Doctors, industry continue to improve contact lens products, delivery, patient care
A day rarely goes by without a development in the contact lens arena. Whether it is a new product, a different way to provide patients with lenses, a call for education, patient protection measures or a paradigm shift, there is always something new for contact lens prescribers to consider incorporating into their practices to provide better care.
Elise Kramer OD, FAAO, FSLS, primarily focuses on specialty lenses in her practice, and she believes every contact lens specialist should offer a wide variety of soft contact lenses.
“For any eye care practitioner (ECP), whether in primary care or specializing in contact lenses, competing with online retailers is a challenge that cannot be ignored,” she said in her Healio column. “For many Americans today, accessing an annual supply of the most advanced contact lens technologies may seem challenging at times. However, contact lens manufacturers are seeking ways to meet the joint needs of patients and ECPs with contact lens subscription programs.”
These programs can bridge the gap between contact lens wearers and their ECPs by streamlining the ordering process and improving access and convenience for annual supplies.
“These programs are generally convenient, reliable and affordable,” Kramer said. “They also save time and increase wearers’ loyalty to ECPs and the practice. They involve ECPs in the entire process from the examination to receipt of the prescribed product. They also provide a competitive alternative to the large online retailers that have been recently taking over the market.”
Kramer explained that orders are usually placed through the ECP’s practice after a comprehensive eye examination and contact lens fitting. The subscription programs allow contact lens wearers to maximize savings by using a rewards program established by the manufacturer and/or their full insurance benefits or by financing the cost of an annual supply into affordable payments, she said.
“It is, therefore, a good option for patients committed to contact lens wear but unable to order an annual supply up front,” Kramer said. “Busy patients may see the greatest benefits – for example, automatic receipt of their contact lenses, with monthly debits instead of paying for an entire year at once.”
When the patient does not purchase an annual supply, the office’s administrative time increases and is not covered by the low profit margin on individual contact lens boxes, she noted. With subscription programs, no fees are usually incurred to the practice to participate. Shipping is generally free, and the lenses are delivered directly to the patients, without clogging up practice accounts receivable and inventory storage. Some of these programs offer marketing and remind patients when they are due for their next exam and direct them back to the office.
CooperVision (through its subsidiary, EyeCare Prime’s Lens Ferry) has even committed to donating a free eye exam to Optometry Giving Sight for each patient subscription, Kramer added.
“In these programs, the prices of contact lenses available for purchase are usually decided by the practice itself, not by the manufacturer,” she said. “This personalization of subscriptions for each practice is important to both ECPs and their patients.”
Kramer said that some programs such as Boxsee even incorporate the practice’s logo into their monthly subscription lens box, and each delivery has a message from the office that can be personalized.
Lens Ferry S allows contact lens wearers to sign up and order their lenses from any connected device, she continued. Staff can enter patients into an electronic system after an examination or other appointment, and the patient then receives an email prompting enrollment in the program. Previously, everything had to be done while the patient was in the office, but now it can be done at the patient’s convenience.
Sightbox, an e-commerce system acquired by Johnson & Johnson in 2017, allows eye care practitioners to sell contact lenses online, Kramer said. For a nominal monthly fee, the company schedules patients for eye exams and mails them contact lenses. Patients, on the other hand, pay a monthly fee for which they receive a comprehensive eye exam and a 1-year supply of contact lenses.
MyContactLens creates a portal accessible through independent eye care professionals’ practice websites.
“Subscriptions improve patient loyalty and offer affordability and convenience,” Kramer concluded. “ECPs should offer an annual subscription to all their disposable contact lens patients.”
ECP perception of daily disposables largely positive
A majority of eye care professionals perceive that silicone hydrogel daily disposable contact lenses offer long-term eye comfort and health, a recent online survey suggests.
“The convenience and other benefits of 1-day contact lenses, combined with higher amounts of oxygen delivered with silicone hydrogel materials, is quickly becoming an industry standard,” Gary Orsborn, OD, MS, FAAO, FBCLA, vice president of global professional and clinical affairs at CooperVision, told Primary Care Optometry News. “Trends in the decisions U.S. optometrists are making in their contact lens practices are consistent with what is being seen in other key markets around the world.”
