Article Date: 4/1/2012

Increase Your Toric Fits
contact lens focus

Increase Your Toric Fits

Stable, comfortable daily-disposable toric lens is a practice builder.

Mitch Cassel, O.D.

A 38-year-old woman wearing a toric monthly lens recently presented to my practice with complaints of lens discomfort due to excessive lid interaction. An allergy sufferer, she said her job at an ad agency required her to wear her lenses an average of 16 hours per day.

I would have liked to switch her to a daily disposable lens to reduce the allergen build-up on her lenses, and, therefore, increase her comfort, but her prescription was not within the available parameters of this modality. Specifically, the patient had an oblique axis of astigmatism OS (-4.00 -1.50 x 120). So, I switched her into the next best option, a two-week toric lens, in hopes it would keep her in lens wear.

I'd argue that most optometrists are no strangers to this scenario. We have been limited by the daily disposable options available, forcing many of these patients to compromise on their lens wear — something that places them at increased risk for contact lens dropout. With this month's release of the 1-Day Acuvue Moist for Astigmatism Brand Contact Lenses, from Vistakon, however, we'll be able to fit a majority of these patients. The reason: The lens offers a sphere of +4.00D to -9.00D, a cylinder of 0.75D, 1.25D, 1.75D and 2.25D and 12 axes (10°, 20°, 60°, 70°, 80°, 90°, 100°, 110°, 120°, 160°, 170° and 180°).

Here, I explain the other attributes of this lens.

1-Day Acuvue Moist for Astigmatism
MATERIAL: Etafilcon A with Lacreon Technology
DK/T: (boundary- and edge-corrected) 23.7
WEARING SCHEDULE: Daily wear
RECOMMENDED REPLACEMENT SCHEDULE: one day (single use)
BASE CURVE: 8.5mm
DIAMETER: 14.5mm
UV BLOCKING: Class 2
PARAMETERS: Sphere: +4.00 D to -9.00 D
Cylinder: 0.75 D, 1.25 D, 1.75 D, and 2.25 D
Axes: 10°, 20°, 60°, 70°, 80°, 90°, 100°, 110°, 120°, 160°, 170°, 180°
(See kit parameter card for exact sphere/cylinder/axis combinations.)

Stabilization

Lens rotation has historically gone hand-in-hand with toric lenses, causing patients blurred and varying vision. The 1-Day Acuvue Moist for Astigmatism lens, however, employs a Blink Stabilized Design, also used in its sibling, the Acuvue Oasys for Astigmatism lens.

Specifically, this design includes four stability zones on the lens that harness the natural pressures of the blink to keep the lens in place and quickly re-align it, should it rotate out of position — even upon significant head and eye movements. As a result, prescribing this lens can cut back on your chair time because you won't have patients calling back three days later complaining of fluctuating vision.

Comfort

Research has shown that a fresh lens every day is the best way to maximize one's vision and eye health. The 1-Day Acuvue Moist for Astigmatism lens goes a step further by incorporating the same material (Etafilcon A) and wetting technology as Vistakon's 1-Day Acuvue Moist spherical lenses: Lacreon. This technology works by permanently embedding a hydrophilic ingredient into the lens matrix to lock in moisture throughout the day.

Patients in whom I've fit the 1-Day Acuvue Moist lens have told me they have been able to wear their lenses longer and more comfortably, and I believe this technology has played a role here. So, to have it in a wide range of toric parameters is a great benefit.

That young patient

Now, with the release of the 1-Day Acuvue Moist for Astigmatism lens, I can offer this patient a 120°-axis daily disposable lens, turning a potential contact lens dropout into someone who is thrilled with her contact lenses and her care at our practice.

Knowing that even those patients who have a high cylinder or unusual axes can immediately walk out the door with the right prescription gives me confidence in prescribing it. And with recent reports indicating that nearly half of patients (46%) have significant astigmatism in at least one eye, finding good contact lens options for our toric patients is a key practice builder.1 Another important practice builder: not pre-judging a patient's willingness to invest in toric or daily disposable lenses. In my experience, astigmatic patients, in particular, easily perceive the added value in the enhanced vision, comfort and convenience they can achieve with such a lens. OM

1. Young G, Sulley A, Hunt C. Prevalence of astigmatism in relation to soft contact lens fitting. Eye Contact Lens 2011 Jan;37(1):20-5.

DR. CASSEL IS PRESIDENT OF STUDIO OPTIX, A CONTACT LENS PRACTICE AND OPTICAL DISPENSARY IN NEW YORK, NY. HE IS ALSO THE FOUNDER AND CO-CHAIR OF THE VISION MANAGEMENT GROUP, A NATIONAL THINK TANK OF OPTOMETRISTS THAT FOCUSES ON PRACTICE MANAGEMENT. FURTHER, HE IS A CONSULTANT TO COOPERVISION AND VISTAKON AND OWNER OF CUSTOM COLOR CONTACTS, PROVIDING PROSTHETIC, COSMETIC AND SPECIAL EYE EFFECTS TO THE MOVIE INDUSTRY. CONTACT HIM AT MITCH.CASSEL@GMAIL.COM, OR SEND COMMENTS TO OPTOMETRICMANAGEMENT.COM.


Optometric Management, Volume: 47 , Issue: April 2012, page(s): 58 59