How To Put Contact Lenses In Small Eyes

The Consummate Guide to SynergEyes Hybrid Contact Lenses

Nov 18, 2020

26 min read

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Whether you lot're treating patients with astigmatism, presbyopia, or irregular corneas, hybrid lenses might just become your new go-to option! These lenses can be used for both specialty and routine care for patients yous see in your practice every day! Let's dive into the benefits for you, your patients, and your exercise.

We all know near the benefits of hybrid contact lenses: for patients with corneal disease needing patient care, hybrid lenses offering incredible options. However, did you know hybrid lenses can be used for routine care and can tremendously help patients with astigmatism, and presbyopia, as well as patients who might not have had success with soft contact lenses? Hybrid lenses can even be used for specialty care exterior corneal disease—giving these lenses fifty-fifty more use cases for the optometrist.

Furthermore, new developments in empirical lens plumbing fixtures techniques make the SynergEyes portfolio of hybrid lenses incredibly attainable for first-time fitters assuasive yous to focus on what matters nigh: your patients' comfort, health, and sight. Plus, this technique does so while reducing your chair fourth dimension, increasing efficiency, and generating new revenue for your practise.

We interviewed five clinicians who accept been leveraging hybrid lenses in their practice for both routine and specialty care. In this article, these doctors share their insights into how they are using the SynergEyes portfolio of hybrid lenses in practice, providing their patients an excellent contact lens wearing solution, equally well equally edifice their do and driving new streams of revenue.

Dr. Kasia Aleszczyk | SoLo Middle Care

Dr. Kasia Aleszczyk was built-in and raised in the Chicagoland area. Dr. Aleszczyk holds membership in the American Optometric Association, the Illinois Optometric Association, the Beta Sigma Kappa Laurels Society, and the Tomb & Central Honor Fraternity. Kasia has clinical interests in specialty contact lenses including lenses for the handling of keratoconus, mail service-operative LASIK ectasia and cornea transplant patients.

Dr. Melanie Frogozo | Alamo Eye Care

Dr. Melanie Frogozo is an optometrist who is a Diplomate in the Cornea, Contact Lens, and Refractive Technologies department of the American Academy of Optometry. Dr. Frogozo is residency trained in the treatment and management of anterior segment affliction through medically necessary contact and prosthetic lenses. Originally from Houston, she completed college at the Academy of Texas at Austin and optometry schoolhouse at the Academy of Houston.

Dr. Tiffany Andrzejewski | Chicago Cornea Consultants

Dr. Andrzejewski's special areas of interest include the management of dry out eyes, keratoconus, and other cornea and contact lens-related issues, besides as scleral contact lenses. She is highly trained in fitting specialty contact lenses for keratoconus, postal service-surgical corneas, and other corneal diseases, as well equally multifocal, prosthetic contact lenses, and lenses for otherwise difficult to fit prescriptions.

Dr. Robert Steinmetz | SoLo Eye Care

Dr. Robert Steinmetz is the manager and possessor of SoLo Heart Care and Eyewear Gallery in the Due south Loop. Dr. Steinmetz is an Offshoot Clinical Preceptor at the Illinois College of Optometry and serves on the advisory board of iii major pharmaceutical companies involved in the research and development of anti-allergenic and dry out heart therapy. His clinical interests include anterior segment illness, hybrid and scleral contact lens technology, and corneal refractive therapy.

Dr. Ryan McKinnis | Cleveland Eye Clinic

Dr. McKinnis focuses a large portion of his career on avant-garde contact lenses for the nearly difficult patients and avant-garde ocular disease. He researches, publishes, lectures, and is a leader in keratoconus, scleral, gas-permeable, hybrid, and custom soft contact lenses. He is former governor of Zone two of the Ohio Optometric Association too as a Beau in the American Academy of Optometry and the Scleral Lens Teaching Society. Dr. McKinnis has achieved the title of Diplomate in Cornea, Contact Lens, and Refractive Technologies of the American Academy of Optometry. While non in the role you can often find Dr. McKinnis with his four children and his wife, Heather. He's passionate about sports, loves to golf game and creatively plans travel adventures for his wife and children every bit frequently as possible. He is besides agile in their local church and customs when not chauffeuring the children!

What are hybrid contact lenses?

