The next-generation Meridia Pro boasts all the advantages Medmont corneal topography is famous for, plus more. Independents like JILLIAN CAMPBELL are extracting all they can from the device that’s proving a sound investment.
By the time many patients reach Ms Jillian Campbell’s practice, they’re frustrated. They’re unable to continue dealing with fogging, discomfort, poor vision – or all the above – created by a vision correction solution poorly matched to their highly irregular corneas.
While many eyecare professionals may feel ill-equipped to manage such challenging conditions, Campbell’s in her element working through the intricacies of advanced contact lens fitting for these patients.
Patients with conditions like corneal ectasia, pathologically high myopia, recurrent herpes simplex keratitis (HSK), extreme dry eye caused by graft-versus-host disease and post-corneal transplant recipients.
For nearly three decades, her practice, Richard Lindsay & Associates, has cultivated a reputation for delivering bespoke solutions that transform these patients’ lives, even in the most demanding clinical presentations.
“We treat an incredibly diverse range of patients, from those newly diagnosed with keratoconus with little understanding of contact lenses or glasses, right through to those who have tried contact lenses elsewhere and feel they’ve exhausted every option, or infants with congenital cataracts,” says Campbell, who took ownership of the practice in 2023.
“Often, it’s about carefully explaining why they’re experiencing issues, helping them understand the root of the problem. When you can swoop in with thoughtful solutions that truly make a difference, they’re incredibly appreciative – and that’s such a satisfying feeling.”
Campbell can do as many as 20 contact lens fits a day. To flourish, she needs gold standard equipment behind her. When a contact lens interest spawned during her early days at the Australian College of Optometry, the Medmont E300 was the first corneal topographer she used.
The same device – Australian-made, world-renowned and ubiquitous in advanced contact lens practices – was also the workhorse at Richard Lindsay & Associates when she landed her dream job there in 2016.
Then, in 2020 Medmont launched its next generation corneal topographer, the Medmont Meridia.
It was a big milestone for the Melbourne-based manufacturer, and Richard Lindsay & Associates was one of the first to have it installed.
“I’m fortunate that I didn’t have to purchase the Meridia Pro myself, as it was already part of the practice’s toolkit before I took over. However, if you asked whether I’d buy it again, I absolutely would,” Campbell says.
“A considerable portion of our revenue is generated by advanced contact lens services – particularly rigid lenses where patients are willing to invest in effective solutions to address complex vision challenges.
“Beyond these direct financial returns, the superior imaging and topography data mean we achieve more accurate initial fits, with fewer refits overall. Our high success rate leads to happier patients, valuable word-of-mouth referrals, and more comprehensive ongoing care – collectively growing our patient base.
“Furthermore, new services such as dry eye evaluations using meibography provide an additional income stream, alongside enhanced patient engagement and retention.”
Simulating for a better fit
The Medmont Meridia is available in two models – Classic and Professional.
The Classic offers the same gold-standard topography as Medmont’s E300, enhanced by a larger colour field-of-view and ergonomic quick keys for navigating the software.
The Professional (Meridia Pro) has the same functions as the Classic, but with more features like anterior imaging and video, fluorescein capture, and meibography. It also offers dry eye grading scales and reports for patient communication and engagement.
Richard Lindsay & Associates opted for the top-of-the-line Meridia Pro.
For Campbell, the device proves its worth in all the essential aspects of anterior eyecare, supported by a high-definition colour camera and three light sources for assessing dry eye, contact lens fits and anterior pathologies.
“Due to the nature of our practice, almost every patient receives corneal topography. I’m using it to track whether they’ve progressed over time in combination with corneal tomography, fitting custom contact lenses, tracking how my orthok treatments are going before and after, and to measure the HVID (horizontal visible iris diameter),” she says.
“One of the very important reasons we stayed with Medmont when upgrading was that we had 20 years of data on the E300, so it was important to maintain that for future comparison, especially for our keratoconus patients who make up the majority of our patient-base.
“The functionality is also an advantage. Our front-of-house staff obtain all the scans, it’s very intuitive. Medmont have also made it easy to swap between different maps; it’s effortless to use, allowing me to focus on the patient in front of me.”
