At Vision Expo East, Drs. Patricia Fulmer and Steven Turpin sat down to discuss how Optometrists can get started with specialty contact lenses and related services in their practices.
What exactly are specialty contact lenses?
“I define specialty lenses as anything that’s not off the rack,” says Turpin. “It’s sclerals, it’s RGPs; sometimes it can even be a custom soft lens. If someone wants a multifocal and they have too much cylinder that you can’t mask with an off-the-rack lens, I consider that a specialty lens.” This also includes multifocals for children, myopia control, and ortho-k, or even tinting a contact lens for a patient with TBI experiencing light sensitivity.
How did you know you wanted to do a specialty contacts residency?
“I’ve always been interested in contact lenses,” says Turpin. “There’s four pillars of specialty lenses that I really like. Number one, you’ve got to be extremely knowledgeable in your ocular disease anterior segment stuff. You’ve got to be spot on, because you’re fitting lenses on diseased eyes most of the time, so you have to be able to see when there’s a problem with that.”
The second thing, Turpin says, is the creativity. “You get to be kind of an engineer at the same time. You get to build these lenses, design them yourself most of the time, and so you get to use that part of your brain to do it.”
The patient side is the third pillar of specialty contacts. “These patients are patients that you’re going to be seeing four, five times by the end of the visit. So they become so familiar to you, that you really build these hard relationships with them. And they are the ones that go out and sing your praises online, everywhere.” Where Turpin is doing his residency, there are patients who have been coming in for specialty contacts for almost thirty years. That’s the kind of patient you can build a practice on!
How would someone who’s further in their practice start working with specialty lenses?
“For me, the biggest thing is learning by doing,” says Turpin. There is so much information about specialty lenses out in the world. The only thing to do is find it! One resource Turpin recommends for getting started with specialty lenses is GPLI, the Gas Permeable Lens Institute. “They have an incredible number of resources on their site,” says Turpin, from fitting resources to information about billing and coding.
“There’s no shortage of information, you just have to want to do it.”
To get started, Turpin suggests looking into sclerals. “We’ve been doing them for long enough that all of the designs out there from all of the manufacturers are so good, it’s easier than you think. You just have to take the jump into it.”
Getting comfortable with the fitting philosophy of sclerals can help you get started. “You can change a lot of people’s lives relatively quickly,” says Turpin, “and if you build that practice, it can definitely be profitable down the road.”
When do you consider a patient for a specialty lens?
“If they have any sort of corneal irregularity,” says Turpin, “generally you can mask that with a lens, a lot like you could with a GP.” But with a GP, you have to put a lens on an irregular surface, so a scleral, with its vaulting, might be more suitable.
There’s also quite a bit of innovation in the dry eye space, says Turpin, particularly for patients who have exhausted other options. “Having that kind of fluid reservoir up against their eye all day long makes a humongous difference,” he says. “Those are the patients that I see sclerals taking off.”
The great thing about working with dry eye patients, Turpin says, is that fitting occurs on a regular cornea. So while sclerals will have a huge benefit for them, the fitting is very simple. This can be a great opportunity for doctors who already treat dry eye and are interested in making the jump to specialty contacts.
What would you say to someone who might be intimidated by the world of specialty lenses?
“Picking something and getting into it!” recommends Turpin. The manufacturers of specialty lenses host workshops and informational meetings about their products, and they’re always open to working with doctors. “That’s part of their model: they’re trying to find practitioners to get started, and so they’re the best ones.”