Researchers evaluated 300 eligible eye care providers from the U.S., U.K. and Japan. To be considered for the study, providers were required to be qualified to fit contact lenses; work at an independent practice, contact lens specialist store or chain, multiple retailer or ophthalmology clinic; have 3 to 35 years of contact fitting experience; be personally responsible for fitting and selecting contact lens brands; fit at least 25 patients with lenses in a typical month with 20% of lenses being daily disposable; and not be affiliated with a contact lens or health care manufacturer serving as a clinical consultant, researcher or investigator.
Participants evaluated 34 statements regarding the comfort, health, patient experience and standard of care of daily disposable lenses using a 6-point Likert scale, with a minimum 70% agreement required to define majority agreement.
Overall, the statement with the highest rating (93%) was “Silicone hydrogel 1-day lenses satisfy today’s patients’ demanding lifestyles,” with the statements “Silicone hydrogel 1-day lenses are the best choice to safeguard my patients’ eye health related to contact lens wear” and “Silicone hydrogel 1-day lenses provide the best benefits to my patients” tying for second highest at 92%. All statements regarding patient health (72% to 92%) met the threshold for majority agreement, while statements regarding comfort (88%), patient experience (88% to 93%) and standard of care (72% to 89%) all exceeded the threshold.
“With increasing parameter availability and a wide variety of options in silicone hydrogel 1-day lenses, it is surprising that more ECPs around the world are not prescribing these lenses for their patients,” Kathy Dumbleton, PhD, MCOptom, FAAO, FBCLA, associate clinical professor at the University of California, Berkley School of Optometry, told PCON. “Hopefully the results from this survey will reassure the ECPs who did not take part in it that their views are similar to their peers and motivate them to recommend and prescribe silicone hydrogel 1-day lenses for more of their patients.”
Alcon launches daily disposable contact lens in new material
Alcon announced the September launch of Precision1 daily disposable contact lenses, which the company said were designed to provide long-lasting comfort and ease of handling.
The proprietary SmartSurface technology uses a micro-thin, high-performance layer of moisture at the lens surface to help support a stable tear film and allow for precise vision and dependable comfort throughout the day, Sean Clark, general manager of Alcon U.S. vision care, said in a company webcast.
Clark explained how the company intends for Precision One, made of the silicone hydrogel verofilcon A, to fit into its existing portfolio of daily disposable lenses.
Dailies AquaComfort Plus is “tailored towards someone that’s looking for an exceptional value in a contact lens,” he said. “Dailies Total1 has been designed for the most extreme needs or somebody who wants exceptional comfort at the end of the day or perhaps has some compromise in their tear film.” Precision1 is “in the middle of the bell curve.”
Clark explained that 40% to 60% of the daily disposable contact lens business is in this “middle ground.”
Precision1 is “aimed at the person that’s looking for a lasting performance, somebody that needs strong visual performance throughout the day and strong comfort throughout the day,” he said.
Rick Weisbarth, OD, FAAO, vice president of professional affairs for Alcon, said in the webcast that the lens “was designed to address the common reasons why nearly one in five new wearers discontinues contact lenses within the first year, and the reasons are poor vision, poor comfort and something as simple as handling issues.”
“We’re launching a new daily disposable lens for patients to start in and stay in,” Mo Merchea, OD, PhD, MBA, Alcon’s head of medical affairs for surgical and vision care, said during the webcast.
Precision1 has an 8.3 mm base curve, Merchea said.
“Through our clinicals, we were able to demonstrate a 100% successful fit in corneal curvatures ranging from 36 D to 48 D,” he said. “That’s a broad enough range that covers pretty much any patient that’s being put into a soft contact lens.
“Additionally, we’ll launch with a full parameter range from +8 D to -12 D to help meet the needs of pretty much any patient walking into a practice looking for a daily disposable,” Merchea said.
In addition, Precision1 has Class 1 UV blocking capabilities, “the highest level that’s available in contact lenses,” he added.
Alcon noted in its press release that Precision1 was launched in Australia and New Zealand in March and that it expects to launch in additional global markets throughout 2020 and 2021.
