Influence of practice setting on contact lens prescribing in the United Kingdom

Morgan, Philip B.; Efron, Nathan

doi:10.1016/j.clae.2014.07.014

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…Reports of low confidence in lens fit success and vision performance, along with increased chair time, have been cited as reasons for hesitation among some ECPs to proactively and routinely recommend multifocal soft CLs. 11 The outcomes of this observational survey in relation to these attributes should help provide confidence that stenfilcon A multifocal performs well, meeting or exceeding ECP expectations. The very high proportion of ECPs agreeing to the perception statements at the end of the survey illustrates that these performance criteria were met or exceeded for stenfilcon A multifocal, with more than 90% agreeing that the fit guide was easy to use, the lenses fast and easy to fit, and that they would be a good option for both existing 1 day single vision wearers as they become presbyopic and presbyopes who do not currently wear CLs.…”

Section: Discussionmentioning

confidence: 93%

“…10 This still leaves around half of CL-wearing presbyopes being fit with something other than a soft multifocal design. Reasons reported for the relative lack of prescribing this type of lens design relate to both fitting and retention: lack of knowledge to fit multifocal CLs successfully, low success rates, and increased chair time have been reported as barriers; 11 drop-out from lens wear is higher in this patient group, most commonly due to lens discomfort and dryness, and poor vision. 12,13 To increase ECP prescribing of soft multifocal lenses, a CL needs to be easy and quick to fit, with a high success rate that can instill confidence in both the ECP and the patient.…”

Section: Introductionmentioning

confidence: 96%

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Wearer Experience and Eye Care Professional Acceptance with a 1 Day Multifocal Contact Lens

McParland¹,

Walsh²,

Comoroda³

et al. 2022

OPTO

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Purpose A large observational survey was undertaken to determine eye care professional (ECP) and patient experience of stenfilcon A multifocal soft contact lens (MyDay multifocal) when prescribed in a real-world setting. Methods A total of 196 ECPs from eleven countries fit up to ten presbyopes with stenfilcon A multifocal. Data were collected on fit success at the initial visit, patient satisfaction with comfort, vision at distance, intermediate, and near, overall vision, overall satisfaction, and handling at the initial and follow-up visits after 1–2 weeks of wear. ECPs completed questionnaires on multifocal fitting experience and expectations before and after the fitting period. Results A total of 196 pre-fitting and 141 post-fitting ECP surveys were collected. A total of 1505 initial fits (mean age 53.4, range 38 to 81 years, 73% female, 27% neophytes) and 1440 follow-up visits were completed. The mean distance vision contact lens prescription was −1.32DS (range −12.00DS to +8.00DS) with Add powers: Low 56%, Medium 24%, and High 21%. At the follow-up visit 77% ( n =1108) of trials were successful. Mean patient satisfaction ratings (1–10 scale, where 1 is not at all satisfied, and 10 extremely satisfied) at the initial visit were higher than eight out of ten for comfort, vision, and overall satisfaction, and were not significantly different after 1–2 weeks of wear. Stenfilcon A multifocal was preferred by 66% of patients over their habitual correction. In most cases mean satisfaction scores and the proportion of patients highly satisfied were not significantly different between myopes and hyperopes, across Add range, between new and habitual wearers, and wearers of frequently replaced and 1 day contact lenses. Conclusion ECPs in real-world clinical settings found stenfilcon A multifocal contact lenses easy to fit to a wide range of patients, with a high fit success rate and high levels of patient satisfaction for overall comfort, vision, satisfaction, and handling.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 96%

Wearer Experience and Eye Care Professional Acceptance with a 1 Day Multifocal Contact Lens

McParland¹,

Walsh²,

Comoroda³

et al. 2022

OPTO

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“…Technological advances facilitated by the high Dk/t of SiHy materials present potential opportunities for expanding the use of contact lenses in areas that have exhibited limited uptake in the past, such as astigmatism and presbyopia,20 where the thicker designs resulted in hypoxia. Indeed, many companies now offer both toric and presbyopic designs in SiHy materials and these options continue to increase in popularity 9,21–23. However, SiHy materials have been associated with reduced in-eye wetting in some patients with poor quality tear films24 and may also deposit tear film lipids to a greater extent than hydrogels 25–27.…”

Section: Introductionmentioning

confidence: 99%

<p>The short-term physiological impact of switching reusable silicone hydrogel wearers into a hydrogel daily disposable multifocal</p>

