How to master hybrid contact lenses

Hybrid contact lenses are an innovative yet challenging way to improve patient vision. At this year's Vision Expo West in Las Vegas, Jason Miller, OD, MBA, FAAO, of Powell, OH, offered strategies to help ODs better understand the process.

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Hybrid contact lenses
New hybrid lens options are opening up treatment possibilities for patients with unusual visual needs.

“There are some options that can make a big difference,” Dr. Miller says.

Options available to ODs include silicone hydrogel soft skirt lenses, gas permeable (GP) lenses, SynergEyes Duette progressives, and SynergEyes UltraHealth for irregular corneas.

Many of these lenses are designed to address several refractive errors at once, such as presbyopia and astigmatism, while others are made to help patients address ocular conditions like keratoconus.

These options have the potential to make patients happier in their lenses while reducing dropout, Dr. Miller says.

“These patients are going to be lifelong patients-a big referral source for your practice,” he says.

Related: New research on improving contact lens comfort for patients with dry eye 

The market for hybrid contact lenses
As the contact lens market grows, ODs can expect to see more patients coming in with complex visual needs.

“There is a big market for this underserved, undertreated optometric specialty,” Dr. Miller says.

Hybrid contact lenses may be particularly beneficial for patients with specific types of visual impairments, such as:

• Post-RK

• Keratoconus

• Corneal scarring or trauma

• Corneal transplants

• Irregular or high astigmatism

• Extreme dry eyes

• Those unhappy with vision of toric or multifocal contact lenses

“These patients don’t realize that potentially they could be wearing contact lenses,” Dr. Miller says.

Providing hybrid lens options to patients isn’t just a matter of staying at the forefront of technology, it’s about giving patients the options they need to improve visual outcomes. Lens selection is just one part of the process.

Related: 9 simple solution to 9 complex cases 

Fitting challenges
Many of the above ocular challenges can be managed with hybrid lenses. For problems that require more sophisticated solutions, however, ODs need a process in place to achieve proper fitting.

They can be successfully treated but it may take time, and ODs should have a process in place to account for the extra challenge.

“You want to block out enough time to make sure you’re comfortable fitting these lenses,” he says.

Dr. Miller also recommends training optical technicians in both process and terminology. Getting staff excited about lenses helps them get patients excited and interested, he says. 

Related: Offer more comfort to contact lens wearers 

ODs must also have the topographical imaging equipment necessary for proper assessment.

“If you don’t have a topographer, you honestly can’t do a lot of these fittings,” Dr. Miller says.

Other tools that may be helpful include a full set of diagnostic lenses, anterior segment cameras, and optical coherence tomography (OCT).

ODs should start by assessing keratometry (K) values and physical characteristics to find a fitting start point.

Related: Why ODs shouldn't stop short with patient care 

When should hybrid lenses be avoided?
Despite their benefits, hybrid lenses are not suitable for everyone, Dr. Miller says.

In particular, those suffering from severe dry eye may need to avoid these lenses until symptoms are under control.

“Any ocular surface disease needs to be treated and addressed ahead of time,” he says.

Other disqualifying factors may include a lenticular cylinder in the patient’s prescription or patients who seek convenience above all else.

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