In Focus: Specialty Contact Lens & Vision Solutions

Can You Write Off Contact Lenses On Your Taxes?

Did you know Arizona allows for 100% of qualified medical expenses to be deducted from your state tax return?

This includes your contact lenses and eye examinations!

After consulting with a Certified Public Accountant regarding tax deduction rules for the State of Arizona, we wanted to alert our patients that contact lenses and eye examinations (and all other qualified medical expenses for that matter) may be 100% tax deductible on your state tax return. Arizona, for example, does allow a 100% tax deduction of ALL qualified medical expenses, with no Adjusted Gross Income (AGI) limitations, even if the Federal tax return does not allow a medical deduction.

The information below is taken directly from this handout from the AZ Government:https://www.azleg.gov/itr/materials/AZ_State_Tax_Adjustments.pdf

1.) Medical expenses are 100% deductible as an Arizona itemized deduction. Federal itemized deductions are disallowed if they don’t meet the Federal threshold.

2.) If you have been diagnosed as Legally Blind, you may qualify for an additional personal exemption of $ 1,500.

To qualify as Legally Blind you must have the following:

(a) A central visual acuity of 20/200 or less in the better-seeing eye WITH your glasses and/or contact lenses on. Vision without glasses or contact lenses does not qualify.

(b) Loss of peripheral vision where your visual field in the better-seeing eye is no more than twenty degrees (most common in glaucoma patients).

If you are one of our snowbirds and have residence in another state, please consult your tax preparer as each state varies and some allow for federal or state deductions over a percentage of your AGI.

This post is for information only and does not qualify as your personal tax advice. You must consult with your own personal CPA, or other qualified tax professional, to make sure that you qualify to use these deductions.

Our patients have the *best* tips and tricks for managing their specialty contact lens supplies, so we share them with you!

This week, one of our patients told us about a travel hack for their supplies. This patient has very low vision when their lenses are not in, which can make using eye drops or cleaners a little tricky - how can you tell the bottles apart?

This patient puts a rubber band around anything that is ok to insert in their eye, such as saline, rewetting drops, prescription drops, etc. “If it doesn’t have a rubber band around it, it doesn’t go in my eye.” We love this simple tip!

Join us for a free contact lens seminar for patients with Dr. Morrison and Dr. Woo!

Saturday, March 18th at 9:00AM PST

All specialty lens patients are invited from around the globe to learn about the latest technology in specialty lenses.

The webinar will include updates like:
- What are the best contact lenses for astigmatism?
- What is the latest technology in scleral lenses?
- Is there any new materials to make lenses out of?
- Is there new technology that could make me see better?
- New solutions or eyedrops to help dry eye or lens comfort?

We will also be answering questions directly from attendees!

RSVP here: https://bit.ly/SpecialtyLensSeminar2023

Great results today for a patient who previously had LASIK surgery and removal of the (now recalled) Raindrop Inlay. Vision prior to lens was 20/60 and distorted. With a lens vision is 20/25, almost 20/20!

The Raindrop Inlay was a plastic insert into the non-dominant eye that tried to give patients the ability to read because of a "pinhole effect". It was recalled in 2018 because it was giving people corneal haze. Most that were in have been removed by cornea specialists.

This patient has residual scarring from her Inlay. You will also she she has a LASIK scar in this eye from prior surgery.

She wanted a simple and easy way to clear up her vision without having to go through a long fitting process. The corneal rigid gas permeable lens was perfect for this.

This is a photo of the lens on the eye where I can observe the tears under the lens by looking at the pattern of green.

You can see right at the bottom of the lens there is a green spot. This is where her scar is. Scars tend to "scar down" making the corneal flatter in this area, thus, more pooling of fluid under the lens.

Thankfully she is wearing the lens successfully and has much better vision.

Here is an interesting case where we used a small hole in a scleral lens to create an area of increased oxygen permeability close to the cornea.

This patient has an older corneal transplant (done because the have keratoconus). With our initial molded scleral lens, vision and comfort were great but because the cornea is so delicate, the corneal transplant started having a mild rejection. This rejection with lens wear is rare but can occur due to the reduction in oxygen to the eye with lens wear.

Because we get better vision in a scleral lens than anything the patient has tried before (RPs, hybrids), we put a fenestration in the haptic zone of the lens, almost right above the area of stem cells. Putting in these fenestrations (holes) in this area does not induce a bubble like putting them in the optic zone (further in), but can help in increasing oxygen.

Of course with oxygen, we do everything we can BEFORE putting fenestrations in. This includes thinning the lens plastic as much as possible, putting lens as close to the eye as possible to minimize the tear film thickness, and using a highly oxygen permeable material (we prefer Acuity 200, the newest material available for these cases).

