We sat down with Dr. Britney Kitamata-Wong, a PROSE Provider at the University of California San Francisco Medical Center, to learn about her experience using PROSE treatment and scleral lenses, and how she chooses between these modalities when working with patients. Prefer video? You can watch Dr. Kitamata-Wong answer our questions here.
What drove you to a career in fitting specialty lenses?
I’ve always had an interest in specialty contact lenses ever since I was an optometry student. I used to work in contact lens research, prior to optometry school and that got me really interested in the art and science of contact lens fitting. When I see patients in my clinic, I see how they can dramatically improve their vision, their comfort, and it’s such a rewarding experience as a provider to work with these patients.
How did you first learn about scleral lenses?
I completed a residency in cornea and contact lenses at the Southern California College of Optometry at Marshall B. Ketchum University. And at that clinic, I learned a lot about scleral lenses, gas-permeable contact lenses, all sorts of specialty lenses. It was a great experience and I love having that variety in my clinical practice.
What led you to become a PROSE provider?
Before becoming a PROSE provider, there was a limitation to what I could achieve with traditional scleral lenses. There were times where I had to look at a fit, and there was something I didn’t quite like about it, but I’d have to leave it because there was no other option for that patient. Now that I know how to fit the PROSE device, I feel like it’s made me a much more picky fitter, because I know I can fix things that I wasn’t able to fix before. Being able to offer that level of customization really inspired me to become a PROSE provider.
How has fitting specialty lenses changed your perspective on the needs of your patients?
So when I learned to become a PROSE provider, it really changed my perspective on how to fit contact lenses in general. We focus a lot on shape, on vision, on design, but what we don’t always focus on is the ocular health of the patient. These PROSE or prosthetic devices are really meant to help treat the eye and to improve the ocular health over time. And that’s something that I really want to bring now to my specialty contact lens fitting in general.
When do you use PROSE treatment vs. a traditional scleral lens?
When I have a patient referred to me for a PROSE fitting, oftentimes they were trying previous scleral lenses where they didn’t have great success with the vision or the comfort, or optimizing their eye health. And so when I see these patients, a lot of times they’ve had some treatment failure in a previous lens design. The way that I describe these lenses to my patients is a PROSE lens is so customizable, it’s almost like the Ferrari of lenses or devices. You can make it as customizable as you like versus a regular scleral lens does work really well for a lot of patients but doesn’t sometimes have those bells and whistles that we need for more complex eyes. If I have a patient where I look at them, I put a sample scleral lens on, and they really aren’t getting the right fit, the shape, and I know is going to be a tough journey down the road, I will upgrade them to a prosthetic device right away.
How has becoming a PROSE provider changed the way you fit specialty lenses?
Becoming a PROSE provider has really pushed my limits as a clinician and a fitter in general. I see now a lot more complicated patients than I was ever seeing before, and it’s really challenged me to think about these patients and to really think of what’s going to maximize their ocular health. What’s going to make them the most comfortable. How am I going to give them the most healthy eye possible. And this is an experience that has been so rewarding for me. And I hope to continue to develop my skills in this in the future.
Is there a patient experience that has had a particular impact on you?
In my clinic, I see a lot of patients who are very unfortunate. They had a lot of previous diseases and hadn’t had the ability to see for a really long time. I had a patient who only had one eye. And he was walking or ambulating with a wheelchair because he didn’t have the confidence to walk without sight. His only goal was to be able to watch tv. To be able to look at the clock, to see the time. And those basic things, we take for granted as people with regular sight. And fitting him with a prosthetic device, he was finally able to see the tv, he was finally able to stand up and walk with confidence. I think that’s a really great example of how these lenses can really help these patients.
What is your favorite part of your job?
It’s not uncommon for a patient to come in for the first time getting their device and crying in the exam room. I mean, they put their device on and they can suddenly see things they were never able to appreciate before. They look down at their clothes they see colors. They look at their hands, they see hairs on their hands. And these are things that we don’t really realize are important to people, and we kind of don’t realize how much of an impact we can provide them with that better vision.