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Test

 assistant managing editor, Emily Kaiser Maharjan, to discuss custom fitting contact lenses as a business model.

 This transcript has been lightly edited for clarity.

Hello and welcome to Optometry Times On Air. My name is Emily Kaiser and I'm the assistant managing editor of Optometry Times. I'm here with Dr Luis Rojas, custom contact lens fitting extraordinaire. Welcome to the show, Dr Rojas.

Hi, how are you? Thank you for having me.

I'm good. Happy to have you here, really excited to really dive into it. So first, can you please describe what custom contact lens fitting means to you? What sets it apart from a standard lens fitting?

Yeah, that's a great question. When I think about custom contact lens fitting, I truly mean it in a tailored type of way. You're tailoring it to the needs of the patient [and] the visual demand of the patient. When I think about custom contact lens fitting, I really refer to it in terms of soft lens customization and tailoring to the patient's needs. The visual demand of the patient, any particular hobbies, their day in and day out from morning till night, and I'm tailoring it to their life. 

Whether or not I have full control over the material, the aspects of the size, the prescription, I'll do my best to do that. But, I really want to listen and take the time to listen to the patient, and really address all their concerns, their visual demands, [and] come up with the solution. More importantly, just have the realistic expectations of how to tackle all those issues.

Fantastic. How can optometrists give their patients the custom fitting experience? Do they need any equipment to level up, is that pretty approachable?

You don't have to have the fancy equipment. I will say, if you have a typographer that has a pupillometry, that will kind of explain some types of designs out there. So if you can explain to the patient, "hey, I'm measuring your your corneal shape, and on top of that, I'm measuring your pupil size in different light settings, whether it's nice optics go topic." You can explain to the patient, I'm selecting a type of lens that has a certain type of power profile that's tailored to the patient's pupil size. So, you can use that instrumentation to help. 

I'm very visual in my office. We have a lot of technology, we have screens to show them all the tech and scans that were that we're doing. So do you have to have these fancy toys? You don't, you just need to listen. You need to have a really good case history. Most of the equipment that optometrists will have in their office should be sufficient to tailor to their needs. But, I think that one of the biggest things is finding the time clock and trying to take that time to really listened to the patient. 

And I think that, going back to your original question, it's more of that custom contact lens fitting approach, where you're just taking the time to really tailor that suit to them. In regards to vision, this ends up being that tailor contact lens.

So, it sounds like you know patient communication is a huge part of the custom contact lens fitting experience. It's not just about getting the lens to fit the eye. It's also getting the patient to understand why it fits the eye or why you're doing the steps that you're taking to make sure that this is what fits.

Yeah, that's correct. I mean, we're in 2023. Moving forward, almost every contact lens has an amazing perk or some type of technology that's just fresh. There's a lot of leaders in the space as well. So in regards to what you're saying, that's absolutely right. The fitting process in itself, the actual physical fitting, ends up not being the hard part. It's trying to select which awesome lens is out there that can better fit the patient's visual needs.

So nearly every type of contact lens on the market has a fitting guide or calculator. How can optometrists leverage these tools to get the best possible outcome?

These are offered by companies as guardrails. They want you to have first time fitting success and they want it to be easy, especially when we're talking about multifocal. [It's] one thing fitting a spherical product, but a multifocal is like fitting a progressive lens with so many corridors. If we're talking about glasses, we're talking segue height and power profiles [and] how fast you get into the different zones in the progressive. Well, if we change that conversation to contacts, we also have different power profiles. 

Every manufacturer has some proprietary thing, so they have a different transition into that multifocal or bifocal segment. You have to understand what the limitations are and the guardrails of these calculators. Ultimately though, you're the doctor.

So yes, it's telling you stick to this, stick to that, but if your experience and understanding the patient's working distance, the expectation and again, going back to visual demand, you can go off those guardrails. That's something that we do all the time, we call it off label. I would say more than half of what we do is considered off label.

Right and once again, that's kind of feeding into the customer experience is fitting what fits the eye in front of you rather than this "fantasy eye" that we're working off of with the fitting guide.

It's not a schematic guy. This is a living breathing person and whether they had previous surgery or other medications that they're taking, maybe some trauma, you have to take in all of that. When you're looking at a calculator, it's giving you that perfect example, perfect patient. Let's be honest, there's not like a perfect patient.

