Advancements in specialty lens manufacturing have made it possible for more patients to wear contact lenses
December 16, 2014
By David I. Geffen, OD, FAAO
Increasingly, many practitioners in today’s practices are
using specialty contact lenses. These contact lenses historically have been
viewed as hard to fit, difficult to find, and much higher in cost. Let’s look
at what’s so special about specialty contact lenses.
Extended-range lenses
What determines that a lens is a “specialty” lens? There are
many categories of these lenses and way too many to list every brand and
manufacturer. The most common specialty lenses are the lenses which fall out of
the parameters of normally available lenses in a category. These would be
lenses that are higher in spherical power than the company normally
manufactures. Biofinity (CooperVision) is a typical lens in this category.
Biofinity spheres are available from +6.00 D to -10.00 D—a very large range,
which is good for the vast majority of patients. The Biofinity XR or extended
range lens is now available from +15.00 D to -20.00 D.
Dr. Geffen: The value of a contact lens patient
Most doctors and manufacturers consider these extended-range
contact lenses to be specialty lenses. These lenses allow us to serve the need
of our patients who fall out of the normal parameter ranges. These are ordered
and manufactured on an as-ordered basis at this time so you may need to wait up
to a few weeks to receive these lenses. There are also a number of smaller
specialty lens companies that manufacture lenses on an as-needed basis. These
companies have thrived in providing eyecare practitioners with lenses with most
any power or base curve or diameter a patient may need. They also can get these
lenses to patients in a few days.
Toric and multifocal lenses
Toric lenses are the next category of specialty lenses. Like
spherical lenses, the major manufactures have a limited power range typically
from +6 to -9 with 3 or for cylinder powers. The typical cylinder limit for
readily available toric lenses is -2.25 D. Smaller labs are able to fill in the
gaps and make a toric lens for our patients with almost any axis or power we
need. These lenses are available in a few days to our patients.
Multifocal lenses are also available in many custom designs
from small contact lens manufacturers. Some ingenious designs have come out of
these labs and we can serve many more patients than ever before.
Lenses for irregular corneas
Now let’s cover some of the truly special designs coming out
of smaller labs. Lenses for irregular corneas are changing the way we think
about providing excellent vision and comfort to our patients. These lenses have
provided a way for doctors to care for those patients who cannot or will not
wear rigid gas permeable (RGP) lenses. Bausch + Lomb brought us the Kerasoft
soft contact lens for irregular corneas. Kerasoft is available in a wide range
of custom parameters and base curves to correct the irregularities in the
cornea caused by keratoconus, surgical imperfections, and disease.
Dr. Geffen: R&D needed for new gas perm car systems, materials
Another lens in this category is NovaKone from Alden
Optical, one of several specialty contact lens labs that have made great
innovations in soft lens designs. NovaKone comes in any custom base curve you
would like and has different center thickness parameters to correct for
irregularities. There are several other lenses of these types from great-minded
individuals creating new and improved contact lenses for every need.
What makes them special
So why are these lenses special? They seem to be treated as
devices only certain doctors are allowed to use. They have a reputation as
being difficult and eating up too much chair time for many doctors. However,
because specialty lens companies are utilizing very advanced manufacturing
processes, the reproducibility and quality has never been better. You can have
the confidence that the patient will not be calling your office complaining
about the lens. These lenses do take a little more time and thought. Specialty
contact lens company consultants are excellent partners in your practice—they
want you to succeed and make it as easy as possible. The cost of the lenses is
higher than standard lenses, and this is a concern for many doctors. Remember
that these patients know that they are not the usual contact lens wearer and
know that they have special needs. As such, they expect to spend more for both
your expertise and the cost of the device. Optometrists are notorious for not
charging enough for our expertise and time. We need to be compensated for the
extra knowledge and study we do to learn about these special lenses and the
time we spend without patients.
So what is so special about specialty contact lenses? I can
answer that question only one way. These lenses are so special because we are
truly changing the life of patients who has sought our expertise to improve
their quality of life!
