Article Date: 12/1/2009

Contact Lens Line Defies Dry Eye
contact lens focus

Contact Lens Line Defies Dry Eye

Provide your patients with two ocular dryness-fighting features.

STEPHEN COHEN, O.D.

Ocular dryness is an especially pervasive problem in Arizona, where I practice. Our 300-plus days of sunshine annually are accompanied by often-windy conditions and humidity that can be as low as 5%. Add these environmental challenges to the facts that many of my patients do computer work all day and that several are presbyopic — making them particularly prone to dryness by virtue of their age, medication use and hormonal changes — and the risk of all these patients dropping out of contact lens wear due to ocular dryness is high. Thankfully, the Acuvue Oasys contact lens line (Vistakon), which is comprised of spherical, astigmatic and multifocal lenses, has enabled me to prevent several of these patients from contact lens drop out.

Here I explain how.

Senofilcon A material

This material offers a Dk of 103, enabling the cornea to stay hydrated. It features a flexible modulus that increases comfort on the cornea and lid, aiding an eye that has reduced tear film quantity or quality. In addition, the senofilcon A material provides a 0.003 coefficient of friction between the lens and the eyelid, helping the lid slide smoothly over the lens' surface with each blink. Further, the lens material includes a 56° advancing dynamic wetting angle, which makes its surface highly wettable. This aids in tear film stability.

Hydraclear Plus

This technology incorporates a long-chain, high-molecular weight polyvinyl pyrrolidone into the lens material itself, making it both smooth and wettable. The Hydraclear Plus technology functions as both a humectant, to bind moisture to the lens, and a lubricant to keep the lens hydrated.

Acuvue Oasys for Presbyopia
MATERIAL: Senofilcon A
DK/T (EDGE CORRECTED): 147
WATER CONTENT: 37%
SCHEDULE: daily wear; may be worn for up to six nights/seven days of extended wear
RECOMMENDED REPLACEMENT SCHEDULE: Up to two weeks
BASE CURVE: 8.4mm
DIAMETER: 14.3mm
PATIENT COST: An average of $45 per box

Success story

A 49-year-old presbyopic female spectacle wearer recently presented complaining of increasing near blur — especially when reading. Patient history revealed 30 years of contact lens wear until she noticed increasing ocular dryness and tried four lens brands that didn't quell the condition.

Examination showed inflammatory dry eye. I felt this patient would prevail in the Acuvue Oasys for Presbyopia lens, given her increasing blurry vision and the material's aforementioned attributes. To provide the patient with the best chance of successful wear, I prescribed cyclosporine 0.05% (Restasis, Allergan) b.i.d. with the concomitant indefinite use of fish oil supplementation (~1000 mg/day) to address her condition.

Six weeks later, I fit her in Acuvue Oasys for Presbyopia lenses and prescribed lubricant eye drops for comfort if needed.

At this patient's last follow-up visit, she said she was "thrilled" with her new lenses and the antidryness regimen.

To give our ocular dryness patients the best chance of maintaining contact lens wear, we must identify and appropriately treat the culprit(s). And when it comes time to choose a contact lens, we should investigate lenses that offer effective ocular dryness-fighting characteristics. OM


DR. COHEN IS IN PRIVATE PRACTICE IN SCOTTSDALE, ARIZ. E-MAIL HIM AT STEPHEN.COHEN@DOCTORMYEYES.NET.

Optometric Management, Issue: December 2009