Dr. James (Jim) Hoffman, shares insights on how to get former contact lens patients with presbyopia and astigmatism back into contacts and WOW them them in the process with new ULTRA Multifocal for Presbyopia from B + L.

 

 


About the Guest

Dr. Jim Hoffman graduated from the University of Houston College of Optometry in 1981 and was awarded fellowship in the American Academy of Optometry in 1985. Dr. Hoffman excels in pediatrics and advanced contact lenses and often lectures to his peers in USA and Canada.

Dr Hoffman is an independent practice owner with two practices in Orange Park Florida (south of Jacksonville), where he practices with his wife Dr. Karen Larson.

 


Episode Notes

Dr. James (Jim) Hoffman, enthusiastically shares insights on how to get former contact lens patients with presbyopia and astigmatism back into contacts and WOW them with new Bausch + Lomb ULTRA Multifocal for Astigmatism.

While multifocal toric contact lenses have been around for some time, the combination of a contact lens for presbyopia and  astigmatism in a stable, easy to fit format has been an unmet need for both practitioners and patients.

In the past Dr. Hoffman acknowledged that he had reluctantly informed patients, “there’s no contact lens for you” that could satisfy both their desire for uncompromised vision and freedom from glasses.

As an early adopter of Bausch + Lomb ULTRA Multifocal for Astigmatism contact lenses, Dr. Hoffman shares tips on how to bring back astigmatic presbyopes that had given up on contacts.

In this podcast Dr. Hoffman shares in detail:

  • how his office prepares specifically for these patients,
  • his in-office protocol,
  • patient communication strategies, and
  • follow up protocol.

Until the availability of this new lens he hadn’t realized just how frustrated the patients were. He and his patients now have the satisfaction of returning to contact lenses and regaining freedom from glasses without compromise to vision.

Key Tip: Since there’s never been a contact lens like this, he stresses the importance of following the Fitting Guide.

Resources

 

Dr. Glen Chiasson

Dr. Glen Chiasson

Dr. Glen Chiasson is a 1995 graduate of the University of Waterloo School of Optometry. He owns and manages two practices in Toronto. In 2009, he co-hosted a podcast produced for colleagues in eye care, the “International Optometry Podcast”. He is a moderator of the Canadian Optometry Group, an email forum for Canadian optometrists. As  a host of  “Eyes Wide Open”, Glenn  looks forward to exploring new new technologies and services for eye care professionals.

Dr. Chiasson enjoys tennis, hockey, and reading. He lives in Toronto with his wife and two sons.

Dr. Chiasson splits EWO podcast hosting duties with Roxanne Arnal.


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How would you explain to your patient the synergistic performance of the two significant design innovations delivered by ACUVUE OASYS® Brand Contact Lenses 1-Day for ASTIGMATISM lenses? Like wine and cheese, that’s how! Often times when you take one great idea and pair it with another the sum is greater than the parts. It takes the more consistent visual performance of BLINK STABILIZED® Design and combines it with the reduced frictional energy profile of HydraLuxeTM Technology, and the result is a lens that is even more consistently clear and comfortable than anticipated.  With each blink, the world is brought back into sharp focus and because of the tighter crosslinking meshwork the lens slides back into optimal position more effortlessly than ever before. Voila! What a magnificent pairing and what a remarkable way to share performance and innovation with your patients.
Kent Prete, OD, Calgary Alberta

ACUVUE OASYS® Brand Contact Lenses 1-Day for ASTIGMATISM combine two unique technologies to deliver excellent comfort and clear, stable vision, with the widest parameter range.

Astigmatic patients achieve their best vision when both sphere and cylinder are corrected. However, toric contact lenses have historically been underprescribed relative to the prevalence of astigmatism. Barriers to prescribing toric lenses include limited parameter availability and difficulty achieving stable vision and comfort.

Among those who have been fit in toric lenses, 58% report declining lens performance over the course of a day, with those who experience more activities or more environments during the day being the most prone to declining lens performance.¹

A new daily disposable toric lens, ACUVUE OASYS® Brand Contact Lenses 1-Day for ASTIGMATISM, has been specifically designed to provide exceptional comfort and performance in challenging environments. It combines BLINK STABILIZED® Design, which works with the natural movements of the eyelids to settle the lens quickly and maintain stable vision, with HydraLuxe™ Technology, comprising an enhanced moisture network of tear-like molecules and a highly breathable, hydrated silicone that integrates with the patient’s own tears to help maintain tear film stability.

