Priya Patel, OD

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Software engineers use the terms “front end” and “back end” to differentiate between the final user interface (front end) and the coded data (back end). The hardware contains the physical tools and infrastructure enabling the program to be processed and displayed. We can apply these same concepts to engineering a specialty contact lens (CL) practice.


	When we refer to a specialty CL practice, we are describing a practice that seeks to excel in and promote CLs as an exclusive niche, both clinically and financially. The clinical focus may be all encompassing or more narrow. A practitioner may choose CLs as a subspecialty and focus, for example, on presbyopia or pediatrics. Likewise, a clinic may serve a population of medically needy irregular cornea patients.

The definition does not imply that all lenses must be complex or custom designed. For example, a successful CL specialist might limit her fitting to soft CLs and still successfully serve a wide variety of patient needs.

How ODs should handle non-compliance with contact lens replacement

ODs are aware of the increasing influence (both positive and negative) of disruptors in the market. These include online spectacles, online exams, and alternative sourcing of CLs products. Direct-to-consumer subscription services are available as well. Many of these disruptors seek to bypass professional optometric services.

Developing a Specialty Contact Lens Practice of Excellence ensures a loyal patient base, one which is, by necessity, less price sensitive. In the end, CL specialists not only help patients see better and deliver life-altering care, but we derive continued intellectual stimulation and re-energize ourselves and our staff with the professional rewards.


	ODs need “data” to drive the specialty CL practice. First, develop an understanding of clinical indications for specialty CLs. Keep in mind that specialty lens fitting does not apply only to irregular corneas. Even “normal” corneas may benefit from custom-designed or extended-range soft CLs.

While the industry has seen a great expansion of available parameters in non-custom soft lenses, including daily disposables, CL fitters often see cases in which patients’ Rx needs fall outside these ranges. Even normal corneas cannot all be squeezed into conventional brands. Remember that sagittal depth comes into play with soft lens fitting, and horizontal visible iris diameter (HVID) is a better predictor of lens fit than central corneal curvature.

When choosing CL modality for correcting astigmatism, it is important to distinguish between corneal toricity and internal (residual) cylinder. When designing toric gas permeable (GP) lenses, corneal cylinder exceeding 3.00 D will require a back surface toric or bitoric CL, and visually significant refractive cylinder in the presence of a spherical cornea will require a front surface toric design.

5 tips to keep presbyopes in contact lenses

Aspheric multifocal CLs, whether GP or soft, are the design of choice for most presbyopes, except for patients having no intermediate needs and high visual demand for a fixed near distance.

Overnight orthokeratology (ortho-K) and myopia management are two fast-growing categories and represent opportunities for developing specialty services.4 The recent launch of an U.S. Food and Drug Administration (FDA-approved daily disposable center-distance multifocal design (MiSight, CooperVision) adds to previously available choices of off-label applications of an extended depth-of-field daily disposable, monthly replacement bifocals, and custom-designed planned replacement soft lenses. Overnight ortho-K offers the benefit of myopia control as well as the freedom from daytime visual correction and a reversible alternative to refractive surgery.

Medically necessary CLs aid in visual rehabilitation and provide critical surface protection for patients suffering from a wide range of anterior segment pathology, including corneal ectasia, post-surgical irregularity, corneal scarring, and a compromised tear film secondary to auto-immune disease. A practice’s “database” for this subspecialty should include a lens selection strategy.

Consider this proposed contact lens classification scheme:

Corneal GP, custom soft, hybrid lenses for low to moderate irregularity with centered corneal apex

Intralimbal or hybrid lenses for post-penetrating keratoplasty, post-filtration surgery, mild pellucid marginal degeneration.

Hybrid or scleral lenses for greater corneal irregularity, greater lid sensitivity, challenging environments and lifestyle

The next level of the data set is fitting analytics. This includes diagnostic (“trial” fitting) and empirical (topography-based modules) analysis. With increased prescription of scleral lenses as well as overnight ortho-K lenses, the trend over the past several years has been toward empirical fitting. This has been supported by increased availability of topographic and surface profiling instruments that offer CL design software modules. Some are brand specific, and others are brand agnostic.

Empirical fitting “gets you there faster” by limiting the number of trial lenses and fitting sets, and allows fitters to visualize changes without multiple on-eye trials. It also reduces potential re-orders.

