Patients base their purchase of sunwear on protection against the elements-sun, snow, etc. Eyecare providers, however, see the match as a way of preventing ocular disease and conditions like age-related macular degeneration, cataracts, dry eyes, and pinguecula.

But there are other visual benefits as well. Sunglasses worn over contact lenses can improve distance acuity for some patients. Additionally, for the back-up glasses all contact lens wearers should have, a pair of clip-ons with photochromic lenses make sense. For outdoor use only, however, a separate pair of prescription sunglasses is advisable.

How do your reasons match your patients' reasons for purchasing sunwear? Here's a look at how and why optometrists and opticians suggest sunglasses as a natural partner with contact lenses-and how they keep that sale in their own offices.

Steve Morris, O.D., Miami

Since sunglasses are often an impulse purchase, Morris moved his sunglass frame display into the front where patients can see them on their way in and out of the office. He added what he refers to as a "minimal inventory of high-end sunglass frames," and to further pique interest, all patients receive a 10 percent courtesy card on plano sunglasses when they purchase contact lenses.

He describes the logic of the dual purchase to patients by explaining, "The proximity of the contact lenses to your cornea will make you more sensitive to sunlight as they are glare-inducing."

The harmful effects of UV rays are Morris' prime focus when discussing the necessity of sunglasses for all patients, especially his contact lens wearers. "When you go to the beach, the sun and glare seem intensified from the water and sand," Morris tells his patients. He's quick to add, "Pingueculae are UV-induced, non-cancerous growths on the conjunctiva that eventually enlarge." When they do, he explains, they will interfere with visual clarity, cause discomfort and often times need to be surgically removed.

Skin cancer, especially basal cell carcinomas, can develop on the eyelids, nose, and periorbitally, so UV-blocking sunscreen and sunglasses can be effective cancer-prevention measures for contact lens wearers.

Talking about the harmful effects of the sun with all patients in his practice, Morris begins with kids who often tell him that the sun "doesn't bother me much." His response is to emphasize the long-term effects of the sun by constant exposure in south Florida.

And, at the Insertion and Removal (I&R) classes for first-time contact lens wearers, he dispenses a booklet with information about the importance of sunglasses with contact lenses.

For the older contact lens patient, he explains how the sun's excessive heat causes drying of the tear film and contact lens discomfort, and, it can be prevented to a large degree with sunglasses.

Morris, the team optometrist for Miami area college sports, advises the use of sunglasses for contact lens wearers during crew and tennis events. Additionally, he recommends sunglass shields under football helmets.

Carl Childress, O.D.

Low vision and contact lenses have been "Dr. Carl's" optometric niche since joining the family practice with his mother and father in the 1970s. Retired from the Medical Service Corps, Captain Childress combined his optometric care in the Northeastern Texas office with the U.S. Navy Reserves in Louisiana and Washington, D.C.'s Bureau of Medicine.

"RGP patients receiving conventional and ortho-k care complain about increased brightness in the sun," says Childress. Soft contact lens patients are often prone to obtaining foreign bodies in their eyes because of the larger size of the lens and the increasing drying of the hydrophilic plastic material, he adds.

He advises sunglasses for contact lens wearers who spend time on the many lakes in the area or hunting in the woods. "A mirrored, polarized lens works best for these patients," says Childress. Photochromic and brown tints are the most popular sunlens after being doctor-suggested, he adds, while gray is still the most familiar to patients.

"We get started early by recommending sunglasses to kids who wear contact lenses, and strongly emphasize that a lack of proper UV protection can lead to the development of cataracts and age-related macular degeneration (AMD) for older patients," he adds.

He communicates this information to patients by giving them a handout about the benefits of sunglasses, but does not assume all patients follow his advice. "We revisit the sunglass issue every time the patient is in the office, because they often say, 'I didn't listen to you,' It's also a good way to follow up with those patients who need an upgrade on their existing pair."

Sheila Wood, O.D.

Education is key in sunglass success for contact lens patients, says Wood. She estimates that 65 to 75 percent of the contact lens patients in her Washington, D.C. practice now wear sunglasses.

"The low astigmatic patient has more glare from the sun, and I always caution older contact lens patients about sun and UV prevention from macular degeneration and cataracts," Wood explains.

Educating a jogger or bicyclist who wears RGPs is common for Wood, as is the importance of sunglasses to protect against glare from the snow during the winter months. And, for all her contact lens wearers, she recommends photochromic lenses as backup glasses.

Eyeing 1600 Pennsylvania Avenue

Two opticians-Mike Pelivanis of Apex Optical and Sam Khalil of the Optical Gallery-operate businesses within shouting distance of the White House. They have a client base that changes with each election, yet their messages regarding contacts and sunwear remain the same.

Pelivanis and his staff explain to customers that their eyes feeling drier with contact lenses, but that, "We like to provide protection against ultra-violet radiation from the sun."

Glare from sunlight, water, and asphalt can be reduced with polarized sun lenses, and Pelivanis recommends that "a brown lens is good for all seasons, especially to reduce glare when shoveling snow in the winter." He adds that yellow polarized lenses are beneficial for night driving for people with macular problems. The three-store owner advises all contact lens wearers to have a separate pair of sunglasses for times of non-contact lens use.

Garrett Drake, five-year optician at Apex, is a big proponent of sun lenses for kids who are first-time contact lens wearers. "Since everyone is treated on an individual basis, we take our time with them to discuss health protection from UV," he says.

He also educates other doctors. "Polaroid technology is much better now, especially to cut glare," he adds, "and we often call up referring ophthalmologists and optometrists to discuss new technology."

Khalil adds, "Contact lens wearers often know what they want in sunglasses before they come into the store." He attributes this to the marketing from sunglass stores, departments in retail stores, and manufacturers' advertising.