The SynergEyes portfolio of hybrid contact lenses combine a rigid corneal contact lens (RGP) with a soft contact lens material bonded 360 degrees to the periphery of the lens, forming a HyperBond®. This design optimizes articulate vision with the GP fabric and comfort with the soft "skirt." There are hybrid designs for both patients with normal corneas and irregular corneas.

The gas permeable material used in these lenses is petrafocon A which has a high Dk value of 130, and the brim is made out of a silicone hydrogel fabric (hem-larafilcon A) which has a Dk of 84 and a 27% water content.^one

About designs of these lenses are bachelor with the ability to correct +20.00 to -20.00 Diopters (D) of myopia and hyperopia, astigmatism up to 6.00 D, and add powers between +ane.00 and +4.00 D.²

SynergEyes Duette and UltraHealth lens designs are now available with Tangible™ Hydra-PEG: a coating that is bonded to the contact lens to increment comfort and wettability. This coating maintains its presence for the unabridged duration of the 6-month life of the hybrid lens.

A closer look at SynergEyes hybrid contact lens options:

1. Duette
   1. Single vision lenses for normal shaped corneas
   2. Corrects hyperopia, myopia, and astigmatism
2. Duette Progressive
   1. Multifocal lenses
   2. Options for center altitude and heart near design
   3. Adds upward to 5 Diopters (CD only)
3. UltraHealth
   1. Advanced hybrid technology for keratoconus
   2. Reverse geometry design allows for flatter base curves and less peripheral tightness when plumbing equipment steeper corneas.¹
4. UltraHealth FC
   1. Designed for flatter post-refractive surgery patients (post-RK, post-LASIK) by using a refined reverse geometry pattern.

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Here'south a cracking overview of SynergEyes lenses

Download the Consummate Infographic

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How can SynergEyes hybrid contact lenses help grow your exercise?

1. Plumbing equipment patients in SynergEyes hybrid lenses tin can assist increase profitability since these lenses are simply available to contained ECPs which means patients must obtain materials through you and are unable to purchase from large box retailers or online.
2. The specialization cistron of hybrid lenses is something patients like to talk to their friends most and volition garner more word-of-oral cavity referrals than soft lenses.
3. Continuum of care. SynergEyes hybrid lenses are designed to offer a continuum of care, meaning these lenses can abound with your patients and evolve with them as their needs modify. The Duette Progressive lens is bachelor in both Centre Distance and Heart Near designs, then if a patient is successful wearing Duette Progressive lenses as an early presbyope, you know that at that place is a Duette Progressive lens option set up for them as their near vision needs alter with age and advancement of presbyopia.
4. Patient retention is stronger when y'all are viewed as providing a unique and special product.

If you are wondering if you take enough patients to start using hybrid lenses, you don't take to expect far!

Patients in your practice who may benefit from a hybrid contact lens

1. Patients who are unhappy with the quality of their vision in soft contact lenses.
2. Patients with subtle irregular astigmatism: dry eye, epithelial basement membrane dystrophy, mail service-LASIK.
   1. Taking a topography on patients whose complaint is "my vision is merely not sharp enough" can reveal these subtleties, and you can exist their hero!
3. Patients who have failed many soft multifocal/progressive contact lens designs.
4. Patients with astigmatism whose soft lenses "move around too much" (Note: in a contempo survey of toric lens wearers, nearly 76% of respondents reported multiple issues involving dryness and toric rotation with their soft toric lenses).⁴
5. People with keratoconus or other irregular corneas

SynergEyes hybrid lenses for normal corneas

Equally discussed, hybrid lenses tin can tremendously benefit patients with normal corneas. These patients can present in your do as those "routine" contact lens wearers. Many of these patients' lives tin be enhanced with the improved optics, stability, and comfort of a hybrid contact lens.

A quick way to identify candidates is to simply enquire current soft contact lens wearers almost the quality of vision in their lenses. When you are hearing less than stellar reviews about vision and lens stability with their current soft contact lenses, this is a perfect opportunity to introduce hybrid lens technology. This, combined with their wide range of parameters, help make hybrid contact lenses a perfect go-to option for these patients.