Our patients are usually very complicated so it is our honor to join them on their journey to achieve the best vision possible and keep the eye healthy.

Here is a patient of ours who we just fit with mold-designed EyePrint scleral lenses! They are extremely happy with 20/20 vision in the right eye and 20/25 vision in the left eye.⁠
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They had radial keratotomy (RK) surgery and were left with fluctuating vision that was unable to be corrected well with soft contact lenses or glasses. ⁠
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Prior to seeing us, they had tried both RGP lenses and soft contact lenses. ⁠
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Because they had pinguecula (tissue growths on the white part of the eye from UV damage), and redundant conjunctiva (where the squishy part over the whites of your eyes increases with time), decided that the impression-designed lenses were going to be the best option for this patient. ⁠
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In the second photo, you will also see where added small holes, or fenestrations, to the landing zone of the lens. This decreases suction which is very common in patients who have had RK surgery.⁠
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We are so happy for this patient and they are over the moon!

Learn more about specialty lenses and Radial Keratotomy here: youreyesinfocus.com/radial-keratotomy

Check out these images of a custom soft contact lens on an eye with a corneal transplant. This eye does not benefit from RGP or scleral lenses because it has damage from glaucoma. We were able to fit this eye with a custom soft lens to achieve 20/200 vision (the best the patient is capable of).

Looking closely at the fit, you can see the edge of the lens is barely over the diameter of the cornea. This is a look at the kinds of things I observe in the office when I am designing lenses.

The original design was ordered based on the patient's measurements from both myself and a corneal topographer machine.

I will order this lens in a larger diameter as well as a flatter curvature to allow for more tear exchange under the lens. We'll have the patient back in a few weeks to try out the new lens!

Learn about our fitting process for specialty contact lenses here: youreyesinfocus.com/post/what-can-i-expect-being-fit-with-specialty-contact-lenses

Once our patients have received their new pair of specialty lenses, we review lens insertion/removal techniques along with cleaning regimens, and make sure the patient is seeing clearly and is comfortable with the fit. ⁠
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Sometimes, first-time scleral and contact lens wearers will report that their vision is immediately blurry when they put the lenses in at home: "How come I can't see with the lenses anymore?" ⁠
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More often than not, this can be easily remedied after asking a few quick questions. Follow the link below for a few things to check if this is happening to you! ⁠
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https://www.youreyesinfocus.com/post/blurry-vision-right-when-you-put-your-contacts-in

Why do we see our contact lens specialists yearly?

This is an OCT (optical coherence tomography) photo of patient’s eye with keratoconus who is wearing a scleral lens.

This patient has been wearing the same pair of lenses for two years because they fit well and they had good vision.

This year we did scans through their eyes at their annual checkup and saw that the lenses were now touching the limbus (an area of the cornea that houses all of our limbal stem cells). The limbus creates new tissue for our cornea. If our lenses touch this area for a prolonged period of time they can damage the cells, making it hard for us to make new tissue. When these cells are permanently damaged we get something called limbal stem cell deficiency. This creates very irregular cells and makes it so patients have difficulty seeing well with glasses and contact lenses.

We are ordering them new lenses with a larger diameter and increased space between the cornea and the lens. This will keep their eyes healthy and seeing well for long into the future.

Have you scheduled your annual appointment yet? Book today: https://www.youreyesinfocus.com

What is the difference between bitoric and spherical lenses?

This patient has a corneal transplant and has 12.00 Diopters of corneal astigmatism.

The first lens (spherical) has one curve on the back surface.

The second lens (bitoric, shown in the 2nd image) has two different back surface curves for a better fit and better centration for vision.

We can see that the spherical lens doesn't fit as well so it is decentering on the eye. The bitoric lens with two curves on the back surface centers better and is more comfortable for the patient.

Usually, with corneal irregularities such as transplants, we do not use back surface toric lenses. Still, if the astigmatism on the cornea is within certain parameters, we can do this and achieve a better fit.

