Toric Multifocal Contacts: Do They Really Work?

[AdminWolf]

Have you experienced the frustration of toric multifocal lenses that don’t adequately solve the unique optical challenges of your astigmatic presbyopic patients?

Maybe a minus distance over-refraction improved distance vision but ruined the crisp near vision your patient loved, or perhaps you increased add power to improve the patient’s near vision but caused distance vision to suffer.

These struggles can make toric multifocal contact lens fittings painful and time-consuming, leading you to question whether the technology even works and worry about your ability to deliver what you’ve promised: functional vision at all ranges. Does this resonate with you?

If so, connect with Dr. Doug Becherer as he explains why these struggles may be happening and how the SpecialEyes 54 Multifocal Toric, a unique pupil-optimized lens with customizable optics, can be a solution for you and your patients.

 

[Jeff Kiener]

Heaven knows we need one that does work.

 

[Richard Frankel]

Heaven knows we need one that does work.

They work, but the patient must understand that change is the rule, not the exception!

 

[Diane Robbins-Luce]

One that works?
They all work.
They all provide multifocal optics. They work like that. They don't work like providing single focal length optics.

Everything done with zones and progresive power designs are just that, things done with optics.

We have to define "works".

They all work the way they are designed to work.

Whether one accepts that as functional vision is up to them.

How much does presentation and persuasion enter into them working?

What if the design spoke for itself without any discussion of the design and the expectations?

What it we don't manage expectation and let the design work?

I have no doubt that they work.

We really need to stop asking if a contact lens works...

 

[AdminWolf]

Thanks again to Dr. Becherer for taking part! There were a lot of questions we didn't get to, we'll continue the conversation here.

 

[Steve Silberberg]

excellent webinar BTW

 

[Lindsay McCorkle]

Hi all!
Lindsay here from SpecialEyes. Thanks to everyone who attended the webinar. If you have any questions about the SpecialEyes 54 Multifocal lens, Korinne and I will be around.

Also, as promised, here are some links to learn more about designing and prescribing this lens:
-Detailed Product Information
-54 Multifocal Email Course - a 5-day email course that provides a great introduction to fitting this lens.
-Multifocal Simulator Video Demos - these short videos give details about the Multifocal Simulator and the importance of pupil size for initial lens design. We actually utilize this software in-house at SpecialEyes

Thanks for the opportunity for us to share with the ODWire community! We really appreciate it!
Happy Fitting!
All my best,
Lindsay

 

[James Jordan]

One that works?
They all work.
They all provide multifocal optics. They work like that. They don't work like providing single focal length optics.

Everything done with zones and progresive power designs are just that, things done with optics.

We have to define "works".

They all work the way they are designed to work.

Whether one accepts that as functional vision is up to them.

How much does presentation and persuasion enter into them working?

What if the design spoke for itself without any discussion of the design and the expectations?

What it we don't manage expectation and let the design work?

I have no doubt that they work.

We really need to stop asking if a contact lens works...

This is funny. We have to define works. It's a matter of tolerance then. Who likes visual noise?

 

[Joe DiGiorgio O.D.]

I have no doubt that they work.

We really need to stop asking if a contact lens works...

How often do you find that they meet your patients expectations? I have mixed results. Some are thrilled and some can read the distance chart and read their cell phone but hate the result. If this was surgery we would have a serious problem.

 

[Stephen G. Hlis O.D.]

I have been wearing Unilens Toric Multifocal contact lenses since 2006.

Today, I'm wearing Unilens' monthly MFT disposable lenses which are available in glass vials.

Each lens is manufactured as a hard flat disc followed by hydration. It is important to obtain accurate K readings, spectacle refraction and weed out patients who have any contraindications.

The Silicon Hydrogel lenses should ideally be broken in by the pt for a week before an over-refraction is performed to refine the Rx.

The Optic Zone, Base Curve and Diameter are variables which may be used to fine tune the Rx if VA's are unsatisfactory.

The pt must realize that the fitting is a process which takes several visits. However, once mastered he or she will be free of spectacles.

I am 54 years old and my Rx is in the -6 to -7 spherical range with about a diopter of cylinder power OU.

 

[Joe DiGiorgio O.D.]

I am 54 years old and my Rx is in the -6 to -7 spherical range with about a diopter of cylinder power OU.

Wow, and we know how picking you are. Engineers are the worst!!!