For sure. So when sitting down to fit contact lenses, you aren't just looking at correcting visual acuity. You're looking at the patient's entire visual system, and you're considering their preferences. How do you usually factor in considerations for dry eye, for contact lens materials, for filtering for blue light, and stuff like that?

It all plays a big role, and it's just a big puzzle piece. You're collecting these pieces of the puzzle throughout the case history, throughout the examination process, whether you take photos of the cornea, whether you notice that there's a reduced tear breakup time. Perhaps they have very sensitive eyes or photophobic. So, you're considering whether we're trying to reduce glare and halos or light scatter. There's so many factors to consider. 

As I'm doing the exam, I'm taking mental notes of where am I going with my contact lens selection [and] how can I leverage that? By the time I get to my contact lens room, I have all these products in front of me and you quickly, in a matter of seconds, whether you call that muscle memory or not, you have to go and select the right product, usually just trust your gut. You know the perks, you know the high points of every lens. Like I said, it's a puzzle piece, but you need to address the patient. For example, [the] patient has dry eye, but they also have light scattering at night. Well then, what lens is out there that can give you that? How can I reduce the evaporation rate of the eye? If I place this contact lens with a certain type of material will I exacerbate the underlying dry eye? Will I enhance the vision by preventing the evaporation of the tear film? 

You have to consider all of these pieces and then explain it to the patient. Going back to communicating with the patient, if you have the mindset of, okay, this patient is going to leave my office and they're going to know exactly why I fit them in a particular product. I think a lot of us can do better about that. Sometimes we just, again, go muscle memory, grab a contact lens, here you go, here's your minus two lenses. The patient has no idea of why you chose it. Vocalizing everything that you're doing is so, so important. I tell the patient as they're washing their hands, "hey, you have this product it has a pupil optimized design. It's tailored to your pupil size, by the way it cuts evaporation rate." Some of them may or may not get that, but I do have a lot of engineers, and they ask those particular questions. 

So it's a very, it's very helpful to explain that. But, I want them to know [they were] not just fit in a contact lens, it was tailored to [their] visual needs, [I] listened to [their] needs, and [I] selected a product and [they] know exactly why.

I'm sure that that helps a lot with patient satisfaction. And even the patients who maybe go home and try out their lenses, and they don't like them for whatever reason. They can come back and have a more informed discussion with you about, "I know that you fit me in this for this reason, but my dry eye is still really bothering me. Can we do something about that?"

I let them know you're not married to the product. At any point in time, we can make changes. That's part of that tailoring process. We have up to, at least in my clinic, 60 days to do that. I'm not going to take the full 60 days, but it's nice and comfortable for the patient to know [they] can come back and re-tweak this and just give it a shot. Again, that perfect patient, you think they're gonna do great in this power profile, this material is gonna be great for them. Or, maybe they have a high prescription [and] they need a breathable lens so they don't have any corneal pathology that develops later. Then they come back, they say it's too stiff, or it's too difficult to use. So, you just have to keep an open mind. In our office, we are about 90 to 92% Johnson and Johnson. 

I am a consultant for Johnson and Johnson, but I feel like their products are very tailored to the patient. We have a wide variety of lenses in our office that we can help [fit]. We fit every type of brand, there is no brand that we don't fit. But, I do feel like the moving forward and the technology aspect of Johnson and Johnson's lenses have have really pushed the boundaries, especially with the new blue light filter that they're incorporating in the max lens and that pupil optimized design. So I do feel like that is the next level of tailoring a prescription and a contact lens that almost matches the tailoring approach that you're doing in a progressive glass. So I think that's pretty unique.

Yeah, absolutely. Going back to our conversation earlier about how you never really have the perfect patient in front of you. Part of that also comes down to patient behaviors. Maybe they aren't always following the correct timeline of how long you should be wearing their contacts or the correct cleaning protocols and stuff like that. 

So, how do you address those issues as they come into the clinic? If they come in and they say, "oh, man, my contacts feel like they don't fit well." And you [say], "Well, how long are you wearing them?" And they [say], "like 14, 16 hours." Do you bake that into your workflow, or do you adjust for that when you're prescribing these contacts?

