FOR ASTIGMATIC PATIENTS, IT’S ALL IN A DAY

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Daily disposable toric lenses offer patients the visual benefits of correcting astigmatism and improved comfort and eye health.

As a millennial herself, Jennifer Lyerly, OD, of Cary, NC, is very familiar with visual demands, especially on younger generations. After all, she says, individuals often spend eight-hour workdays staring at computer screens, playing video games, and simultaneously watching television and looking at smartphones.

In April, U.S. Time Spent with Media, a report from eMarketer Inc., estimated that digital usage for 2017 would total nearly six hours a day. Indeed, individuals spend an average of more than three hours daily using mobile devices for purposes other than telephone calls.

“That means even small imperfections in vision can be a huge detriment to our daily performance,” Lyerly said. “While in the past it may have been acceptable to ignore astigmatism when writing a contact lens prescription, our patients expect and deserve the sharpest 20/20 vision (or even 20/15) they can achieve.”

Thanks to the advent of daily disposable toric lenses, it’s possible to offer patients this vision as well as improved eye health benefits.

COMFORT AND CLARITY
But, are they getting that vision? According to Bausch + Lomb, approximately 73.2 million people in the U.S. have astigmatism, yet only 8.8 million, or 12% of them, currently wear toric contact lenses.

“Approximately 42% of vision corrected teens and adults in the U.S. have been diagnosed with astigmatism, and it is often a challenge to fit them with a lens that has the right combination of visual clarity and comfort to meet their unique vision correction needs,” said Mile Brujic, OD, of Bowling Green, OH.

Brujic described himself as “delighted” to offer patients with astigmatism “the comfort and clarity they need in the convenient form of a daily disposable lens” when Bausch + Lomb introduced its Biotrue ONEday for Astigmatism daily disposable contact lenses in March.

Biotrue ONEday for Astigmatism features Surface Active Technology, which uses a large volume of hydrophilic polyvinylpyrrolidone (PVP), a water-loving molecule, and Poloxamer 407, a surface-active macromer, to form a unique dehydration barrier that helps the lens maintain 98% of its moisture for up to 16 hours. B+L engineers also created an evolved peri-ballast design that employs spherical aberration control in both axes to help reduce halos and glare, even in low-light conditions.

HEALTH BENEFITS
Besides the visual advantages, ODs say that the health factors shouldn’t be overlooked. “Any one-day lens, toric or otherwise, should be seriously looked at by eye doctors,” said John McIntyre, OD, of Corpus Christi, TX.
For example, he said, patients wearing monthly replacement torics might report no comfort issues during the first two weeks of wear but less comfort by the third and fourth week, and he may observe corneal edema on the exam. “I tell them they need to consider switching to the one-day modality,” McIntyre said.

McIntyre also likes using daily disposable lenses with teenagers not only because of the eye health benefit but because he is concerned about whether they will comply with the care regimen.

TEST SITE
McIntyre’s practice tested MyDay toric daily disposable contact lenses from CooperVision Inc. before it launched last month. This latest entry into the daily disposable toric segment offers the same Optimized Toric Lens Geometry found in CooperVision’s Biofinity toric, which the company says provides uniform horizontal ISO thickness, an optimized ballast band design, large toric optic zone, and a smooth, continuous surface to make it an easy-to-fit, stable toric lens.

The lens also features Smart Silicone chemistry, which optimizes oxygen permeability. The lens consists of just 4.4% silicon, leaving more room in the lens for hydrophilic material, resulting in improved surface wettability, higher water content, and lower modulus for a softer, more comfortable lens-wearing experience. It also enables a modulus of only 0.4 MPa to make MyDay CooperVision’s softest ever one-day silicone hydrogel contact lens. While the lens provides the optimal softness of a hydrogel, it remains strong enough to ensure the exceptional handling of a silicone hydrogel lens.

“The MyDay specifically just hits all cylinders. It’s good Dk, it’s good water, it handles well, and the vision is excellent,” McIntyre said. (For more on this new lens, see “New Product Gallery,” page 12.)

CONVENIENCE AND STABILITY
Besides the health benefits of using a new lens each day, Stephen Pullen, OD, of Jacksonville, FL, says daily disposable lenses have become standard in his practice because this modality “offers the convenience of no solutions, cases or cleaning regimen and provides consistent vision due to state-of-the-art technology in production.”

Pullen says he offers Johnson & Johnson Vision’s ACUVUE OASYS Brand Contact Lenses 1-Day for ASTIGMATISM for anyone with -0.75D or greater cylinder. ACUVUE OASYS combines HydraLuxe Technology, which includes tear-like molecules and highly breathable hydrated silicone that integrate with the patient’s own tear film, and BLINK STABILIZED Design, which harnesses the natural power of the eyelids, to help keep the lens in the correct position even with head and eye movements.

“Patients are able to discern the improvement in acuity immediately,” Pullen said. “The BLINK STABILIZED Design provides consistent vision and holds its orientation throughout the day very well.”

In addition, he said, the lens features a stiffer modulus for easier handling and ease of insertion, and the thinness of the lens makes for more comfortable lens wear.

“In my experience, patients who have handling difficulty with many single use toric lenses find the OASYS 1-Day for ASTIGMATISM to handle very well and to be extremely comfortable all day,” he said. “The Hydralux technology used on the OASYS 1-Day for ASTIGMATISM is a great wetting and ‘slick’ lens all day.”

EASE OF HANDLING
Lyerle says DAILIES AquaComfort Plus Toric from Alcon Laboratories has become her go-to lens due to its ease of handling.

The lens combines dual thin zone Precision Curve lens design, which the company says supports excellent visual acuity, and Blink-Activated Moisture, in which moisturizing agents are released with every blink for all-day comfort.

Lyerle also points out the convenience of clearly visible alignment markings, which allow patients to self-align their lenses for immediate clarity and determine whether the lens is inside out before insertion.

“In an era where we expect technology to respond immediately, waiting even just a few minutes for visual clarity is a drawback for patients with astigmatism lenses,” she said. “They love seeing that green ‘OK’ to be able to easily insert their lenses in the perfect location for immediate vision performance.”

COST CONCERNS
One final piece of advice these doctors offer is not to let cost discourage you from offering daily disposable lenses. “Asking an existing toric patient if they experience visual fluctuation during the day or during the life of the lens can often provide an opportunity to discuss single use as a better alternative,” Pullen said. “Clean lenses tend to stay aligned, and that is a natural segue to offer a single-use option.”

“As eye doctors we just need to overcome our own fear of prescribing something that we think is expensive,” McIntyre said of daily disposable toric lenses. “I think they’re the present and the future. We’ve embraced it in my office, and we’ve been quite pleased at the result.” O|O

WHERE TO FIND IT
Alcon Laboratories
800.451.3937 | Alcon.com

Bausch + Lomb
800.828.9030 | Bausch.com

CooperVision, Inc.
800.341.2020 | CooperVision.com

Johnson & Johnson Vision
800.843.2020 | ACUVUEProfessional.com

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