For blink-independent designs such as ortho-K, scleral CLs and, to a large degree, intralimbal designs, empirical fitting is very reliable. Empirical fitting software also facilitates rapid calculations for back surface toric corneal GP lenses.

5 facts about contact lens wear with COVID-19

Diagnostic skills, however, still must be relied upon for evaluation of suitability for dispensing as well as for troubleshooting. Trial lens assessment is helpful when fitting corneal GPs and custom soft designs to gauge patient tolerance and evaluate lens centration and movement with the blink.

Here is a recommended fitting set inventory:

One well-configured spherical corneal GP fitting set in a 9.5 mm diameter

For presbyopic GP fitting, a low-eccentricity back surface aspheric design that can incorporate additional add power on the front surface will accommodate most needs

For mild corneal irregularity in post-refractive surgery or corneal transplant patients, one larger-diameter design (i.e., 10.4 mm) offering a reverse geometry profile is beneficial

Hybrid fitting sets are available for both regular and irregular cornea patients

Laser vision correction: Look backward to move forward

A solid foundation of specialty CL practice infrastructure includes clinical equipment and supplies, staff training protocols, and administrative procedures and tools.

Equipment considerations can be divided into basic tools and advanced technology. Necessary equipment is largely already found in a well-outfitted primary-care exam lane but should also include a topographer, V-gauge, loupes, a Burton lamp, and scleral lens inserters and removers. Advanced instrumentation to consider are a radiuscope, lens modification unit, anterior segment ocular coherence tomographer (OCT),  scleral profiler, and confocal and or specular microscopes. Must-have accessories include CL cases, disinfecting and storage solutions, lens cleaners, removers and inserters, and table mirrors.

Delegating all procedures that can be performed outside of the exam room is the key to achieving the most proficient and profitable CL practice. Staff training protocols should develop conceptual, technical, and patient-communication skills. This includes:

Proficiency and accuracy with instrumentation; ability to explain the why of testing

Topography and tomography: Knowledge of which maps are relevant to condition

Follow-up examinations: Understanding how to handle patient complaints and assess compliance with care products and I&R techniques

Phone triage: Knowledge of what constitutes an urgency or emergency, how to appropriately advise patients or direct their questions

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	The third cornerstone of your well-engineered specialty CL practice is comprised of the fee structure, the appointment template, lens ordering procedures, tracking and return protocols, and the written patient communications templates.

Your fee structure can be either “global” or “a la carte,” but in either case should yield proper return on investment for all materials and time spent with the patient inclusive of fitting, training, lenses, supplies, and follow-up care. Be sure to account for shipping and handling costs when setting your fees.

Regarding patient scheduling, here are tips for optimizing practice efficiency and profitability:

Differentiate between comprehensive primary care exam and CL consultation regarding exam procedures and the corresponding fees

Differentiate between CL consultation and the actual diagnostic evaluation

If possible, do not use chair time for procedures that can be handled by a technician

Work in other patients during all “fits”

Schedule catch-up time or time to work in new patients or dispensing visits on any given day

Finally, draft and store templates for patient forms such as advance beneficiary notice (ABN), financial agreement, scleral lens consent form (Figure 1), myopia management/ortho-K consent forms and letter of medical necessity (Figure 2).(See article on website for downloadable figures.)

The myopia epidemic: Are new therapies in sight?


	Through creative and resourceful front-end engineering, utilizing all forms of communication and media, ODs can convey their expertise, effectively educate current and potential new patients, and successfully build patient referrals.
	Let’s break down these marketing efforts into internal marketing and external marketing.


	The most direct and personalized approach is to start right in the exam room with the patient in the chair. Providing a newly fitted or refitted patient with comprehensive oral and written instructions is paramount to patient success and will ensure affirmation of the OD’s superior care and expertise.

Here is a short checklist of patient management best practices:

Prefitting: Summarize findings after comprehensive diagnostic evalution; describe two alternatives; explain the “first” choice; outline process

Dispensing: Reassure patient that it is not “one and done;” establish time guidelines; be sure all questions and concerns are addressed; mention after-hours “support”

Follow-up: Pre-appoint visits; post-dispensing call; update spectacles; perform any “postponed” tests; order spare lenses

Semi-annual or annual progress visits, even with a successful fit and happy patient, should never be merely “routine.”  Remember the “humble brag” goes a long way. Remind patients of how complex their cases were and how pleased you are at the outcome. Try to bring up one or two new developments you are looking forward to discussing or providing to them in the future.