I listen to the patient. I'm understanding, I sympathize with the patient. I've been practicing for almost eight years. When when I first graduated, I'm wanted to be the people pleaser. So I said, "oh, don't don't worry you can continue doing that." That's a very bad approach just to win a patient over and just go along with their habits. I also, over time, have learned if you are really, really strict, you may rub somebody the wrong way. So there is something right in the middle where you understand their their habits, and you start making some micro changes over time. You don't have to instill a lot of fear, or show them acanthamoeba or an ulcer in a cornea and say this is what's going to happen to your eyes. 

Some of them do need that. But, I'm very frank with them and said, "hey, you only have one pair of eyes, so daily disposable contact lenses are going to be the healthiest [and] the most hygienic." We always start off with daily disposables in our clinic. We don't even, how should I say this, ask what do you prefer? That's not the type of prescribing psychology and philosophy that we follow. 

What we do is we just assume that they're going to be a daily disposable contact lens where unless proven otherwise, you have to give me a reason why you need to downgrade to a different type of lens. We're in a market now where daily disposables today, there's just so much benefit towards them. Let's face it, we don't want to be cleaning, buying solutions and cases, etc. If I can just give you a lens, that's one less thing for you to worry about. At the end of the day, you just toss it. But I do listen, and I try to sympathize with them as well.

Yeah, absolutely. So part of the challenge of providing a customized contact fitting experience is finding a lens with enough power profiles. Do you have any favorite lenses for this particular workflow?

Yeah, absolutely. When it comes down to power profiles, like we said, there's a lot in the market that offer a low and a high example, and we're just referring to multifocal here. You can have a low and a high, you can have a low, mid, high. That's about 2 or 3 power profiles. There's another brand. I know biofinity offers more power profiles as well, with a distance lens and the near lens, etc. You get to up to several. 

But, another reason why I've kind of stuck with a maximum multifocal, [is] we have 183 power profiles, 183. Not just the low to mid and a high. Now the cool thing here is you don't have 183 drawers in your fitting kit, that would be crazy, that's a lot of real estate. 

Let's say I go to a low drawer and a multifocal. I grabbed the low drawer and in between all those power profiles, I know that if I grab a minus one and I compare it to a minus five, I'm getting a different power proof [and] I'm getting a different optical zone. That pupil size of a given patient is going to match that optical zone a lot better. If I can customize that in such a way where I'm now matching the patient's pupil size to the obstacles under the contact lens, you get this perfect marriage of distance, intermediate and near. Now getting everything perfect, we know perfection is hard to find, and some of them might fall out of this range. But, I've had really good success with that lens. Just understanding how this lens was made, understanding the mechanics and how they reengineer the curing process, and how to make this lens more breathable. 

To answer your question, that goes back to knowing how to fit the lens, listening to the patient, and then selecting a lens that's going to match the power profile of that lens to the patient's pupil. So, a patient's pupil size from from a 14 year old versus a 6 year old is going to be completely different. We know that the pupil size gets smaller as we age. We know that myopic patients or nearsighted patients are going to have larger pupils versus farsighted patients. So again, going back to my kit, instead of having 183 drawers, I don't have to think twice. I grab a mid or a low, whatever I'm going to grab, and I know that has a unique tailor to power profile to the patient's pupil.

Yeah, that's such a fantastic option. So we've talked a lot about the clinical side of fitting things. Obviously, that is what you're here to talk about. But, I also want to touch on the practice management, the business side of things. Do you use customized contact fittings as a marketing tool? Do you use that as part of your business model?

That is 100% of what we do. In fact, most of our patients are referral based because of that model. So, our entire business model and philosophy of fitting contact lenses has been in the specialty niche, in the customized and tailored niche. This has led to a lot of referrals from ophthalmology as well, where they said, "hey, I did such surgery and now they're stable from an anatomical perspective, but can you fix their vision because we're not there yet." 

Sometimes the patient and I feel bad for these retina specialists because they'll do scleral buckles and they'll do these amazing retinal surgeries to get them the foundation of vision, and then they're left with a lot of cylinder or a lot of other things that they just can't see. At the end of the day, they might not see the benefit of that retinal detachment surgery, but ultimately just want to drive or they want to see. So they come to me with, "hey, they fixed me, but I still can't see, so what solutions do you have?" That has led our practice to grow and thrive, just focusing on that. Other colleagues around the areas, fellow ODS that said, "hey, I don't have the expertise to fit a gas pump lens or a scleral lens." Or even if it's [a] simple soft lens, "hey, I don't have the availability or the lenses in stock, so can you take care of this patient's needs? Okay, great." So, we do that. It's basically what we do. So, it's embedded in my DNA. This is what we do, it's all about that tailored approach.