A subject-masked, one-week dispensing study of 162 habitual toric soft lens wearers (324 eyes) was conducted in the U.S.² Within just 3 minutes of lens insertion, almost all lenses (97%) settled within 10° of nominal orientation (toric lens markings exactly vertical at 12 and 6 o’clock). At 15 minutes, all 324 eyes showed less than 5° movement on blink, which is a key factor in providing stable, predictable vision.

Clinical performance

In a busy practice, I’m looking for a lens that stabilizes quickly. But what is even more impressive to me than fit and stability in the office is how well the lens performs in the patient’s world, during everyday tasks that can challenge vision. In the study, 99% of eyes were successful at one week in the first lens fit, and visual acuity was excellent, with 97% seeing 20/20 or better monocularly.

My patients also loved the comfort of these lenses. They have busy lives and spend a lot of time on digital devices, which tend to reduce the blink rate and increase discomfort. Because it works with the tear film to stay lubricated, ACUVUE OASYS® 1 Day for ASTIGMATISM helped my patients stay comfortable throughout the day.

ACUVUE OASYS®  1-Day for ASTIGMATISM

  • First-fit success rate of 99%
  • Settles within 10˚ of nominal orientation in just 3 minutes
  • All patients achieved 20/25 or better monocularly, and 97% achieved 20/20 or better
  • Available in 2,260 parameters–40% more than any other daily disposable toric lens

Widest parameter range
The parameter range, the widest of any daily disposable toric contact lens, makes this lens very easy to fit. In the past, the lack of oblique axes or plus powers meant that some patients had to accept a level of visual compromise, or forgo the benefits of a daily disposable lens.

With ACUVUE OASYS® 1-Day for ASTIGMATISM, all three cylinder powers (-0.75DC, -1.25DC and -1.75DC) are available in axes around the clock for sphere powers plano to -6.00DS. For patients with higher astigmatism, an additional -2.25DC option is available in the most common meridians. This allows us to bring the benefits of daily disposable toric lens wear to more of our astigmatic patients.

References
1. Mathews, K., et al. AAO poster presentation, Nov 2016. Market research survey on performance throughout the day with toric soft lens wearers. US, n=208, 12% daily disposable toric, 88% reusable toric.
2. Straker B, et al. Global Specialty Lens Conference Poster presentation, January 2017

ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information. Complete information is also available from Johnson & Johnson Vision Care division of Johnson & Johnson Inc., by calling 1-800-267-5098 or by visiting acuvueprofessional.ca.

ACUVUE®, ACUVUE OASYS®, HydraLuxe™, BLINK STABILIZED®, and EYE-INSPIRED™ are trademarks of Johnson & Johnson, Inc.
©Johnson & Johnson, Inc. 2017

 

This article is sponsored by J&J Vision Care Canada.

 

ROXANNE ACHONG-COAN, OD, FAAO, FIAO

Dr. Coan received compensation for her work on this article.


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When was the last time a patient phoned you up and asked you, “I was wondering if you could tell me the difference between BLINK STABILIZED® Design and prism-ballast design and how that potentially affects the stability of my vision in eccentric positions of gaze?” It’s been a while, right? But why don’t astigmatic patients ask this question when inconsistency of vision with traditional toric lenses is historically one of the main reasons why they struggle with wearing contact lenses?  The reason is people don’t know what they don’t know. BLINK STABILIZED® Design may be established technology to you but for your patient, if explained properly, it could be just the change that takes them from merely surviving with contact lenses to thriving.  Sharing education about unique innovational EYE-INSPIRED Designs will make you the essential link between technology and better dynamic visual performance for your patients.  The opportunity to let them know what you know, awaits you if you open the door by asking the right question: How consistent is your vision with your existing toric contact lenses?
-Kent Prete, OD, Calgary Alberta

With a design that is easy to fit and quick to stabilize, ACUVUE® Brand Contact Lenses with BLINK STABILIZED® Design can help your patients consistently see their best.

