Cristina Schnider, OD, MBA, FAAO, Quan Wei Ng, OD, MSc
Introduction
The COVID-19 pandemic has radically changed our personal and professional lives and has made us rethink how we manage the contact lens patient in our practices. But the fact remains that contact lenses are still a sought-after option by patients – perhaps even more so in the era of routine use of face masks or shields and spectacle lens fogging issues.
Since minimizing in-person patient interactions is important, and prioritizing health and ease of compliance are key, what factors come to mind when you consider contact lenses for your patients? Looking at common causes for issues that might eliminate a trigger for an office visit, we can narrow our focus to 4 major factors: maximizing all-day comfort, maximizing flexibility in fitting, minimizing the risks of contamination, and avoiding mechanical insult. If we can accomplish these four goals, we can hope to assure a more comfortable wearing experience with fewer complications and unscheduled visits.
Johnson & Johnson Vision developed ACUVUE® OASYS 1-Day with HydraLuxe® Technology long before the COVID-19 pandemic reared its ugly head, but the design intent for the lens fits nicely with needs of practitioners today. Patient-focused and drawn from the natural eye’s physiology and function, the EYE-INSPIRED™ Innovations built into this lens family have earned the trust of both professionals and patients. They help us bring exceptional vision experiences to millions across the world, every day.1
Four key factors to consider in streamlining the office fitting process and maximizing the patient wearing experience.
Minimize Contamination
Daily Disposable Option
Maximize Flexibility in Fitting
Wide range of parameters
Minimize Mechanical Insult
Thin & uniform designs
Maximize All Day Comfort
Robust & lubricious wetting technology
All Day Comfort
Comfort is consistently cited as a reason for dissatisfaction with contact lenses.2 The reasons are complex but looking at the lens in the tear film sheds some light on possible reasons. As shown in Figure 1, the thin tear film and its matrix of mucins that help stabilize the tear film is disrupted when a contact lens is placed on the eye.3 The first EYE-INSIRED™ Innovation – MOISTURE- INFUSED FOR HYDRATION – attempts to address this issue in a unique way. The long-chain PVP (polyvinylpyrrolidone) used in HydraLuxe® Technology has many functional similarities to the mucins that are on the cornea and in the tear film, lubricating and moisturizing to help support a more stable tear film.4–6 And while no lens is perfect for everyone, in 29 clinical studies posted on www.clinicaltrials.gov (a website maintained by the United States National Institutes of Health) that evaluated subjective comfort as a primary or secondary endpoint as of 20 September 2020, the ACUVUE® OASYS Brand Family of Contact Lenses has never been beaten in comfort. This includes 4 studies featuring ACUVUE® OASYS 1-Day with Hydraluxe® Technology.
A second innovation related to comfort is the presence of the antioxidant Norbloc™, which delivers 4 times the antioxidant capacity of Vitamin E (determined in a laboratory study on a mass basis). This helps support comfort by keeping tear film lipids in their natural state when they interact with the lens material.7
And finally, ACUVUE® OASYS 1-Day Contact Lenses have an ‘Invisible Edge’ design so the eyelids glide over them as if nothing is there, further contributing to on-eye comfort.8
Figure 1. Free-floating mucins in the tear interact with both the membrane-bound mucins at the corneal surface as well as with the hydrophobic heads of the polar lipids of the lipid layer to stabilize the tear film. However, when the 70-100 micron thick contact lens is placed in the 3-5 micron thick tear film, considerable disruption occurs, as shown in the illustration on the left and the OCT image below.
Fit Flexibility
Having a wide variety of parameters and a reliable design is desirable when selecting a lens of first choice. Because nearly 50% of patients have astigmatism of 0.75D in at least one eye,9 it is important to have both spherical and toric parameters available, and for the astigmatic fits to be quick and accurate.
ACUVUE® OASYS 1-Day for ASTIGMATISM Contact Lenses with Eyelid Stabilized Design are designed to realign naturally with every blink and quickly orient and stabilize within minutes of insertion.10 And based on high fit success rates, number of lenses and time required to fit patients during clinical studies, ACUVUE® Brand Contact Lenses for ASTIGMATISM can be fit with sphere-like ease.10 And lastly for even more ease and simplicity of fitting, the extensive range of spherical and toric parameters help to accommodate almost all your patients’ prescription needs.10
Minimize Contamination
Minimizing the risk of lens and eye contamination is always a priority, but with all the unknowns about how the coronavirus is transmitted and what viral loads are needed to cause infection, practitioners and patients may be more concerned than ever about lens hygiene. Daily disposable lenses are a logical choice, as they eliminate potential issues with lens solutions and more importantly, the lens case. A model set forth by Stapleton that looks at population attributable risk predicts that disease load in daily wear reusable lenses could be reduced by almost two-thirds by attending to just TWO factors: storage case hygiene and storage case replacement.11 Daily disposable lenses address both factors; but they do not eliminate risk entirely…careful and consistent attention to good patient instruction and ongoing surveillance of care and hygiene practices are still critical. But they do minimize the opportunity to transfer microbes to the eye, and have been shown to be reduce the severity of disease if it does occur.11
Minimize Mechanical Insult
Mechanical issues can lead to both comfort issues and irritation of the cornea and eyelids, so it is wise to consider these factors in selecting your “go-to” lens. Modulus is important, but lens design must also be considered, as a thicker lens will be stiffer than a thin one given equal modulus values. A thicker lens may be easier to apply but may be more difficult to remove due to a greater resistance to bending, for example, so it’s the balance that matters. All ACUVUE® Brand Contact lenses have low modulus values and thin edges, minimizing lid margin/lens interactions, and the astigmatic designs are uniquely thin in the vertical meridian due to the stabilization design employed.8 Very low coefficient of friction values create a highly lubricious lens with a silky, smooth feel,8 and the low coefficient of friction has also been shown to have a high correlation with comfort.12
These factors are not only important with respect to mechanical properties on the eye, but they can also influence lens handling for the patient. During an in-market assessment of 95 prescribers who fit ACUVUE® OASYS 1-Day for ASTIGMATISM to 1072 new and existing contact lens wearers, nearly all of the 341 patients who completed the post-assessment survey agreed the lens was easy to handle (97.4% existing wearers and 95.9% neophytes, post-hoc analysis).13
All in all, the combination of design and material in ACUVUE® OASYS 1-Day Contact Lenses provides excellent comfort, vision, handling and health,8 and is a great choice for your first “Pandemic Contact Lens” – and beyond.