That's so great. I know a lot of people these days love a tailored approach, especially in the days of online shopping and influencing and all that kind of stuff. It's so easy to take the stock option, but getting something custom fit, especially for your one set of eyes is so huge.

We all want a one size fits all approach, and that would make our life a lot easier. But you really have to dig deep, especially now there's so many great ones. So again, explaining to the patient why you're selecting such product is so, so crucial.

Absolutely. Do you have any lingering advice for people who maybe want to get into the custom contact lens game?

One would be [to] have the time to listen to the patient's visual demands. Listen to their hobbies, what do they do? Maybe just not ask those simple questions, but "hey, Ken, do you have time to explain to me day in and day out? I mean, are you at your house working remotely? Are you outdoors a lot? Are you going in and outdoors? Do you drive a lot at night? Do you have dry problems? Do you have allergies?" Asking all of these questions, not just to put it in your medical record for thoroughness, [and] really listening to the patient, going out there, and just telling the patient, "I understand where you're coming from, I actually have a product or solution for you." Whatever brand that's going to be, and voicing that out. So that's number one. 

Number two would be the psychology of how confident you are. They're going to listen to you, they're going to read your body language. I would say one of the biggest pitfalls for most practitioners [is] when they're troubleshooting a contact lens, or maybe it's not coming out as they expected, they sort of give up [and say], "oh, it's I'm another multifocal, these are going to be quite difficult." Your body language will show a lot. If you're doing over-refraction and the patient doesn't say wow, then you kind of start losing the confidence. I would say this, be super confident about the changes you're making about the lens selection that you're prescribing. They read it, they feel it, you just have to be super confident and always know there's another option if you can't fix it. We haven't given up on any patient. We always find a solution. Whether it's A, B, or C, you can end up finding a solution for a particular patient.

All right. Well, thank you so much for taking the time to join us On Air today, Dr Rojas, this has been a fantastic discussion. I've really enjoyed it. So thank you.

Thank you for the opportunity. Thank you so much.

Luis Rojas, OD, shares his tips and tricks for getting the best fit for multifocal contact lenses, as well as how to leverage custom fittings as a service as a marketing tool.

How to implement a custom contact lens fitting model into your practice


Ocular emergencies account or 3% of all emergency visits. In this week's episode, Alison Bozung, OD, speaks on classifying "ocular emergencies," differentiating between urgencies and emergencies from a patient's perspective, and much more! 



Dr. Bozung is a fellow of the American Academy of Optometry and a member of local and national Optometric Associations. She is a regular contributor to optometric journals, has served as a co-editor for the Review of Cornea and Contact Lens’ Cornea Consult column, and is a member of the editorial boards for Review of Optometry and Eyes on Eyecare.

Listen to more OYE Technology podcasts here

OYE Technology

Open your eyes: ocular emergencies 

Explaining how different examinations are billed by insurance to patients can make a difference in patient care.

An age-old optometry patient dilemma: Vision or medical?

Kristin Adams, OD, and Colleen Onstad, MSW, LICSW, detailed the importance of recognizing the signs of domestic violence in patients during Optometry's Meeting 2025.

AOA 2025: Collaborative approaches to recognizing and addressing domestic violence

A recent $1 million gift will aid in broadening access to emotional support services, including social workers, peer connections, and multimedia content include videos and podcasts.

Hadley’s Donahoe Center for Support expanding emotional and social resources for patients with vision loss

Anthem will also be required to conduct quarterly self-audits beginning in July of this year in order to document the correction of the issues stated in the report. 

Anthem agrees to pay $100,000 civil penalty following complaint filed in part by Maine Optometric Association

The Vision Lab Choice Act of 2025, S 1716 was introduced to the US Senate floor on May 12.

VBM reform efforts continue with latest bill introduction

Cothran, OD, FAAO, discussed the importance of optometrists addressing mental health with patients in their chair.

