I planned on having a disco nap just now but there’s some really loud music happening and it’s too far away to enjoy yet too close to ignore. Anyway, I thought I’d use this time to say a bit about the NCC. First, though, I wanted to talk about communication and multifocal fitting.

Yesterday, on the way from Schiphol, I got a chance to chat with a master of communication. Basically, this man’s job is to chat to people, to befriend, inform and, ultimately, promote his company. I was asking about multifocal lenses and I noticed his language was quite different from mine.

When I chat to patients about multifocals, I tend to use the word compromise – a word which my colleague, the expert communicator, pointed out has negative connotations. Instead of telling a patient they have to compromise between having great near vision and great distance vision, what I should be saying is that we have to find a balance. I was also told that asking the patients to rate their DV and NV numerically is a good trick, as well as asking them to rate their comfort. He also recommended that we encourage our patients to look at their phones as well as a near chart, since the smaller text on phones is one of the things presbyopes struggle with and, in my experience, one of the things that will prompt a long-time presbyope-denier to go for an eye test!

I’ve done a lot of multifocal fitting in the last couple of months. I don’t know whether it’s because we’ve been very proactive about multifocals when testing presbyopes (in our practice, all the optoms are proactive when it comes to contact lenses) or if there’s increased awareness through advertising and other channels. I’ve also changed my thinking from “monovision first” to “multifocal first”. After all, monovision is a bandaid – it will only work for a while so why not fit MFs instead?

Well, the congress is in full swing. The expo has some interesting exhibitors but I’ve been struggling to find information in English. Also, there seems to be quite a focus on scleral lenses. I wouldn’t even know where to start with sclerals and, since the lecture on scleral lenses coincided with the myopia control one, there’s a chance I’ll never know.

It was interesting to hear that base curve has nothing to do with the fit of a soft contact lens. All that keratometry then multiplying the flattest K by 1.1 is just something you learn in uni. Unless you are fitting a mark ennovy soft contact lens, you don’t need keratometry. Apparently the limbal-scleral junction is key to fitting but it’s something we can’t really assess since you need an OCT.

I also attended an interesting workshop on the meibomian glands, where, as the only person with severe dry eye and MGD, I was poked and prodded for a while. I discovered a notch on my right lower lid a few weeks ago, which I found a bit depressing, and today it was confirmed that those glands are long gone. Warm compresses and lid massage every night for me from now on.

The myopia control lecture was good but most of it was still fresh in my mind from my final year at uni. We don’t see a lot of high myopes in the east end of Glasgow so I’m not sure if controlling myopia with multifocals is something I would be doing in the future. I certainly don’t think I’ll be using ortho-k for this in the near future.

The music has stopped so I’m going to have a nap before the gala dinner and then, hopefully, a reasonably early night tonight. These contact lens practitioners are party animals – I can barely keep up.

Advertisements