Quarterly newsletter on Soft Specialty Contact Lens
Research, Developments, Designs and Materials   SUMMER 2011

Marco van Beusekom

Let Special Lenses be Special!

Globally, there is virtually not a single prescription left that cannot be corrected with a contact lens. With lots of new silicone hydrogel materials entering the market and more and more labs offering new specialty lenses made from silicone hydrogel materials, the future for this modality looks like a beautiful sunrise. Without any doubt, many patients with out-of-standard prescriptions can benefit from these developments. Many of these patients have tried contact lenses before, but dropped out because their only option was an RGP lens or a conventional soft lens that resulted in hypoxia complaints. I am a strong believer that we should do everything we can to reconnect with these patients and to offer them the benefits of contact lenses so they can experience relief from the optical burden these high prescriptions give them. The message should be that today we can offer comfortable, functional contact lenses for every patient regardless their prescription. Fitting these lenses needs a specialist's hand, and therefore we must consider these specialty lenses as the next level in our profession. Specialty lenses are special: let's make sure our patients know that they are available - and special indeed. For more see the link below.

Marco van Beusekom
The Netherlands
'Real Life' Astigmatism
Visual Acuity, Quality of Life & Testing



James Wolffsohn et al from Aston University in the UK induced astigmatism in healthy presbyopes and found that not only does distance visual acuity decrease with increasing astigmatic power, but near visual acuity and reading speed also decrease with increasing uncorrected astigmatism power. Uncorrected astigmatism at the 45-degree and 180-degree orientation resulted in worse distance and near visual acuity and subjective rated clarity compared to the 90-degree orientation. Correction of astigmatism in presbyopes seems imperative to optimize vision and quality of life in this age group.

Journal of Cataract & Refractive Surgery 2011 37: 454-60 



Conventionally, soft toric lens evaluation is usually done 'statically' in the consulting room. A new study at the University of Manchester by Paul Chamberlain et al shows that this may not be sufficient. This way of visual acuity testing for toric soft lenses does not represent 'real world' situations, as it was shown that versional eye movements lead to reduced visual acuities. The investigators suggest a more dynamic method for assessing visual performance in astigmatism. This may also mean that subjective assessment by the lens wearer may play an important role when evaluating the success of the fit.

Optometry & Vision Science 2011 88;534-538 


Benefits of a Specialty Lens Practice
Differentiation between Lens Fitters and Lens Specialists

The April edition of Optometric Management features the 2011 annual contact lens update, which listed nine trends to watch in 2011. Many of these include specialty contact lens fitting - both RGP and soft lens related. It seems that this may be the time for practitioners to make a critical decision between being a simple contact lens provider and being a contact lens specialist.

Specifically regarding soft lens fitting, the number one trend is 'management of astigmatism.' 'Start fitting toric lenses or patients will find practitioners who do,' optometrist Barry Eiden states in this article. Toric lenses are available in high Dk materials in any power now. More silicone hydrogels will make their debut in the marketplace, the article further states. And the Generation Xers will continue to widen the emerging presbyope market - more mutlifocal contact lenses emerging is the prediction. Also, more children will become wearers, with their specific demands and needs. The article states that, "Specialty contact lenses appear to be recession proof."

Tara Rosenzweig - Optometric Management April 2011

In the same journal, an article by Robert Murphy titled 'You Truly Change Lives' is solely devoted to building your specialty lens practice. One of the key aspects mentioned in this article is to 'Equip your practice.' This means looking at corneal topographers, aberrometry ('an aberrometer is an autorefractor on steroids,' states optometrist Gary Gerber in this article) and even OCT (optical coherence tomography). Once established as a specialty lens practice, referrals from surgeons are common as well as from other eye care professionals who did not make the choice to transfer into a specialty lens practice. And once patients are fitted successfully, patient referrals also can be a very strong factor, especially nowadays as patients may use social media to communicate this.
Robert Murphy - Optometric Management April 2011 

Silicone Hydrogel Lens Fit after  

Chemical Burn

Fitting of an Individualized Multi-Curve Toric Lens

A 25-year-old man sustained an injury to his left eye on New Year's Eve 2002/03 when fireworks exploded immediately in front of his face. The initial diagnosis at his local eye clinic was burn/chemical burn of the direct ocular surface and the adjacent structures in his left eye. Despite surgical removal, recurring nasal conjunctival pannus hindered the fitting of a RGP lens. This case report by Stafan Facherand and Stephan Degle from Germany demonstrates the successful fit in this case of an individualized multi-curve toric Silicone Hydrogel lens


Influence of Center Thickness on the Performance of Custom Soft Lenses 

Matt Lampa & Mark André

For patients with irregular corneal astigmatism, visual acuity is usually not ideal with a traditional soft contact lens. While rigid gas permeable contact lenses are considered the gold standard for visual optimization of patients with irregular corneal astigmatism, there are strategies in the design and selection of a custom soft contact lens that can optimize the final visual outcome. In many cases, these custom designs can closely approach the visual quality provided by a well-centered, non-flexing rigid lens material. With silicone hydrogel materials becoming an option in custom soft contact lens design, these lenses show good promise for our patients with irregular astigmatism.  Click here for more

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