of multifocal RGP designs and advice on how to incorporate prism for optimal positioning of translating lenses. The importance of pupil size was stressed, particularly when considering that the geometric centre of the lens normally differs from the visual axis. We were also reminded to consider the refractive index when prescribing RGP aspherics, the higher adds being much easier to achieve with high index materials. Finally, in a comprehensive and fascinating lecture, Professor Caroline presented information on multifocal soft and hybrid lens designs.

After the key note lecture the delegates split into four groups to attend each of four workshops. Pat Carolines workshop was entitled “Presbyopia and Contact Lenses” and he shared insights into optimising the fitting of bifocal contact lenses with particular emphasis on RGP products. Pat used a series of videos to highlight the fitting issues and outlined strategies to overcome some challenging patients.

The second work shop was delivered by CIBA VISION Contact Lens Consultant Jayne Schofield and started with an update on new silicone hydrogel products. She explored the compatibility of silicone hydrogel materials and solutions including an update on the latest research in this area. The conclusion was that peroxide is generally best to minimise staining, and if using an all in one solution be guided by the manufacturer’s recommendation. The same solution may perform differently with different silicone hydrogel materials.

Meanwhile Mark Draper, Professional Marketing Manager at CIBA VISION was exploring “Tomorrow’s Specialist Fitting Skills: A Subject for Concern?”. In this highly interactive workshop practitioners agreed specialist fitting skills were in decline amongst new entrants to the profession. Possible causes were the problems of clinical teaching at university and the lack of exposure to rigid lenses in the pre-reg year. Mentoring of newly qualified practitioners may help to overcome the issue.

Finally, the last workshop was lead by Mike Broadhurst. Mike is an independent practitioner with three practices in the north west of England. Mike discussed how to market a specialist practice and shared many excellent ideas, many of which were concerned with good communication to the patient.
Memorable advice included

• think of all patients as potential contact lens wearers and offer a trial
• have well trained staff and talk about new product innovation at every opportunity
• take the luxury out of lens wear by making it easy and accessible, then comparing the cost of a days use of contact lenses to other everyday items.

Specialist Club membership is open to all those registered with the GOC and having an interest in contact lenses. To join go to http://specialist.cibavision.co.uk/