AOA 2025: A mental health primer for the optometric physician with Dr Nora Lee Cothran

During the American Optometric Association's Optometry's Meeting 2025 in Minneapolis, Minnesota, Nora Lee Cothran, OD, FAAO, delivered a presentation titled "Hello Darkness, My Old Friend: A Mental Health Primer for the Optometric Physician." Her primary objective was to educate optometrists about mental health, focusing on depression, anxiety, suicide, and intervention strategies. 

The lecture emphasized the importance of recognizing mental health changes in patients, staff, family members, and health care professionals. Cothran highlighted that mental health disorders can be triggered by significant life events like losing a loved one, experiencing divorce, or job loss, but can also emerge unexpectedly. She stressed the significance of observing behavioral changes, such as deteriorating personal hygiene or missed appointments, which could indicate underlying mental health issues. Cothran encouraged health care professionals to ask open-ended questions like "Are you okay?" and demonstrate genuine care, as sometimes simply showing someone they are valued can be life-changing. The presentation covered various mental health conditions, including major depressive disorder, seasonal affective disorder, and peripartum depression. She shared alarming statistics, such as 1 in 7 women experiencing peripartum depression, which is the leading cause of maternal mortality in the US. 

A critical aspect of her talk was destigmatizing suicide discussions. Cothran emphasized that talking about suicide does not drive individuals toward it but can actually prevent it by making people feel supported and understood. She noted that during psychological distress, individuals might not think rationally, and compassionate intervention could be life-saving. Cothran also discussed how chronic or sight-threatening conditions impact mental health. For instance, 60% of stroke patients experience poststroke depression, which increases the risk of subsequent strokes and mortality. 

Cothran's core message was for health care professionals to adopt a holistic approach to patient care. By looking beyond medical symptoms and considering patients' entire well-being, doctors can provide more comprehensive and compassionate care. She urged her colleagues to be observant, supportive, and proactive in addressing mental health concerns. The lecture concluded with a powerful call to action: Health care professionals should look out for their patients, family members, and themselves, recognizing that mental health is an integral part of overall health.

Videos

Nora Lee Cothran, OD, FAAO, discussed the importance of optometrists addressing mental health with patients in their chair.

Conference

Matt Jones, OD; Matt Burns, OD; and Joe Sugg, OD; detailed what optometrists can expect to change when HB 1353's regulations are enacted later this year.

Arkansas' passage of HB1353 received well by optometrists in the state

A significant change is coming through new legislation that grants the Department of Insurance expanded authority to regulate vision benefit managers (VBMs). HB 1353 brings VBMs under the health benefit plan definition, providing regulators with more oversight capabilities that weren't previously available. Arkansas Optometric Association legislative cochairs Matt Jones, OD, and Joe Sugg, OD, and executive director Matt Burns detailed what optometrists can expect to change when the new regulations are enacted later this year.

The association will be implementing educational resources to help doctors with this transition, ensuring companies follow the law in coordination with the Department of Insurance. Doctors will need to be proactive in filing complaints with the Arkansas Insurance Department when violations occur.

The bill addresses several crucial areas:

Prevents discriminatory reimbursement based on buying groups or business models

Eliminates mandatory product routing to specific labs

Prevents patient steering to distant offices

Prevents reimbursement through credit cards

Protects against retroactive payment reversals when eligibility was confirmed

The feedback has been overwhelmingly positive concerning HB 1353 from legislators, optometrists, and ophthalmologists. Sugg, Jones, and Burns cited that optometrists feel the playing field has been leveled, allowing them to prioritize the doctor-patient relationship. The bill has also received support from across the medical community.

The legislation aims to level the playing field between VBMs and optometrists, make it more attractive for optometrists to accept these plans, improve patient access to care, enhance patient choice, and create better conditions for optometrists contracting with these plans to practice.

The success of such initiatives relies on professional unity and participation. Jones said he encourages other optometrists in and outside the state to join their state and national associations, support their state leaders working behind the scenes, get involved in grassroots efforts, and contact state association executive directors for involvement opportunities

Matt Jones, OD; Matt Burns; and Joe Sugg, OD; detailed what optometrists can expect to change when HB 1353's regulations are enacted later this year.

Arkansas' passage of HB 1353 received well by optometrists in the state

Dana Shannon, OD, FAAO, shares pearls on spotting red flags in need of referral and enhancing patient care with follow-up compliance.