Even if you don't think your patient would choose a more advanced lens, informing them of their options solidifies that you are an expert in your field and offer the best possible products to them. In a recent survey of toric lens wearers, nearly 75% of respondents suggested that they would be willing to pay an additional $50 or more per year for a contact lens that eliminated the bug they currently experience with their lenses.⁴ You may exist surprised at how many patients value lenses that tin can offering the best technology, regardless of cost, because they want the best vision possible.

Drs. Steinmetz and Aleszczyk routinely offer SynergEyes hybrid contact lenses to astigmats and presbyopes—ii of the most common patients y'all are likely to see in your practice!

Duette : for patients with astigmatism

Dr. Steinmetz has found success fitting hybrid lenses for his normal cornea patients who take astigmatism and specifically targets athletes. Whether athletes in high school, higher, or on professional sports teams, if patients have astigmatism and their soft toric contact lenses aren't providing the most clear and stable vision, chances are, vision can be a major problem while trying to track a brawl or focus on a moving target.

^{Duette lenses}

Dr. Steinmetz prescribes these patients Duette hybrid contact lenses and explains how both improved optics and stability can help take their athletic performance to the next level. When it comes to choosing betwixt hybrid lenses and RGPs, the stability of hybrid lenses is much ameliorate than with RGP lenses, peculiarly for those who need front surface toricity with prism ballast, making information technology an piece of cake choice for these patient types.

"When you take a expect at an example of a loftier-terminate athlete, high-velocity brawl sports require vision amend than 20/twenty," says Dr. Steinmetz. "The best way for me to requite my patients 20/xv or even 20/12 vision is going to be with a hybrid lens—because with SynergEyes lenses, athletes don't have to worry about blurred vision, which could exist the difference between winning and losing a game."

Dr. Aleszczyk routinely offers Duette hybrid lenses when she finds herself in the office faced with a patient who has loftier astigmatism or high myopia and is but non getting the visual clarity they desire. These patients typically accept never heard of hybrid lenses and are not enlightened other options exist. They call up they are limited to the vision they are currently getting out of their soft lenses.

After educating these patients on the eyes of hybrid lenses and how they tin can ameliorate vision, non only are these patients eager to endeavor hybrid lenses, they are thankful to you for introducing them to engineering they have never heard of.

Dr. Melanie Frogozo suggests because hybrid lenses for patients with astigmatism, particularly oblique astigmatism which can be so difficult to correct with soft contact lenses due to rotation.

Patient case: Dr. Aleszczyk

Dr. Aleszczyk remembers a 30-year-former highly myopic (-12.00 D) patient who scheduled an appointment with her because the patient knew she fit hybrid lenses. The patient had been wearing soft contact lenses simply was unhappy with the quality of her vision. Dr. Aleszczyk fit her with Duette lenses considering of Duette's extensive parameter options. Fitting this patient in a Duette lens was life changing. It's important non to underestimate how improving a patient'due south vision, even "merely a lilliputian bit" can make a difference in their lives. This patient instantly became a patient for life, and an advocate for the exercise.

Some patients may be much more than sensitive to the rotation of soft toric lenses than others. This may be because the prism anchor of a soft toric lens is ruled by gravity. When a patient is not sitting upright and is, for example, laying on their side to watch Tv, the lens will rotate and vision volition be out of focus. Hybrid lenses through the GP component and tear lens, make this rotation inconsequential. This is a perfect case equally to why you should take the fourth dimension to discuss lens performance and satisfaction with your contact lens wearers, specially those with astigmatism! They might be happy with their vision simply when staring straight alee, but might report full lens failure upon caput movements or while doing other hobbies or playing sports.

Duette Progressive: for patients with presbyopia

With his presbyopic patients, Dr. Steinmetz finds that the confidence that comes from non having to pull out reading glasses at a dinner table is plenty of a motivation to move into hybrid lenses.

He also notes skillful patient retention in the practice since these patients tin age with their lenses due to the continuum of care Duette lenses can provide. He will outset fit an emerging presbyope with a Duette Progressive with a depression ADD ability and graduate them to higher ADD powers every bit they age, all while keeping the exact same lens design. This makes the fitting procedure an accented dream and increases efficiency in the examination lane: "I can't tell you how peachy it is to be able to fit a lens one time, and simply change the parameters I need every bit the patient's needs evolve without having to re-fit!"