This patient still needs additional flattening of the central curves to achieve the best fit which we will address at the next visit. The process continues - we can't wait to see the next lenses on this patient!

https://www.youreyesinfocus.com/corneal-transplant

Every specialty contact lens wearer knows the saga of supplies - we gotta have them and when we find really useful ones, we stock up! ⁠
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Follow the link below to see the top specialty contact lens supplies that just make sense to us right now, and let us know what you can't live without!

https://www.youreyesinfocus.com/post/specialty-contact-lens-supplies-that-just-make-sense

Sometimes, the type of scleral lens a patient uses can make all the difference! ⁠
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This patient of ours had Radial Keratotomy (RK) and was experiencing fogging and discomfort in their conventional scleral lens, as seen in the first image. ⁠
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RK was a surgery that gained popularity in the 1980s using manual incisions in the cornea to correct a person's glasses prescription by changing the shape of the cornea. See the second image for a closeup of the incisions made on this patient's cornea. ⁠
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tried an impression-based lens for slightly sharper vision and better fit, as conventional sclerals cannot always incorporate the design needed to accommodate strong irregularities like bumps and scars. ⁠
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This turned out to be a great solution for this patient's fogging and discomfort as seen in the third image - the eye is far less irritated, the fit is relaxed, and this patient's vision was clear - a win all around. ⁠
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This patient called us the day after receiving her lens to say how happy she was with her lens. We love to hear it!

Learn more about radial keratotomy here: https://www.youreyesinfocus.com/radial-keratotomy

Do you wear contact lenses for keratoconus? Here is a longtime patient of ours who wears SOFT contact lenses for keratoconus with 20/20 vision!

This patient is wearing a lens called the NovaKone lens. This is a lens made out of a completely soft material. This lens is specifically made for people with keratoconus (a condition where the cornea starts to thin and bulge forward).

Most patients with keratoconus wear contact lenses made of a rigid (or "hard" material). These can be RGP lenses, hybrid lenses, or scleral lenses.

This patient has most of their "thinning" inferior to their pupil, which allows them to have better central vision than others with keratoconus who have central corneal thinning. They were fit with NovaKone lenses providing them clear, 20/20 vision.

The first photo shows the lens on the eye (the lens is dyed yellow slightly from my dye that I use in the office. It is a special dye that does not permanently change the color of soft lenses).

The second photo shows a picture of when we shine a blue light onto the dye and it turns green. The green signifies the tear film under the lens which is even. There are no spots where the lens is touching the eye and rubbing, which causes irritation and scarring.

This patient ordered new lenses and will be back in six months for their regularly scheduled follow ups!

Read more about soft lenses for keratoconus here: https://www.youreyesinfocus.com/post/custom-soft-lenses-for-keratoconus

This patient recently had a consultation with us to see if they could improve their vision with specialty contact lenses. ⁠
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They had radial keratotomy (RK) surgery in the 1990s, which was the pre-LASIK way of correcting nearsightedness during this time. This worked well for years until the pressure behind the cornea continued to push out the weakened incision areas, causing farsighted progression, starbursts, halos around lights, and blurry vision that fluctuated often. ⁠
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These photos show the lenses they came in wearing - RGP (rigid gas permeable) lenses which are small, hard contact lenses.⁠
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Because of how flat the central cornea is, the lenses move often with blinks and tend to decenter, which is common with many of my patients with RK who wear GP lenses. ⁠
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This patient was comfortable with their lenses but we decided to try on scleral lenses to see if the stability of the lens would be able to provide better vision. ⁠
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Sometimes a more stable lens on the eye can provide superior vision because where the optics are placed mid-lens is more centered in front of the pupil. ⁠
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They were extremely happy with their 20/25 vision in the scleral lenses and are going to return to us to take molds for the more advanced mold-based EyeFit lenses from EyePrintProsthetics. ⁠
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We are very happy for this patient! ⁠

Learn more about RK and specialty contact lenses here: https://www.youreyesinfocus.com/radial-keratotomy

Have you heard of giant papillary conjunctivitis (GPC)? ⁠
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This is a photo of a patient with GPC on the inside of the upper eyelid - the dye highlights all the large bumps so they are easier to see. ⁠
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GPC causes discomfort, which is usually first experienced when wearing contact lenses, and then if the bumps become large enough, the discomfort will be felt without contact lens wear. ⁠
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GPC can feel like scratchiness and is commonly associated with a white rope-like discharge from the eye. It is an important thing to look for when a contact lens wearer is complaining of recent discomfort that is worsening.⁠
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Good news: GPC can be healed! We advised this patient to continue to clean their scleral lenses with Clear Care overnight and to rub the lenses in the morning with their saline solution to remove any protein deposits that may be irritating the upper eyelid. ⁠
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We also put them on steroid medication to get rid of the bumps and allow them to return to comfortable lens wear, once again!

Need to stock up on Clear Care or other scleral supplies? Follow this link: https://www.youreyesinfocus.com/ordersupplies

Whether you use soft contact lenses that last one day, one month, or one year, it's important to know how to clean and care for them.