 

[Joe DiGiorgio O.D.]

So there are factors like pupil size, and corneal asphericity, that are the wildcard variables in these cases, as well as the adaptability of various patients.

 

[Stephen G. Hlis O.D.]

So there are factors like pupil size, and corneal asphericity, that are the wildcard variables in these cases, as well as the adaptability of various patients.

Absolutely. That is why each lens is customized like a tailored suit and comes in glass vials with the patient's name typed on it.

 

[Korinne Andrew]

Good morning everyone!
I am the lead multifocal fitting consultant here at SpecialEyes. If anyone has any questions regarding the customization features of the SpecialEyes 54 Multifocal Toric design, please don't hesitate to ask. I am happy to help!
Best regards,
Korinne

 

[Stephen G. Hlis O.D.]

Good morning everyone!
I am the lead multifocal fitting consultant here at SpecialEyes. If anyone has any questions regarding the customization features of the SpecialEyes 54 Multifocal Toric design, please don't hesitate to ask. I am happy to help!
Best regards,
Korinne

Great News!
I am interested in going for a test drive with your product. Please send a "test" email to the following address: info@DrHLIS.com so I may provide you with my fitting parameters. I am always eager to find better MFT Silicon Hydrogel lenses.
Sincerely,
Stephen

 

[Jeff Kiener]

I couldn't see the video, so I apologize.

1. Material?
2. Stabilization method?
3. Multifocal type?
4. Central (near?) zone default diameter?
5. Price?
6. Frequency of replacement?
7. Return policy on diagnostic lenses?

Thanks!

 

[Korinne Andrew]

Great News!
I am interested in going for a test drive with your product. Please send a "test" email to the following address: info@DrHLIS.com so I may provide you with my fitting parameters. I am always eager to find better MFT Silicon Hydrogel lenses.
Sincerely,
Stephen

Will do! You should receive an email within the next few minutes. Just so you are aware, the lens material is Hioxifilcon D 54%.

 

[Korinne Andrew]

I couldn't see the video, so I apologize.

1. Material?
2. Stabilization method?
3. Multifocal type?
4. Central (near?) zone default diameter?
5. Price?
6. Frequency of replacement?
7. Return policy on diagnostic lenses?

Thanks!

No problem! See answers to your questions below:

1. Hioxifilcon D 54% Material
2. Prism Ballast & Back Surface Toric (Standard toric design has 1 diopter of base down prism, but we can increase it up to 4.0 diopters)
3. Aspheric
4. We recommend starting with a center near design OU, however we do offer center distance designs upon request.
The size of the multifocal zones will be determined by the patient's pupil sizes in ambient/regular room illumination.
5. $40.00 per lens
6. Quarterly replacement
7. SpecialEyes will provide remake or exchange lenses at no lens cost until optimal fit and vision is obtained. The trial period extends 90 days from the original order date or from the most recent remake/exchange order date (if applicable).
If the trial is unsuccessful or the patient is unable to adapt to the lenses, we will provide full credit for the trial lens cost. Better yet, you do not need to return lenses to us for exchanges or credits.

If you would like me to email you more detailed information, I would be happy to do so!

 

[Stephen G. Hlis O.D.]

Will do! You should receive an email within the next few minutes. Just so you are aware, the lens material is Hioxifilcon D 54%.

Sent you an email

 

[Diane Robbins-Luce]

How often do you find that they meet your patients expectations? I have mixed results. Some are thrilled and some can read the distance chart and read their cell phone but hate the result. If this was surgery we would have a serious problem.

Expectations are fine.
They don't have anything to do with the technology though.
Who doesn't want clear relaxing vision at all distances all of the time?
Those are the real expectations.
That requires little to no refractive error and accommodations.
We know that, patients don't.
Tell them that the technology is what it is and that it is an option and work hard together to find the best design and fit for them.
Setting expectations are hot air.
Discussing what the technology can and cannot do is worthy.
This is what you do anyway Joe.
No magic, just bad refractive error, poor accommodation and optics of various designs.

 

[Joe DiGiorgio O.D.]

Setting expectations are hot air.
Discussing what the technology can and cannot do is worthy.
This is what you do anyway Joe.
No magic, just bad refractive error, poor accommodation and optics of various designs.

I have learned to not promise them they will see like they are 17. I tell them I can turn the clock back like 10 years. Most say that would be thrilled with 10 years.