There is your routine presbyope, so in that location is your presbyope with astigmatism. These patients have often been left frustrated by express soft contact lens options that offer piffling in terms of articulate quality vision at all distances. Dr. Frogozo leverages the Duette Progressive lenses for these patients. These lenses are highly customizable with varying optical zone sizes and Add together powers giving optometrists an incredible arsenal of options to offer these patients, not to mention they can be ordered empirically.

Patient Case: Dr. Steinmetz

A 49-year-former single female physician who presented to my function with mild hyperopia and significant corneal astigmatism of i.75 diopters. Her health history is unremarkable, aside from a history of surgical cosmetic procedures. Her ocular health is normal and she presents with no signs or symptoms of dryness.

Her habitual single vision glasses are two years old and used for reading, viewing electronic medical records at piece of work and performing minor in-part procedures. Her chief complaint at the time of her visit was the disability to read minor impress without glasses and that they fabricated her "look former." She has attempted soft monovision contact lenses in the past just never was able to adapt to the eyes and felt "imbalanced." She would dear a contact lens she could clothing all day and would fifty-fifty be happier if she could wearable them socially.

^{Duette Progressive}

She was a perfect candidate for Duette Progressive lenses. I chosen the SynergEyes Technical Consultation team and empirically fit her in a Duette Progressive lens with Tangible Hydra-PEG with a low +i.00 Add together power in a flat skirt. Her corneal cylinder nearly matched her refraction. She returned for her fitting and was very pleased with the comfort and acuity at all distances. At her 2 week follow upward, she loved the overall experience, just wanted a piffling bit more reading power when property her phone and dining in dim light. She was plano at distance merely loved an additional over refraction of +0.50 at near OU. I was satisfied with her fit but wanted a slightly meliorate centration. I steepened the brim to medium and ordered the new lenses in a +1.75 ADD power. The results were remarkable. She was able to wear the lenses full time for 15 hours a solar day. She explained that she is fifty-fifty able to remove sutures in-office without her reading glasses. She has since referred several of her colleagues and friends to see if they are candidates for this technology.

UltraHealth: for patients with irregular corneas

When because treatment options for patients with irregular corneas, most ODs might be more than familiar with the benefits of hybrid lenses or RGPs. Notwithstanding, why consider hybrid lenses over RGPs as your beginning choice? For these patients, UltraHealth is a slap-up pick.

^{UltraHealth lenses (Photograph Credit: Dr. Ryan McKinnis)}

Patients who have keratoconus, corneal transplants, corneal scarring and more, can all benefit from the enhanced optics of a rigid lens. Those with highly altered corneal shapes can feel an instability in their RGP lenses or subtract in comfort, both of which tin exist improved with a hybrid lens.

SynergEyes recommends using the UltraHealth hybrid lens design for patients with balmy to moderate keratoconus, while their SynergEyes VS lens, a scleral lens, may be preferable for more advanced cases.

When because which lens to fit, hybrid lenses accept advantages over scleral lenses. One is the ease of insertion and removal, which is closer to that of a soft lens. Those with glaucoma filtering blebs may benefit from the hybrid lens every bit a way to avert compression by a scleral lens. If worried about corneal edema when fitting a corneal transplant, hybrid lenses provide increased oxygen due to the thin contour of the RGP lens and greater tear exchange.

Dr. McKinnis finds success with hybrid lenses considering the weight of the lens is distributed more evenly across the lens and avoids compression over the apex of the keratoconic cornea, as compared to RGP lenses. He finds them easier to fit than many other kinds of lenses and orders them empirically using his patients' topographies and prescription.

Dr. Tiffany Andrzejewski uses hybrid lenses for irregular corneas to bridge the gap betwixt a patient who has previously worn soft contact lenses just needs the GP optics. The handling of the hybrid lens feels less foreign to patients since awarding and removal is similar and the fit is more than simplified.

She uses topography images to evaluate the elevation data of the cornea. Those with primal corneal steepening are keen candidates for hybrid lenses because the lens volition take a good centration.

Patient example: Dr. Andrzejewski

Dr. Andrzejewski describes a immature Hispanic male person patient with moderate keratoconus who was referred afterward corneal crosslinking surgery. During his initial consultation, Dr. Andrzejewski diagnosed him with floppy eyelid syndrome and bilateral pinguecula. She decided that a hybrid lens would be preferable to an RGP lens because of improved stability under the loose lids, and an easier fit than a scleral lens by avoiding having to vault over the pinguecula. The patient has successfully worn hybrid lenses for a year.