Additional important touch points include the reception desk and the waiting area. This can come in the form of office brochures (Figure 3) and copies of articles in publications written by the doctors. The literature should cover a range of topics related to specialty lenses, from myopia management to scleral lenses, and serve as excellent conversation starters in the exam room. These brochures go on to list indications, fitting process, and basic handling. Patients are a prime source of family and friend referrals and an ideal demographic to offer an update to newer technology.


	Consumers are constantly bombarded with a stream of digital marketing sent directly to their handheld devices. In order to succeed with building an online presence, employing efficient strategies can capture the next new patient and keep current patients invested in the practice’s services.

Reach within the practice’s internal patient base is limited, so taking the marketing approach online may cast a wider net. Most social media platforms such Twitter, Facebook, and Instagram are free to post on. Sponsoring posts to targeted groups, such as “emerging presbyopes” or “mothers in your neighborhood,” is a cost-effective way to utilize the marketing budget. Numerous platform management tools, such as Hootsuite and Buffer, will streamline the tedious task of multiple daily posts onto various channels. A main key of gaining a social media presence is persistence in posting, instead of a “set it and leave it” approach.

Corneo-scleral topography allows for precise fitting

Facebook Boost or sponsored posts are a cost-containing option in comparison to print ads. Digital Facebook advertising works within a budget to set parameters to reach a specific age range, gender, and ZIP code.

Newspaper ads and alternative print ads are often much more expensive and require weekly repetition to truly gain traction.

One of the first impressions of the office is the practice website. It is imperative to make sure it is mobile-device friendly (optimized for mobile). In order to achieve search engine optimization (SEO), ensuring that the site appears high on the list of results through a search engine, list all available services. The addition of a blog or newsletter added in accordion pages can improve the ranking of the page in search engine results. This can include industry and professional journal publications.

Google Reviews are a strong basis of internet referrals. Once the front desk staff confirms updated email address and mobile number for patients, they receive a direct link to write a review after completing their exams. The reviews then show up to the office-location–specific Google pages, linking real patients and their experiences in their own words with the office information directly alongside it.

Finally, referral sources from within the community are a tried-and-tested option to building a specialty contact lens practice. During calmer periods, meet with corneal specialists, pediatric ophthalmologists, cataract surgeons, pediatricians, and optometrists in various settings. Instead of setting up an appointment and taking up valuable time otherwise spent with their patients, call ahead to ensure the specific doctor is in that day. Stopping in during patient hours allows time for a brief encounter with the office manager and the doctor between patients regarding the services you can offer. Often, bringing literature such as the brochures mentioned in this article, as well as referral pad and business cards, will serve to remind the doctor when the next CL patient comes around. After a canvassing visit, we send a letter to summarize our discussion, and reiterate our promise to send the patient back for all other services.

Articles

Contact lens experts detail how to help more patients see better and deliver life-altering care.

Engineer a specialty contact lens practice

The specialty lens-fitting optometrist has a variety of lenses in the arsenal to choose from for the simplest to the most complex patient. Armed with patient goals in mind, increasing options can push ODs to aim for the “troubleshooting” tool without a reason to consider the simpler solution.

Many times customized gas permeable (GP) lenses or scleral lenses are the only fix, but taking a step back can yield a creative solution using standard designs. This article will highlight several such cases.
	
	

Scleral lens aids in visual rehabilitation


	A 71-year-old Caucasian male, JZ, presented to our office after previously wearing keratoconus-specific aspheric design GP lenses, customized soft lens for keratoconus, and most recently a mini scleral design. See Figure 1 for his topography.

He complained that the GPs were uncomfortable, the customized soft lens did not yield great vision, and he had difficulty applying and removing the scleral.

In spectacles, he was correctable to OD -5.50-2.75 x 148 with visual acuity (VA) of 20/50, OS -0.75-3.25 x 095, VA of 20/30+, and preferred glasses to contact lenses. He had discontinued lens wear several years prior.

Initial evaluation was undertaken utilizing Biofinity Toric XR lenses (CooperVision): OD 8.7 mm base curve, 14.5 mm diameter, -5.50-2.75 x 150, and OS 8.7 mm base curve, 14.5 mm diameter, -0.75-3.25 x 095, yielding 20/25- vision OU.

