Bitoric rigid and soft contact lenses prescribed in tandem for keratoconus: Preliminary results

Use of spherical rigid and spherical soft contact lenses prescribed in a “piggyback” modality has generally failed in the past. A new technique uses a back surface toric soft contact lens, which becomes bitoric when placed on the highly astigmatic keratoconus cornea, and a bitoric rigid gas-permeable contact lens worn in tandem. The lessening of rubbing and the good contact lens centration appear to be an improvement over the rigid contact lens alone. The author has stated that he does not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article.     

Soft multifocal simultaneous image contact lenses: a review

Soft multifocal simultaneous image contact lenses have boomed in recent years due to the growing number of presbyopic patients demanding visual solutions, allowing them to maintain their current standard of living. The concept of ‘simultaneous image’ is based on blur interpretation and/or blur tolerance of superimposed multiple images on the retina formed by various powers of a contact lens. This is the basis for a specific type of multifocal contact lens developed for the compensation of presbyopia. Manufacturers have released a great variety of soft simultaneous image lens designs to meet different patient needs but their fitting is still unsatisfactory in some cases. Some presbyopes discontinue wearing contact lenses due to some limitations in visual quality and comfort that can be overcome with an appropriate contact lens selection based on a comprehensive pre‐fitting evaluation. This paper aims to review the different types of soft multifocal contact lenses that are currently available for presbyopic correction and to define the steps and factors crucial for their fitting, such as pupil, aberrations, accommodation and centring. A discussion about useful tools to achieve a customised fitting leading to a successful outcome, such as the defocus curve, power profile and questionnaires, is performed.     

Smoking cessation counselling practices among Québec optometrists: evaluating beliefs,practices, barriers and needs

Background: Despite the fact that cigarette smoking is a well known risk factor for many ocular diseases, very little data exist regarding optometrists' interventions in smoking cessation counselling with their patients. The aim of this study was to evaluate the practices, perceptions and educational needs of Québec optometrists regarding smoking cessation counselling. Methods: A self‐administered questionnaire pertaining to smoking cessation counselling practices was mailed to 600 optometrists licensed in Québec. Results: The response rate was 51 per cent. The majority (90 per cent) of respondents (n = 288) reported having the required knowledge of ocular diseases related to smoking. Most respondents recognised that optometrists should ask their patients if they smoke (73 per cent), should advise their smoking patients to stop smoking (65 per cent) and should be cognisant of the resources available that can support patients in their efforts to quit smoking (65 per cent). Few responders asked their patients on a regular basis if they indeed smoked (16 per cent) or advised them to stop, if such was the case (29 per cent). Moreover, only eight per cent of respondents knew the resources toward which they should direct their patients who wish to stop smoking. Only eight per cent of respondents perceived themselves as being competent to offer counselling. For 72 per cent of the respondents, the main obstacle to smoking cessation counselling was the lack of knowledge about counselling. Approximately half (48 per cent) of respondents are interested in acquiring competencies in smoking cessation counselling. Conclusion: Based on the results of the present study, optometrists in Québec are well aware of the effects of smoking on ocular health and the importance of educating their patients; however, they might not possess the required skills to assist their patients in quitting smoking. Because they have not received sufficient training, optometrists in Québec remain an untapped resource in tobacco cessation counselling.