NOA Midwestern Symposium 2025: Knowing when to refer when post-trabeculectomy complications arise

Related to a presentation on hypotony-related complications post-trabeculectomy that she gave at the National Optometric Association Midwestern Symposium earlier this month, Dana Shannon, OD, FAAO, focused on critical follow-up care and monitoring for patients who have undergone trabeculectomy, a surgical procedure for glaucoma treatment. She emphasized several key aspects of post-surgical patient management, including immediate post-op monitoring and patient education and engagement. 

For post-op monitoring, the primary concern is detecting potential complications early. One critical diagnostic technique involves using a sodium fluorescein strip to check for aqueous leakage. If leakage is detected, immediate referral is necessary to prevent serious complications like endophthalmitis or excessive eye pressure issues. The presence of aqueous leakage indicates a potential breach in the eye's structural integrity that could lead to significant medical risks. 

Key signs that require immediate attention include aqueous leakage, developing choroidal effusions, and potential retinal complications.

For patient education and engagement, Shannon noted that many patients mistakenly believe that surgery "cures" their condition, which can lead to poor follow-up compliance. Healthcare providers should explain the ongoing nature of glaucoma, discuss potential sight-threatening complications, assess patient comprehension through interactive questioning, and help patients understand why consistent follow-up is crucial, according to Shannon.

Shannon shared that she also takes a proactive approach to patient follow-up, including personally tracking patient appointments, actively calling patients who miss scheduled check-ups, creating a team-based approach to patient recall, and recognizing that patients have complex lives and may inadvertently miss appointments.

The overarching message is that successful glaucoma management extends far beyond the surgical procedure itself. It requires continuous patient education, vigilant monitoring, and a collaborative approach between healthcare providers and patients to prevent vision loss and manage the chronic nature of the condition.

Agatha Sleboda, OD; Arti Shah, OD, FAAO; and Kent J. Nozacki, OD provide the best tips that they give to their patients during natural disasters events in light of the recent Greater Los Angeles wildfires. 

What patients should know about eye protections during natural disasters

The Los Angeles area is still dealing with the aftermath of widespread wildfires that raged through the month of January. Having seen their fair share of patients affected by the fires, Californian-based optometrists weigh in on what advise they give their patients on how to best protect their eyes from poor air quality and smoke that may be present during natural disasters.

Editor's note: The below transcript has been lightly edited for clarity.

Things that people should avoid during natural disasters are rubbing your eyes when they're itchy or if they're burning, avoid touching your eyes if you don't have access to clean water, and stay away from using contact lenses to minimize the risk of eye infections. During natural disasters, injuries from sharp objects, exposure to smoke and other airborne chemicals, as well as use of unsanitary contact lenses can lead to vision threatening conditions, which is why early detection and accessible care is so essential. Eye protection is also very important. So wearing sunglasses and other protective eye wear while outside can minimize the risk of irritation from smoke. Finally, stay away from using tap water to rinse out your eyes, because that water can be contaminated. Instead, we recommend you use saline or artificial tears. If you experience any pain, sudden changes in your vision, or injuries from sharp foreign objects, seek immediate care at your local eye clinic.

First and foremost, I would say if they can come in for an appointment so we can just evaluate their ocular surface and see what's going on, sometimes we just have other conditions that are affecting our patients, and the fires just kind of tip the scale. So we want to make sure that we are giving appropriate advice and treatment measurements. But if they're unable to come in, I would say, the fires, all of the fumes, definitely have caused a lot of dryness and irritation, light sensitivity, difficulty keeping eyes open, excessive blinking, blurred vision. So to definitely utilize some really good, nonpreservative eye drops on a regular basis, stay hydrated. If they're really close to the fires, we would even go as far as to say some safety goggles, though they may not have access to that. They may not know what that exactly entails. So keeping it simple, I would say mostly eye washes and nonpreserved artificial tears until they can be seen and we can appropriately diagnose and treat whatever the condition may be.

First thing, of course, would be number 1: the smoke and particulates that are in the air, the pollution, that hangs around for a long time and it can travel for miles. My personal office is 30 miles away from where we were doing the clinic and where Malibu is, and yet we had to, while the fires were going on, weeks afterwards, we'd have to keep our doors closed because the smoke that would come in would irritate not just my patients' eyes, but also my assistants' eyes. And so what we can do there is, number 1: stay indoors. Number 2 would be use artificial tears, preferably nonpreserved. A third thing I could think of would be using cold compresses when your eyes are being irritated. You could also get 1 of those HEPA air purifiers. Those would be things that I could think of. Certainly, if you do have to go outside, then along with the artificial tears, you could have glasses that are close fitting to your head, or even goggles, if it's that bad.