Though the rigid lenses produced better vision, JZ stated that he felt more comfortable physically with soft lenses and would wear the soft toric lenses full time. He reported glare with the right eye, the eye with the bigger cone; nevertheless, JZ ultimately had better success with the XR toric lenses and has been wearing them full time.

This case demonstrates that soft toric lenses may be an option when best-corrected spectacle VA is acceptable to the patient.
	
	

5 reasons ODs don't fit toric contact lenses


	A 43-year-old Caucasian female, LM, complained of strain when reading near in low light in her MyDay (CooperVision) toric lenses. Because her cylinder was OD -1.75 D and OS -2.25 D, she could not accept the vision from a standard soft multifocal lens, even in her non-dominant eye.

We discussed monthly Proclear Toric Multifocals (CooperVision) as well as a custom-designed toric multifocal by SpecialEyes. Because she preferred daily disposable lenses, we pushed +0.50 D sphere over her non-dominant eye, and she was able to see 20/20 comfortably at both distance and near.

We look forward to the future when daily disposable torics are available in presbyopic designs, but for now, often a mild monovision adjustment solves the problem.
	
	


	A 17-year-old Asian male, ZL, came to the office after experiencing bitemporal headaches and asthenopia. He had been experiencing stress with the college admission process. 

In his current glasses that were just about a year old, he was seeing OD 20/40-2, OS 20/40-2. We measured a full diopter myopic shift with a normal retinal evaluation. At near, he was seeing 20/25+ OU but exerting effort, resulting in strain and requiring an add of +1.00 D.

We diagnosed accommodative insufficiency. He displayed the common symptoms of blurred vision, headaches, and loss of concentration.

We discussed vision therapy as the most effective treatment for accommodative dysfunction to increase accommodative amplitudes, but he was already overloaded with exams and extracurriculars. ZL simply requested an updated glasses prescription and was open to considering contact lenses.

We elected to fit NaturalVue Multifocal daily disposable lenses (Visioneering Technologies), which have a universal extended depth of focus add with a center distance design.

ZL made a follow-up appointment two weeks later. At that visit, he was seeing 20/25+ OU at both distance and near, and his headaches had resolved.

This case illustrates how multifocal contact lenses may be beneficial for children and young adults experiencing symptoms related to accommodative dysfunction.
	
	


	A 50-year-old Asian female, HC, came to our office expressing difficulty reading street signs 13 years after LASIK OU. She had been fit in -1.00 D sphere OD, -0.75 D sphere OS lenses and saw 20/20 in the distance but needed to use +1.50 D readers over her contact lenses.

We discussed retreatment with Kamra corneal inlay (AccuFocus), but she did not want to go through another surgery. Because she initially chose LASIK to avoid glasses, we decided to try a soft multifocal to correct her distance and near vision.

We prescribed Alcon Dailies Total 1 Multifocal: OD 8.5 mm base curve, 14.1 mm diameter, -1.00 D, low add; and OS 8.5 mm base curve, 14.1 mm diameter, -0.75 D, low add. This lens yielded 20/25+ OU both at distance and near.

The aspheric lens was able to mask aberrations and provide improved subjective vision.

 Additionally, we chose a low-modulus lens, which draped over the cornea more smoothly (Figure 2). She was happy in these low-add multifocal lenses OU.
	
	

Fit multifocal lenses for older and younger patients 


	A 70-year-old Caucasian female, ES, presents with a history of numerous strabismus surgeries, complaining of diplopia in all gazes. ES is a daily disposable contact lens wearer considering another revision surgery for her residual 6^ esotropia and 4^ right hypertropia.

She is currently a vision therapy patient with good horizontal control, but she is frustrated with diplopia resulting from the hyper deviation. Her most up-to-date manifest refraction is OD: -6.50-1.75 x 025, 20/20; OS: -6.25-1.25 x 170, 20/20.

She has two options:
	
	• Continue with her current daily disposable toric contact lenses in both eyes with vertical prism glasses
	• Consider a customized soft toric lens with vertical prism correction by SpecialEyes

Specialty contact lenses can include customizations including incorporating base down prism (SpecialEyes allows a maximum of 4^ base down optical prism in a lens).

 The empirical order of the right lens is 8.0 mm base curve, 14.4 mm diameter, -6.00-1.75 x 020,  4.0^ base down in the SpecialEyes Toric 54 percent material.

Along with good control of her horizontal deviation, ES needs 4^ needs base down vertical prism over her right eye to alleviate her diplopia.