Moezzi

Varikooty

Luensmann

et al. 2019

OPTH

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Purpose: To evaluate ocular physiological responses to etafilcon A multifocal (etMF) daily disposable (DD) lenses after 4 weeks of wear, when switching from habitual silicone hydrogel (SiHy) daily wear. Method: A single-arm, open-label, bilateral dispensing study was conducted in 39 habitual spherical SiHy wearers (14 hyperopes; 25 myopes). Clinical visits occurred with habitual SiHy (control) at baseline and after 4 weeks of etMF DD open-eye lens wear at exit. Objective limbal/bulbar hyperemia using the Oculus K5M (0–4) and subjective grading of lid wiper epitheliopathy (LWE) (0–4) were tested for non-inferiority (NI), using a margin of 1 grade. Corneal thickness along a 10 mm cord was measured using the Visante OCT and tested for NI using a 30 μm margin. Corneal staining area was graded (0–100%). Results: The least-square mean differences (LSMD) and 95% confidence interval (95% CI) between etMF DD and habitual SiHy in central and peripheral corneal thickness (μm) were 3.64 (−2.0, 9.29) and 3.0 (−7.72, 13.72) in hyperopic, and 3.56 (−0.66, 7.78) and 6.40 (−1.62, 14.42) in myopic subjects. The LSMD (95% CI) for bulbar and limbal hyperemia were −0.08 (−0.19, 0.02) and −0.01 (−0.12, 0.09) in hyperopes, and 0.04 (−0.03, 0.12) and 0.04 (−0.04, 0.11) in myopes. The LSMD (95% CI) for LWE were 0.11 (−0.39, 0.60) and 0.30 (−0.07, 0.67) for hyperopes and myopes, respectively. Conclusions: No clinically significant differences in a variety of physiological responses were found when habitual reusable SiHy daily wear subjects were refitted into hydrogel etMF, when the subjects were followed for 4 weeks.

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“…We will explore two overarching issues: the key reasons for conducting aftercare examinations and the appropriate frequency for aftercare visits. Although many of the issues discussed here relate to all genres of eye‐care practitioner, our discussion will focus on the aftercare examination in optometric practice because of the unique characteristics of this profession, such as the often commercial practice setting and lens wearer demographics …”

mentioning

confidence: 99%

Rethinking contact lens aftercare

Efron

Morgan

2017

Clinical and Experimental Optometry

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The evolution of contact lens technology and clinical practice over the past three decades has been remarkable, with dramatic improvements in material biocompatibility, better lens designs and care systems, and more flexible and convenient modalities of wear. However, our approach to the aftercare examination has remained conservative, with the general modus operandi having not fully evolved from the difficult, early years of fitting non-regular replacement rigid and low water content hydrogel lenses. In this paper, we review current aftercare practice and in particular, the preferred frequency that lens wearers should return for routine visits and the appropriateness of regulations governing contact lens prescription expiry. Four key clinical reasons for conducting a routine aftercare visit are identified: preserving ocular health, maintaining good vision, optimising comfort and ensuring satisfactory lens fitting performance. Commercial reasons for conducting aftercare visits are also considered. A decision matrix is presented to help practitioners decide on an appropriate time interval between routine aftercare visits. The first aftercare visit should always take place within one to two weeks of lens dispensing. After this, the following time intervals between routine aftercare visits are advised as a general guideline: soft daily disposable, 24 months; soft daily reusable and rigid daily wear, 12 months; soft and rigid extended wear, six months. These aftercare visit frequencies may need to be adjusted when rapid rates of refractive change are anticipated, such as every six months during child/teenager myopic progression and every 12 months during the advancement of presbyopia. Numerous clinical caveats for varying these recommended aftercare frequencies are also discussed. Those new to lens wear should be seen within the first two months of lens dispensing. Regulatory authorities charged with the responsibility of stipulating the validity of a contact lens prescription should continue to allow optometrists to set an expiry date relevant to the circumstances of individual lens wearers.

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Influence of practice setting on contact lens prescribing in the United Kingdom

Cited by 8 publications

References 6 publications

Wearer Experience and Eye Care Professional Acceptance with a 1 Day Multifocal Contact Lens

Wearer Experience and Eye Care Professional Acceptance with a 1 Day Multifocal Contact Lens

<p>The short-term physiological impact of switching reusable silicone hydrogel wearers into a hydrogel daily disposable multifocal</p>

Rethinking contact lens aftercare

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