For the past 10 years, ACUVUE® Brand Contact Lenses for patients with astigmatism, including 1-DAY ACUVUE® MOIST Brand Contact Lenses for ASTIGMATISM and ACUVUE OASYS® Brand Contact Lenses for ASTIGMATISM, have relied on BLINK STABILIZED® Design to satisfy patient needs.

It’s more than just a catchy marketing term. BLINK STABILIZED® Design was inspired by the anatomy of the eyelids and their dynamic interaction with a contact lens during blinks. Scientists used high speed photography to better understand the lens-lid interaction and figure out how to use it as a force for good—stabilizing and repositioning the lens with every blink.

The result was a completely unique design that has four “active zones” or points of stabilization on the outer central periphery, and a minimal pressure zone under each lid. Symmetrical weighting limits the influence of gravity—and that is critical to how astigmatic patients experience these lenses in their daily activities.

Real-World Vision
Prism- or peri-ballasted lenses can perform well in the exam lane when the patient is upright and looking straight ahead, but these gravity-dependent designs are challenged by eye and head movements outside the office. When the head is tilted 90˚ degrees, for example, to align a golf ball or look under a bed, gravity-dependent lenses rotate about 2.5 times more than BLINK STABILIZED® Design lenses do.¹ BLINK STABILIZED® Design lenses have also been shown to provide greater stability than prism-ballasted lenses for large versional tasks such as looking at the rearview mirror and then back at the road while driving.²

These benefits help patients achieve consistent vision throughout the day, making them less vulnerable to visual discomfort and contact lens dropout.

Avoiding Prism
Due to their uneven thickness, toric lens designs that rely on prism- or peri-ballast can have residual prism in the optic zone. My colleagues and I measured the mean vertical prism in  the central 6.0mm zone of eight commercially available soft  toric lenses.

Lenses with BLINK STABILIZED® Design had virtually no vertical prism. The other seven lenses had mean vertical prism ranging from 0.5 ∆ to 1.2 ∆.³

This may be particularly undesirable for patients who wear a toric lens in only one eye. Eye Care Professionals should be aware that an imbalance in vertical prism may create or exacerbate disturbances in binocular vision function.

The Eye Care Professional Experience
Not only can BLINK STABILIZED® Design offer a better patient experience, it also makes it easy to fit
astigmats. ACUVUE® Brand lenses with this design are symmetrical, so they are easy to fit and settle quickly, within 3 minutes. With a high first-fit success rate and wide parameter coverage (more than 98% of spherical and astigmatic eyes can be accommodated by the stock prescription ranges of 1-DAY ACUVUE® MOIST Brand and ACUVUE OASYS® Brand), you can be confident that BLINK STABILIZED® Design lenses will help you meet the needs of your astigmatic patients.

BLINK STABILIZED® Design

  • Quick to settle—in just 3 minutes
  • Symmetrical weighting makes lenses quick to settle with each  insertion and helps keep them  stable during blinking
  • Eye/head movements minimally affect rotational stability
  • Available in reusable and daily disposable ACUVUE® Brand Lenses for ASTIGMATISM to suit a wide range of patient lifestyle and ocular needs

References
1. McIlraith R, Young G, Hunt C. Toric lens orientation and visual acuity in non-standard conditions. CLAE 2010; 33 (1): 23-26.
2. Zikos GA, Kang SS, Ciuffreda KJ, et al. Rotational stability of toric soft contact lenses during natural viewing conditions. Optom Vis Sci 2007;84:1039-45.
3. Sulley A, Hawke R, Lorenz KO, et al. Resultant vertical prism in toric soft contact lenses. Cont Lens Anterior Eye 2015;38(4):253-7.

ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information. Complete information is also available from Johnson & Johnson Vision Care division of Johnson & Johnson Inc., by calling 1-800-267-5098 or by visiting acuvueprofessional.ca.

ACUVUE®, ACUVUE OASYS®, 1-DAY ACUVUE® MOIST, EYE-ISNPIRED and BLINK STABILIZED® are trademarks of Johnson & Johnson, Inc.

©Johnson & Johnson, Inc. 2016

Dr. Hamada is Associate Director, Professional Affairs for Johnson & Johnson Vision Care, Inc.

 

This article is sponsored by J&J Vision Care Canada.

 

WESLIE M. HAMADA, OD, FAAO

Dr. Hamada is Associate Director, Professional Affairs for Johnson & Johnson Vision Care, Inc.


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