Upon dispensing the empirically ordered lens for the right eye, ES corrected to 20/20 OU with no residual vertical misalignment. Additionally, she is able to function without the need for glasses over her contact lenses. ES is elated with the results.
	
	

Related: Experts offer advice on fitting, pricing daily disposables


	A 65-year-old Caucasian female, RM, is loyal to her GP lenses, but she is frustrated with the “film” appearing on them throughout the day (Figure 3).

Initially, she removed her lenses midday to clean with Boston Simplus (Bausch + Lomb) before re-insertion and subsequently moved on to using alcohol-based Lens Fresh cleaner (Orion Vision Group) multiple times a day. Frustrated with the frequency of cleaning her lenses, she arrived seeking a better solution.

RM wears the same parameter aspheric GP multifocal lenses in both eyes: 7.64 mm base curve, 9.49 mm diameter, +7.50 D sphere, +2.50 D add, 3.0 mm center-distance optic zone.

After a thorough fit assessment and ruling out a significant contribution from dry eye disease or meibomian gland dysfunction, the next pair of lenses were ordered with Tangible Hydra-PEG (Tangible Science). Tangible Hydra-PEG is a 90 percent water PEG-based polymer mixture that is covalently (permanently) bonded to the surface of the contact lens, creating a wetting surface on the underlying lens material, separating it from the ocular surface and tear film.

RM continues to wear the new lenses without filming concerns and rarely finds herself taking out the lenses midday to clean.
	
	

Increase contact lens comfort by paying attention to the lids


	A 61-year-old Caucasian female, SG, is a long-time two-week disposable contact lens wearer complaining of dryness worsening throughout the day. After discussing the health benefits and added convenience of upgrading to a daily disposable lens, she agreed to the update.

Her most current refraction is OD -1.50-1.25 x 160, 20/15; and OS -1.50-0.50 x 015, 20/15.

We refit SG from Johnson & Johnson Vision Acuvue Oasys for Astigmatism/Acuvue Oasys to the same prescription and material (senofilcon A) in a Acuvue Oasys 1-Day/Acuvue Oasys 1-Day for Astigmatism. Lens parameters are OD -1.50-0.75 x 160, base curve 8.6 mm, Acuvue Oasys for Astigmatism; and OS -1.50 D sphere, base curve 8.4 mm, Acuvue Oasys.

At the follow-up visit, she reported the vision and comfort of the lens in the left eye was unequal to the right eye and inferior to her two-week lenses. On a positive note, her dryness symptoms were considerably improved.

We tried multiple other daily disposable designs without success; SG felt the same physical discomfort in her left eye.

As a last resort, we tried Acuvue Oasys 1-Day for Astigmatism, base curve 8.6 mm,  -1.00-0.75 x 020. She reported an immediate improvement in comfort. We hypothesize that lid interaction with the prism ballast system in the toric lens OS created a different sensation compared to OD. Her vision still corrected to 20/20 OU, and feelings of discomfort remain resolved.
	
	

Why you should add upper lid eversion to your comprehensive exam

Case 8: When sclerals are not the solution


	A 44-year-old Caucasian male, ED, presented with an unknown scleral design in both eyes fit by another provider. He is frustrated with variable vision, discomfort, and redness after a few hours of wear.

ED had strabismus surgery in the left eye to correct an esotropia as a child, but he still manifests a residual 10^ intermittent left esotropia. His entering acuities with his scleral lenses were 20/30 OD and 20/40 OS.

Upon initial examination, the cornea exhibited epithelial bogging likely from interaction with non-preserved saline and excessive vault underneath the lens (greater than 300 nm).

 The fit was tight; we noted significant conjunctival impression post lens removal.

After a week long wash-out period of no lens wear, the initial refraction post lens wear revealed OD -14.00 D sphere, 20/30; and OS  -14.25-0.50 x 90, 20/50.

At the one-week follow-up visit,  we trialed Alcon Dailies AquaComfort Plus OD -12.50 D sphere; and OS -11.50 D sphere OS. With these lenses, ED achieved visual acuity of 20/25 OD and 20/40 OS. The symptoms of fluctuating vision, discomfort, and redness subsided, and he is remains happy with the convenience of daily disposable lenses.
	