Read more about our recommendations for cleaning and caring for your soft contact lenses based on how long they last here:

https://www.youreyesinfocus.com/post/cleaning-and-caring-for-soft-contact-lenses

"Any doctor who educates you is worth their weight in gold, and I learned a lot from Dr. Morrison about scleral lenses, their use, maintenance, and idiosyncrasies, and even about the health of my own eyes."⁠
- B. Nco, In Focus Patient⁠
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Thank you, B., for your touching testimonial! And we agree - wear your safety lenses! 🙏 Read this patient's entire review below, and see more patient testimonials here: https://www.youreyesinfocus.com/patient-testimonials
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Image text: ⁠
"After an unfortunate accident that left a 95% full-thickness laceration in my cornea, I came to Dr. Morrison to be fitted for a scleral lens. In her field she sees the worst of the worst - considering my circumstances were relatively benign compared to other pathologies she routinely treats, she maintained patience and sympathy nonetheless, which I appreciated throughout the process. Any doctor who educates you is worth their weight in gold, and I learned a lot from Dr. Morrison about scleral lenses, their use, maintenance, and idiosyncrasies, and even about the health of my own eyes, injury aside. Scleral lenses may take a bit of getting used to, but I was amazed when I went from having not great vision post-injury back to my normal 20/15 with the new lens. Honestly seeing normally again lifted a two-month depression that persisted after my injury (during the healing process) which had left me feeling pretty hopeless. Now whenever I need to have my eagle eyes, I know I can easily pop my lens in and not have to worry about anything. A nice bonus was that the lens provided some additional relief from residual pain left after an earlier laser PRK surgery. I highly recommend entrusting Dr. Morrison with the care of your ojos and suggest following her on Instagram if you are looking to sharpen not only your knowledge but your vision... oh and please don’t forget to wear your safety glasses."⁠

What's the Difference Between Scan-Designed Scleral Lenses and Conventional Scleral Lenses?

During a Specialty Contact Lens Consultation at In Focus, Dr. Morrison often explains the difference between scan-designed scleral lenses and conventional scleral lenses to patients when they are deciding on lens options.

Many patients are candidates for both types of sclerals, and in most cases, one type will be more beneficial than the other.

Read more about why Dr. Morrison chose to go with scan-designed lenses for this patient who has keratoconus, low vision, and pinguecula here:

https://www.youreyesinfocus.com/post/what-s-the-difference-between-scan-designed-scleral-lenses-and-conventional-scleral-lenses

Have you heard of Kamra or Raindrop Inlays? These two devices are implanted into the cornea which is the front clear surface of your eye. These implants are for those over 40 who want to get rid of their reading glasses. ⁠
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While there are many amazing surgical ways to improve your vision, any surgery can result in complications if the body responds to the procedure in an adverse way.⁠
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This patient had the Raindrop Inlay which was removed (this device is now recalled). This resulted in central corneal scarring, which you can see in this image. ⁠
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This patient's vision with glasses was only 20/60-. We designed them a new rigid gas permeable lens (RGP) which gave them 20/25 vision and the ability to read more clearly and use both eyes together.⁠
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Read more about the way these devices work and ways to correct vision after inlay complications: https://www.youreyesinfocus.com/post/ways-to-fix-vision-after-kamra-or-raindrop-inlay-complications

"One thing I love about my practice is that I’ve set it up so I can really get to know my patients. The first visit with me can last more than an hour, which is very unusual for any doctor, and that provides a solid foundation for the patient-doctor relationship. Usually, my patients have seen many doctors for their vision concerns before they get to me. Taking extra time to get the full picture of their issues and explain all treatment options thoroughly makes them feel comfortable. I enjoy this kind of patient-first approach."⁠
- Dr. Caitlin Morrison, OD FAAO, FSLS ⁠
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Check out Dr. Morrison's feature in this summer! Read about her inspiration to focus on specialty contact lenses, how she got started and what she's learned along the way:

http://voyagephoenix.com/interview/community-highlights-meet-caitlin-morrison-od-faao-fsls-of-in-focus-specialty-contact-lens-vision-solutions/ ⁠

Contact lenses that block out all vision? Yes!
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One of the really interesting lenses that we've been doing a lot more of lately is called an occlusive pupil contact lens. This is a soft contact lens that essentially occludes or blocks out all vision from one eye. ⁠
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A few reasons we would choose to use an occlusive lens would be if someone has double vision that they are unable to get rid of by any other measure, or if a patient has been wearing an eyepatch and wants something that looks a little bit more cosmetically subtle. ⁠
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Read more about the types of prosthetic lenses that can help block light and eliminate eye patches by following the link below: ⁠
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https://www.youreyesinfocus.com/prosthetic-soft-contact-lenses⁠
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