Hybrid Lenses for Myopia Control

Hybrid lenses are used in cases outside of the regular and irregular cornea, just have also go more usually used in myopia control. While this is an off-label use, doctors like Dr. Frogozo, have been leveraging the Duette Progressive for myopia control providing however another use example for hybrid lenses and practice revenue stream.

Myopia control has get a focus for a lot of doctors. Not but is myopia control an important public health consequence, only the pediatric population tin be one of a practice's greatest drivers of growth equally parents are likely to refer other parents to doctors who specialize in contact lenses for young kids.

According to studies, lenses that are used for myopia command should have the blueprint of center-distance optics with a stronger ADD ability of nigh +2.50 or more than. The most recent progressive study showed greater myopia control effects with college ADD powers (+2.fifty) compared to medium Add together powers (+1.50).³ The Duette Progressive Center Distance is available up to +5.00 Add together ability which is higher than a soft progressive lens and could have a amend myopia command effect.

Dr. Melanie Frogozo has found success using Duette Progressive hybrid lenses for myopia control due to:

1. The optics of the central GP lens allows for more than authentic correction of both myopia and astigmatism, especially oblique astigmatism.
2. Hybrid lenses allow for the fit of the skirt and base of operations curve to optimize centration of the optics of the centre. You are unable to change base curve in a soft lens
3. Yous can customize for higher ADD powers
4. You can customize the distance and near zones past modifying center distance zone size based on educatee size to ensure that the near zone is within the visual axis in lodge to command for myopia

How to start plumbing equipment SynergEyes hybrid contact lenses in your practice

Fitting hybrid lenses does not have to be intimidating. There are a few main things you lot need in society to go started:

1. Your patient'due south prescription
2. Your patient'due south keratometry (Thousand) readings or topography
3. Horizontal Visible Iris Diameter (HVID)
4. Pupil size in photopic light (for fitting the Duette Progressive Center Distance blueprint)

Is that it?

Yes, that'south information technology!

You tin at present fit Duette and UltraHealth lenses empirically. You only need to call in with the information to a higher place and yous are good to go!

What is empirical plumbing equipment and why is it a major advantage?

Beingness able to fit empirically tin can accept tremendous benefits. Both SynergEyes Duette and UltraHealth lenses can be fit empirically.

1. Not only can it allow yous to relieve precious chair time, only it gives those practitioners who might not have a lot of experience fitting hybrid lenses the opportunity to do and then.
2. At a time when hygiene is more of import than ever, limiting patient encounters, specially those that involve a lot of contact is paramount.
3. Another major benefit is you do not need to invest in a fit set! This saves your do coin, and space!

Dr. Aleszczyk and Dr. Frogozo both employ empirical fitting exclusively in their office for patients with normal corneas. Dr. Aleszcyzk found that her lens designs ended up with the same parameters equally her design with an in-office fitting prepare. She confirms that more often than not, the lenses fit well on the first order with no demand for changes.

If you are feeling motivated, you tin can certainly even so obtain a plumbing fixtures set. The "WOW" factor of trialing these lenses on patients in the office is second to none and can really exist helpful for those patients who are on the argue virtually moving to a specialty lens. Giving patients the opportunity to experience the comfort and quality of vision offered by the lens tin make a huge difference.

How to innovate hybrid lenses to your patients

Patients appreciate existence given the option of advanced engineering. You would be surprised at how many routine patients might elect for a more advanced lens design because they want to have the highest quality vision possible.

When information technology comes to navigating the price of hybrid lenses, the benefits of clear, consequent, and comfy vision oftentimes is enough. It is also important to explain to patients that hybrid lenses last longer than soft contact lenses and overall, the price point for an almanac supply can be similar to a year supply of daily lenses.

As for explaining hybrid lenses to patients who might already exist familiar with soft lenses and rigid gas permeable lenses, it is easiest to talk about hybrids the way they are usually taught! Hybrid lenses are taught every bit "the eyes of a rigid lens, with the condolement of a soft lens", and that's exactly the manner you can explain them to patients!

You tin add in a small word about how the tear moving-picture show is able to "fill in all the gaps" to create a more perfect optical surface to see with. Dr. Steinmetz explains the lens as "floating" on the tear layer. These explanations assist patients understand the technology and why it is special.