	

Daily disposables deliver benefits for patients and practicioners


	A 62-year-old Caucasian male, JG, is post cataract surgery in both eyes with multifocal intraocular lens implants. Evaluation without contact lenses reveals residual refractive error, higher order aberrations, and symptomatic glare in his left eye.

Uncorrected acuity is 20/25 OD and 20/40 OS. He notes best visual acuity in bright light. With his habitual daily disposable contact lenses, toric OD and sphere OS, VA is OD 20/20 and  OS 20/50.

Shortly after his cataract surgery in the left eye, JG developed posterior capsule opacification (PCO). JG’s surgeon removed the PCO via YAG capsulotomy, then recommended PRK in an attempt to alleviate his symptoms.

 In his search for a second opinion, the likely next step was lens exchange surgery, but the YAG procedure rendered any subsequent lens exchange surgeries too risky.

 The resulting corneal surface is irregular, and his aberrations are still present.

What ODs need to know about YAG laser vitreolysis for floaters


	
	We initally elected to fit a hybrid design at the referring surgeon’s request, but after experiencing decentration challenges we moved on to a scleral design.

We fit a Bausch + Lomb Zen RC scleral lens with parameters of 7.71 mm base curve, 4400 sagittal depth, 15.4 mm diameter, +0.25-0.75 x 030. This lens improved his vision from a slow 20/40 to 20/25+ in his left eye.

JG wears the lens for a full day with good tolerance with nearly full elimination of higher order aberrations and glare.


	Keeping patient goals in mind, innovative solutions often enable simple solutions to seemingly complex problems. This creates a loyal patient base and solidifies the doctor as an expert problem solver. The advancements in contact lens technology afford ODs the opportunity to optimize both vision and comfort even for out-of-the-ordinary patients.
	
	

 likes spends her time training for marathons and endurance bike rides. She has no disclosures.
	priyaa1025@gmail.com
	

 likes to scope out the up-and-coming hotspots in the NYC restaurant scene. She has no disclsoures.
	

is a Diplomate in the Cornea, Contact Len,s and Refractive Technology Section of the American Academy of Optometry, a Diplomate of the American Board of Optometry, and a Vision Source Administrator. She is a consultant or speaker for Alcon, Baush+Lomb, and Visioneering Technologies, Inc. She likes to spend time with her newborn grandson and work on her golf game.
	

1. GP Lens Institute. Lens Materials and Treatments: What GP Lens Material Do You Recommend? Available at: https://www.gpli.info/lab-consultant-materials-treatments/. Accessed 6/28/19.
	2. Chmiel J. Comparing Custom Soft Toric Lenses to Off-the-Shelf Toric Lenses. SpecialEyes. Available at: https://specialeyesqc.com/blog/custom-soft-toric-contact-lenses-vs-off-the-shelf-soft-toric-contact-lenses/. Accessed 6/28/19.
	3. Brujic M, Miller J. The Stereopsis Solution. 

. Available at: https://www.reviewofcontactlenses.com/article/the-stereopsis-solution. Accessed 6/28/19.
	4. Sindt CW. Tangible Hydra-PEG: A novel custom contact lens coating technology designed to improve patient comfort and satisfaction. Tangible Hydra-PEG Whitepaper. Available at: https://www.artoptical.com/storage/docs/THP_White_Paper.pdf. Accessed 6/28/19
	5. Caroline PJ, Andre MP. “Life” beneath a scleral lens…epithelial bogging. 

 Available at: https://www.clspectrum.com/issues/2015/march-2015/contact-lens-case-reports. Accessed 6/28/19.
	6. Yu JO. Fitting Contact Lenses Post-LASIK: Using the full spectrum of contact lens options will help optimize difficult post-surgical fits. 

 Available at:
	https://www.clspectrum.com/issues/2009/november-2009/fitting-contact-lenses-post-lasik. Accessed 6/28/19.
	7. Schena LB. When Lenses go Wrong: Tips on IOL Explantation. American Academy of Ophthalmology. Available at: https://www.aao.org/eyenet/article/when-lenses-go-wrong-tips-on-iol-explantation. Accessed 6/28/19.
	8. Kent C. Three Cases: Explanting the Errant Intraocular Lens. Rev Ophthalmol. Available at: https://www.reviewofophthalmology.com/article/three-cases-explanting-the-errant-intraocular-lens. Accessed 6/28/19.

Author | Priya Patel, OD

Articles

Engineer a specialty contact lens practice

9 simple solutions to 9 complex cases