Wide corneal topography coverage is considered key to custom contact lens fitting, helping remove the guesswork. It’s something Medmont has achieved with up to 11 mm of real corneal data in a single automatic capture, plus, for even more data, it has a Composite Mapping feature for “gold standard” limbus-to-limbus coverage.
In Campbell’s clinic, that baseline data is the key to high quality orthok and rigid contact lens fitting. It also supports an enviable first-time fit rate, helping to avoid unnecessary chair time and unsatisfied patients.
A big part of that is Meridia’s contact lens simulator, which can integrate with custom lens design software or export files straight to contact lens labs.
“The contact lens module is excellent for simulating the fit of various lens designs. This speeds up the process by reducing the number of lenses applied to the eye. Additionally, the lens fitting simulation software enables us to make adjustments to the lens design while comprehending the effects of individual modifications on other parameters,” she says.
“As long as you’ve got high quality initial scans, which Medmont instruments offer, and you’ve well trained staff to take them, it gives great insight into how the contact lens is going to sit.”
Detailed fluorescein images, using cobalt blue light with a built-in wratten filter, also ensure efficient and effective orthok fits. The practice’s support staff are trained to acquire these images that are “easy to take and come out focused and clear”, saving Campbell time to attend to higher patient needs.
The fluorescein images are also useful for documenting pathology like loose sutures, graft bullae/oedema, and dimple veiling to name a few.
With the device, she’s found new ways to encourage greater patient buy-in too, thanks to new video capability. It doubles as an excellent educational tool when she lectures optometry students at the University of Melbourne.
“For patients struggling with blurry vision I can demonstrate, for example, dimple veiling – bubbles underneath the lens – helping to explain why they’re having these issues. Another great example is a patient that had chronic wettability issues with scleral lenses and was a religious user of kohl liner – using Medmont Pro’s meibography, I could demonstrate the root cause of her issues and put in place management strategies to create better habits around contact lens wear.
“For educational purposes, the videos allow you to sit back and think more about how the lens is moving on the eye, not just in a photo in one position. You can look at how the lids interact with the lens while the patient blinks.”
And it’s good for problem-solving when the patient’s left the clinic.
“Many times, we’ve been huddled around a Medmont fluorescein video after work, problem-solving a complex reverse geometry fit.”
Assessing the ROI
Given its broad-base functionality, it’s easy to see how the Medmont Meridia does much of the heavy lifting in Campbell’s clinic.
From a business perspective, it becomes much easier to justify the return on investment (ROI). Looking at orthok alone, which can cost patients around $2,000 for a pair of lenses in a treatment plan, Medmont notes it would require as few as 15 patients to recoup the investment.
That’s before the more intangible returns, such as patient satisfaction, retention and the best marketing tool there is – word-of-mouth referrals.
Using the Meridia Pro has also enabled Campbell to focus more on dry eye management, while enabling her to effectively demonstrate and document patient outcomes. Her management strategies include ciclosporin eye drops, BlephEx, and Zocular eyelid and skin hygiene products, as well as topical steroids, lid margin debridement, a comprehensive range of ocular lubricants, warm compress therapy, and manual lid expression.
Campbell can be confident in her clinical diagnosis and recommendations because of the device’s advanced features. The Meridia Pro offers a robust set of dry eye analysis tools, including meibomian gland imaging, Meiboscale meibography grading, tear meniscus height measurements, and visual dry eye reports.
“This is something I’ve under-utilised in the last five years, but I’ve cottoned on to it during the past 12 months, and patients love it,” Campbell says.
“It’s helped me put more of a focus on managing dry eyes and we’re seeing more patients come back because they want those scans to see if their treatment has been working.
“I love using meibography to take photos of the glands and then the machine generates these excellent grading reports that you can show to the patient. It’s great for educational purposes, showing what type of dry eye they have and the reason for their symptoms.
“I then print the dry eye report, give it to the patient, and it includes their diagnosis, management and review schedule and their instructions for management. When they come back in, I can compare it to their baseline scan.”
For Richard Lindsay & Associates, Meridia Pro has allowed the practice to raise the bar in advanced contact lens fitting and disease management, while creating new differentiation opportunities for the business. It’s been a worthwhile investment.
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