Dr. Steinmetz introduces these lenses to his patients by allowing them to concur the hybrid lens in the office on their get-go engagement. This helps them to empathize why the lens is special and takes abroad the apprehension of wearing a "difficult" lens.

Dr. Andrzejewski explains hybrid lenses as an option for amend customization to the shape of the patient'due south heart compared to a soft "off the shelf" production.

How to ensure success when fitting hybrid contact lenses

Provide Instructions Before The Dispensing Appointment

Accept the patient lookout man insertion and removal videos prior to their dispensing appointment. SynergEyes provides these videos online (Duette and UltraHealth) also equally brochures that you can give to the patient at their starting time appointment to assist them find the videos and educate them on their new lenses. Patient teaching prior to the appointment saves a lot of time on the day of dispensing.

Provide Exact Lens Care Instructions

To avoid any confusion, type up the exact care regimen you'd like your patients to use with their lenses, put your personal office branding at the top, and voila! Patients feel that they are receiving a high-quality, personalized product and service. Dr. Frogozo'southward patients leave the dispensing appointment with a "goodie pack" of solutions and instructions.

Tips To Abound Your Practice With Hybrid Lenses

1. Fit yourself and your staff with hybrid lenses. The more feel and comfort your part has with the technology, the easier you can explicate it to your patients. This especially helps with teaching insertion and removal.
2. Once you decide to incorporate this technology, go the word out! Send it out in your office'southward e-mail marketing letter of the alphabet, put a post or blog about it on your website and social media channels.
3. When y'all have a happy hybrid patient, have a photo and enquire if you tin can share their story on your social media. Patients and referring Doctors love to encounter examples of happy patients.
4. Allow current patients know. If they are in your chair with complaints about their lenses, explain the hybrid technology. Many just want the best that's out there and are willing to brand the investment.

Dr. Steinmetz recommends adding hybrid lenses as 1 way to differentiate yourself from other practitioners. He has constitute that the optics of the Duette and Duette Progressive lenses provide his patients the best vigil of any lens on the market place.

Dr. Aleszczyk, who has fit hybrid lenses for years, thinks of them as a "no-brainer" tool to add together to your role, especially with the success of empirical fitting with SynergEyes, which allows yous to social club lenses without having to employ trial lenses in the office.

Dr. McKinnis finds that the unique simplicity of empirical fitting means hybrid lenses are a favored selection in his clinic for reduced chair time and improved patient satisfaction, particularly for his many patients with high astigmatism, presbyopia, and irregular corneas.

Why hybrid lenses will be a nifty addition to your practice

Whether you're treating patients with regular or irregular corneas, hybrid contact lenses are a great choice for those who want to attain sharper vision. Not only can hybrid lenses allow you to go on your corneal illness patients returning to your practice, simply they have a strong identify in routine care too!

Every practice sees patients with astigmatism and presbyopia, forth with soft contact lens wearers who are unhappy with the quality and stability of their vision. You practice not need to exist a "specialty" practice to use hybrid lenses, or demand a lot of experience or be an "good" at fitting them to get started—hybrid lenses can exist fit empirically, making it easy to get started without a lot of feel or investment.

Hybrid contact lenses can provide your patients GP quality vision with the comfort of a soft lens, and they tin drag the care you provide to patients, enhancing their feel while differentiating your practise and growing profits through patient memory and word of mouth referrals.

References

1. Watanabe, RK. "Contact Lens Design & Materials: Hybrids – And so And Now". Contact Lens Spectrum. November ane, 2017. https://www.clspectrum.com/supplements/2017/november-2017/contact-lens-spectrum-special-edition-2017-your-g/contact-lens-design-amp;-materials
2. "Patient Education Booklet For The: Duette®SiH Hybrid Contact Lens. www.synergeyes.com.
3. "Multifocal contact lenses dull myopia progression in children". National Institute of Wellness News Release. Baronial xi, 2020. https://www.nih.gov/news-events/news-releases/multifocal-contact-lenses-wearisome-myopia-progression-children
4. "Toric Wearer Survey 2020." AYTM Online Survey (prepared by SynergEyes), Nov 5, 2020.

Source: https://eyesoneyecare.com/resources/complete-guide-synergeyes-hybrid-contact-lenses/

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