SynergEyes Sub Articles

Toric Challenges: Finding the Right Contact Lenses for Astigmats

By Brooke S. Kaplan, OD


July 1, 2015

Fifth article in the series “Differentiating Your Practice”


Correcting slight amounts of astigmatism is a judgment call. But it’s an easy decision if you’ve got tools to provide your patients with the best visual experience.


ASSESS DEMANDS AND EXPECTATIONS. Determine your patient’s visual needs—and their expectations
MAKE SMALL CORRECTIONS. Correcting even 0.50D of astigmatism can improve the visual experience.
DEVOTE CHAIR TIME. Fitting specialty CLs takes time—but it has a big payoff in patient satisfaction and premium fees.

Research indicates as many as 80 to 85 percent of patients we see for routine eye exams have some degree of astigmatism. The question for us as optometrists: Is the patient’s astigmatism significant enough to correct?

The answer, in short, is that it depends. Correcting for astigmatism with contact lenses needs to be considered on a case-by-case basis, and there are two key factors for consideration:

•    What are the visual demands faced by the patient?
•    What are the patient’s expectations of their visual experience?

About SynergEyes…

SynergEyes® is a world leader in the specialty contact lens market, focused on developing and delivering advanced-technology, high-performance vision products that transform vision for patients with astigmatism, presbyopia and irregular cornea conditions. The company offers a range of hybrid contact lenses that promote eye health while providing GP vision and soft-lens comfort.

SynergEyes is focused exclusively on the leading independent eye care professionals and offers unique opportunities for increased patient satisfaction, practice differentiation and a recurring revenue stream. Products include Duette® and Duette® Progressive for astigmatism and presbyopia, and UltraHealth® and UltraHealth FC for irregular corneas, as well as SynergEyes A, MF, KC, and PS and ClearKone®.

More information is available at:

A patient may only have 0.50D of astigmatism, for example, but find that they see significantly better in their glasses than they do in their contact lenses. In the main office of our multi-location practice, 60 percent of the patients wear contact lenses, and they expect perfect vision all day long. The vast majority of those who are astigmatic, or who have irregularly shaped corneas, choose specialty lenses, assuming they have the means to purchase them, because they know these products will provide them with the best vision.

We’ve had remarkable success in this patient population with the hybrid Duette contact lenses from SynergEyes. The hybrid design—with the gas permeable optical center and the soft skirt—enables these lenses to overcome the majority of the issues associated with other contact lenses in these patients. Daily disposables, for example, are convenient, but rotational stability can be an issue. Stability is also an issue with many toric contact lenses. Gas permeables provide excellent optics, but comfort can be a problem for some patients.

The hybrid Duette contact lenses effectively provide the comfort of a soft lens with the optics of a gas permeable, for patients with 0.50D of astigmatism or more. And with the Duette Progressive, presbyopic patients don’t have that “long arm, short arm” syndrome so many multifocal contact lens wearers experience. Both lenses provide consistent vision throughout the day. And we’d rather have our patients seeing “20/Happy” all day than 20/15 in the morning and 20/40 as the day goes on.

Differentiate your practice from big box retailers

Offering the Duette product line has enabled us to differentiate our practice, at all locations, from our “big box” competitors in the area. In the main location where I practice, we have a contact lens capture rate of 82 percent. However, the fact that 18 percent of our contact lens patients are buying their lenses monthly, box to box, is really disheartening for us. We know that wearer compliance, and overall eye health, is significantly better when we can dispense an annual supply.

From the beginning, the patients we fit with Duette contact lenses know that they are not getting a product that a worker at Wal-Mart or Costco can pull off the shelf. During the fitting process, these patients undergo corneal topography and keratometry, so that we can collect the measurements needed to fit this specialty lens. I often pull up the online Duette Empirical Lens Calculator with the patient sitting in the exam chair, so that they can see the science behind the fitting process. As a result, they know they are getting a product customized to their eyes and their own unique vision needs. They truly understand the value of their contacts as a medical device.

Click HERE to view a video of Dr. Kaplan talking about fitting Duette contact lenses.

Click HERE for more information on Duette contact lenses.

Help patients make life changes

We had a male patient in his late 20s who had been told by every optometrist he saw before he came to us that he was not a contact lens candidate. By the time we saw him, he said he wanted to make changes in his life, and we talked about contact lenses—specifically the Duette. The fitting process was thorough; he started a trial and eventually we found a lens that worked for him. Within a few months, he had lost 50 pounds, changed jobs and proposed to his girlfriend. The contact lenses didn’t make all of that happen, but they were the trigger.

For some optometrists, this extensive, though straightforward, fitting and trial process can be intimidating. A lot of practitioners are hesitant to devote the time that may be required for some patients. But I would argue that spending that chair time creates a loyal and satisfied patient, making that chair time more valuable to you and your practice over the long haul. Ultimately, you need to see these hybrid lenses on your patients’ eyes to become comfortable with them. Hybrid technology sounds scary, but once you see how happy these patients are, and figure out the fitting process, you will definitely see the value—both in terms of profits and patient care.

Brooke S. Kaplan, OD, is a staff optometrist at Schaeffer Eye Center, a 15-location multi-disciplinary practice in Alabama founded by her father, Jack Schaeffer, OD. She earned a B.S. in genetics from the University of Georgia and is a graduate of the School of Optometry at the University of Alabama-Birmingham. To contact her:

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