CDC identifies need for education on contact lens care
One-third of contact lens wearers surveyed recalled never hearing lens care recommendations from their eye care providers although most doctors reported sharing them always or most of the time.
In a recent report from the CDC, Konne and colleagues recommended that ECPs use communication techniques that are easy to understand, specific, use repetition and minimize jargon and be sure the patient understands the information.
When the CDC released these study results, the group also collaborated with partners from clinical, public health, industry and regulatory sectors to promote healthy contact lens wear and care practices during Contact Lens Health Week, Aug. 19 to 23.
The American Optometric Association and the CDC partnered on a Facebook Live chat on Aug. 19, with AOA President Barbara L. Horn, OD, and CDC medical epidemiologist Jennifer R. Cope, MD, who provided prevention tips to help contact lens wearers keep their eyes safe from infection, according to a press release from the CDC.
According to the study in MMWR, Porter Novelli conducted an online survey of contact lens wearers and collected responses from 733 subjects who were at least 18 years old. The American Optometric Association received 365 responses from ECPs surveyed.
One-third of contact lens wearers recalled never hearing any lens wear and care recommendations, according to the report. About half recall a recommendation to not sleep in lenses and to wash and dry hands before insertion and removal. About 42% recall a discussion of replacement schedules, 12% recall being told to avoid swimming in their lenses, and 8% recall being told to avoid showering in their lenses.
ECPs said they shared these messages more frequently at initial visits and complication-related visits than during regular check-ups.
“Developing effective health communication messages can help ECPs communicate with their patients,” the CDC said in a related announcement about Contact Lens Health Week. “Practicing proper contact lens hygiene and regularly visiting an eye care provider are important actions for keeping contact lens wearers’ eyes healthy.”
Contact lens prescription verification bill introduced in Congress
The Contact Lens Prescription Verification Modernization Act was introduced in the House of Representatives July 25.
The legislation, sponsored by Rep. Bobby L. Rush (D-Ill.), is aimed at making the contact lens prescription verification process easier and safer, according to a press release from the Health Care Alliance for Patience Safety.
“HR 3975 increases patient safety by prohibiting prescription verification made via robocall and establishing a paper trail by instead requiring that online sellers use direct communication – a live phone call, fax or email – to confirm prescriptions,” the alliance said in the release. “The bill also requires online sellers to develop HIPAA-compliant methods for patients to electronically transmit contact lens prescriptions.”
The text of the bill is not yet available.
Deanna Alexander, OD, alliance chair, said in the release: “Increasing patients’ choice in the contact lens marketplace should never jeopardize patient safety.”
She said this legislation would address, “a loophole in the current passive verification system, which often leaves patients at risk of being provided incorrect prescriptions that can lead to adverse health conditions and even vision loss.”
While the FTC’s proposed supplemental rulemaking to the Contact Lens Rule, announced May 2, acknowledges problems with prescription verification via robocalls, it does not close the loophole, the alliance said in the release.
“The alliance believes congressional action is necessary to ensure that patients receive the exact lenses prescribed by their doctor and increase patient safety,” the group said.
Members of the alliance include the American Optometric Association, Johnson & Johnson Vision, VSP, CooperVision and Sightbox. – by Nancy Hemphill, ELS, FAAO, and Eamon Dreisbach
Konne NM, et al. MMWR Morb Mortal Wkly Rep. 2019; doi.org/10.15585/mmwr.mm6832a2external icon.
Orsborn G, et al. Cont Lens Anterior Eye. 2019; doi:10.1016/j.clae.2019.02.012.
For more information:
Elise Kramer, OD, FAAO, FSLS, who is residency-trained, practices at Weston Contact Lens Institute and specializes in ocular health and disease, ocular surface disease, and regular and specialty contact lens fitting. Over the last few years she has created a unique scleral lens practice.
Disclosures: Clark is employed by Alcon. Dumbleton reports she is a consultant for Alcon, CooperVision, Johnson & Johnson Vision and VSP. Kramer reports she is a consultant for Spectrum International Group. Merchea is employed by Alcon. Orsborn is employed by CooperVision. Weisbarth is employed by Alcon.