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HomemiequipmentExploring Astigmatic Contact Lenses: Options & Opportunities

Exploring Astigmatic Contact Lenses: Options & Opportunities

New toric contact lenses are easier than ever to fit and they provide crisp clear vision for astigmatic patients. Sydney optometrist Narelle Hine describes her experience with Acuvue Oasys 1-Day for Astigmatism.

In recent years, I have seen an increasing number of patients with astigmatism. As we know, without correction, many astigmats experience visual discomfort as well as headaches and migraines, and reduced reading speed. Their need for correction has made understanding options for astigmatic solutions a greater priority. It has also provided optometrists with more opportunity to fit astigmatic contact lenses to patients.

When comparing contact lenses and spectacles, research shows that contact lens wearers are typically more satisfied1 for lifestyle and visual reasons.

patients report feeling no difference in comfort between wearing the toric Oasys lens in one eye and the spherical Oasys lens in the other…

My contact lens patients love the uninterrupted peripheral vision and comfort that newer contact lens designs offer, but would the majority of astigmats say they enjoy crisp optics?

Most patients are not aware of the benefits and improved acuity that astigmatic contact lenses can provide so they don’t request toric lenses, they simply trust their optometrist to decide on the best lens for their needs.

Research indicates that nearly half of people with an eye condition have astigmatism of 0.75DC or more in at least one eye,2 yet only 21% of contact lens wearers are fitted with toric lenses.3 Clearly, many of us choose to leave low astigmatism uncorrected and for what reason?

Some optometrists avoid correcting low astigmatism because they are concerned that a toric lens is a more time-consuming fit for little extra acuity or, in cases of monocular astigmatism, that toric lenses can’t match the comfort of a spherical contact lens worn in the opposite eye. Understandably, these concerns may be a result of previous experience with older, less stable lens designs, or working with less comfortable edge designs. Sadly, the decision to rely on a spherical lens to mask the astigmatism too often consigns the astigmatic patient to a world of suboptimal visual acuity.

FITTING DECISIONS

My decision to fit a more complex toric contact lens is based on the patient’s response when I remove the cyl correction (easily tested using a trial spectacle lens or spherical contact lens). If binocularly they miss the high-definition clarity on the distance or near chart when I remove the cyl, then I must correct the astigmatism – even if it is only -0.50 or -0.75DC.

In cases where the one astigmatic eye is also the dominant eye, I always correct the astigmatism where possible. The axis usually determines whether I can fit a daily disposable toric, or whether I need to choose a two-weekly or monthly lens to access a wider 10º span of axis availability.

When working with Acuvue Oasys 1-Day for Astigmatism, I find that lens selection and fitting time is equivalent to fitting a spherical lens. I am truly impressed that in cases of monocular astigmatism, patients report feeling no difference in comfort between wearing the toric Oasys lens in one eye and the spherical Oasys lens in the other. I attribute this, and their clarity of vision, to the design of the Oasys toric lens. There is minimal lower lid interaction due to the absence of prism in the optic zone and the horizontal and vertical symmetry, which is designed to stabilise the axis position with natural blink movement.4

With these developments for successful astigmatism correction in mind, Acuvue Oasys 1-Day for Astigmatism is a lens that I am happy to prescribe. Importantly, my patients are very happy to wear this lens. They love the crisper, stable vision4 and improved comfort throughout their office day that is offered by HydraLuxe technology with low co-efficient of friction.5,6 I think the patients also benefit physiologically from the high dK/t and the daily disposability that avoids difficulties associated with overnight lens disinfection.

Years of practice have taught me that contact lens patient retention depends on me fitting lenses that give them optimal comfort and clarity, so I frequently offer my patients trials with upgraded lens technology when it arrives.

Their annual contact lens examination is the perfect time to discuss new developments in lens technology that have become available. Clearer, safer and more comfortable vision helps build my practice by reducing dropouts, and can be positively life changing for my contact lens wearing patients.

Narelle Hine is the principal optometrist at HineSight in Sydney. She has extensive experience in clinical eye care and disease screening, contact lens prescribing and relieving the chronic visual fatigue of screen users.

References 

  1. Pesudovs K, Garamendi E & Elliott D. A Quality of Life Comparison of People Wearing Spectacles or Contact Lenses or Having Undergone Refractive Surgery. Journal of Refractive Surgery 2006; 22:19-27 
  2. Young, A Sulley & C Hunt. Prevalence of Astigmatism in Relation to Soft CL Fitting. Eye & Contact Lens: Science & Clinical Practice. 37(1):20-25, January 2011. 150047 
  3. Growth Lever Study 2018 Australia, P12 month. 15-64 y.o. Astig Correction Need 
  4. JJV Data on File 2021. ACUVUE Brand Contact Lenses for ASTIGMATISM – Overall Fitting Success, Orientation Position, Rotational Stability, and Vision Performance. 
  5. JJV Data on File 2015. Minimal Frictional Energy/Sliding Work with ACUVUE OASYS Brand Contact Lenses with HydraLuxe Technology 
  6. Coles, M.C. and N.A. Brennan, Coefficient of friction and soft contact lens comfort. Optom Vis Sci, 2012. 89.

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