Agatha Sleboda, OD; Arti Shah, OD, FAAO; and Kent J. Nozaki, OD provide the best tips that they give to their patients during natural disasters events in light of the recent Greater Los Angeles wildfires. 

What patients should know about eye protection during natural disasters

Optometrists local to the Los Angeles area overview their efforts to continue providing support to patients affected by January's wildfires. 

Eye care organizations, practices provide vision care amid the Greater Los Angeles wildfires

Kent J. Nozaki, OD, had an unconventional but heartwarming interaction with one of the patients he was treating in part of wildfire relief in the Los Angeles area. "[The patient] was 30 years old. He came in and he was wearing these little, tiny glasses, like for a child," Nozaki said. "I thought, 'Wow, what's he doing here?' And I found out that he had to be evacuated again, after just finding out, in 10 minutes and he could only run in [his house]. He was wearing contact lenses at the time, so he didn't think of getting his glasses, and he just represents 1 person of many who just didn't have time to get their glasses. So the only glasses he could find after he ran out of his contact lenses were the glasses that he had at his parents' house that he used to wear when he was in middle school. And so he was so thankful, and all the patients that we saw, the many patients that we saw, they were just so thankful that we're there to provide care. But you know what? It's just 1 small thing that we can all do. We all have a gift that we can share with others, and that's just the one small way that I found that I could help out."

Nozaki is 1 of countless California ODs that provided vision care and aid while wildfires raged in the Los Angeles area from January 7-31. Eye care organizations, including VSP Vision and CooperVision, and local private practices alike conducted eye examinations and provided free glasses to those in need. 

CooperVision's Patient Emergency Relief program was able to assist both eye care providers and patients in the Los Angeles area by providing contact lenses for providers to distribute to patients. Arti Shah, OD, FAAO, senior manager of Professional and Academic Affairs at CooperVision, shared her insights with her work through the program and her own experiences owning a practice in the area. 

"So CooperVision implemented the patient emergency relief program well over 5 years ago, and it's used for any disaster relief," Shah said. "So my role within the program is simply to offer this program to the patients I'm involved in patient care. So it is something that I offer all of my patients. Being with CooperVision, I support ECPs – eye care practitioners – as well as our schools and colleges of optometry within the United States. So we did let all of those schools of optometry also aware of this program, which has been utilized pretty extensively, so that patients can benefit during this really devastating time. 

"Unfortunately, when patients, including our practice owner, community members, were asked to evacuate, really top of mind was just the most important valuables," Shah continued. "But we do know that vision is 1 of our most important senses, and they do need to see. And so contact lenses is something that CooperVision does provide our patients through this Patient Emergency Relief program. The benefit of the program is that our patients, who do participate in the Patient Emergency Relief program, are given 2 complimentary boxes of contact lenses which will allow them appropriate vision to take care of some of the most important essential day to day living tasks that they need to accomplish during this really trying time. 

"I can add that CooperVision's Patient Emergency Relief program has been in effect for over 5 years, and right now, with the fires, it has already helped support over 120 patients, and as we see and hear from more and more patients, we do expect that number to go up. It's all about awareness. So if there's anything more that we can do to create awareness about the support from CooperVision as well as many of our other wonderful industry partners. I think this can really help all of the communities in southern California that have been affected, which it goes beyond Pacific Palisades, though, that is probably the most devastating I can think of in Southern California's history. But at the same time, we suffered close to 7 excruciating, devastating fires here in Southern California. So there are hundreds of patients who are more likely not aware of this program or similar programs out there. So I thank you, 

, for everything that you're doing to create awareness around what we can do as a community for all of these patients and for mankind."

VSP Vision Eyes of Hope, The Power of Sight Foundation, and the Los Angeles County Optometry Society also provided free eye exams to over 230 patients in 2 days in early February. A majority of those patients received replacement or new prescription glasses. VSP is also offering eye care and/or replacement eye wear for impacted VSP Vision Care Members. 

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