Toric Contact

[TX-ms1-to-be]

I want to know what are some things to look for in shopping for toric lenses. What brand, polymer of the lens, and if to get monthly or weekly disposable. In your experiences which lenses seem to correct best for astigmatism. I have astigmatism in both eyes of -1.25 and -1.50 or so. I can see much better with my glasses than with the conventional single vision contacts I have. Any help is appreciated.

Thanks

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[Ballew21]

I'm not an optometrist, but I play one on TV. Seriously though, I've worked in an eye doctor's office for three years, and our doctors would ask you a few questions prior to fitting you with one type of lens over another.

1. Do you have any problems with dryness with your current conventional lenses?
2. Do you want to sleep in your contacts, i.e, be fit with an extended wear contact lens?
3. Are you myopic or hyperopic/nearsighted or farsighted?
4. How many hours per day do you typically wear your contacts?
5. How much time, if any, do you spend on a computer each day?

At my office, our doctor prefers Encore Toric (made by Cooper Vision) as a two week lens, and the Frequency 55 Toric as a monthly lens. I'm fairly sure that Encore can be wore as an extended wear lens, but I'd have to check Tyler's Quarterly to be sure. For the most part, the vision out of Lens Type A will be similar to Lens Type B, but one lens is usually more comfortable than the other.

Edited to add that most patients with astigmatism do see better with their glasses versus their contacts because the lenses of the glasses stay in the same position, while the contacts do not stay in the same position on the eye.

Nick

 

[TomOD]

Tx,

Why would you be "shopping" for contact lenses? Don't you have an OD or OMD to recommend (and fit) a lens for you? Sorry, I'm a little testy after I had a 15 year old girl today with a para-central corneal ulcer/infiltrate who bought her contacts illegally from her beauty salon (and shared them with her friends). This happens alot unfortunately.

Anyway,you probably realize that we have today, probably hundreds of toric contact lenses and the manufacturing process is getting better and cheaper.

I highly recommend the Soflens 66 Toric by Bausch and Lomb as either a 2-week or monthly replacement (mostly depending on the amount of protein deposited on the lenses from your eyes)....great stablilizaton and reproducibility...and at a good price for a toric lens.

It is expected that these and all soft lens will soon (in the next few years) be produced in the silicon polymer that is making the lastest extended wear (30 day) lens so popular.... A dk (oxygen permeability) of near 100 or even above compared with about 20-30 for conventional disposible lenses. So far though, they are not availalbe in astigmatic powers.

Good luck.

 

[cpw]

I have to agree with Tom here. i've been wearing the B&L 66 Toric for 2 years now and I love them! It's what every OD I've worked with fits their patients in too. Granted, I don't see as well as I can with my glasses, but for people who really don't want to wear glasses the 66 Toric does very well for a moderately priced 2 week lens.

 

[canuck_OD]

Hmmm,

Somehow I forgot my old login .... but it's me freddie stuck up here in Waterloo, canada!

Ahh ... how good it is to be in fourth year!

From my contact lens fitting experience ... however limited that may be both Freq 55, and Softlens 66 are excellent choices! However I'd like to throw in one other option .... how about Proclear Torics ?? They're already a very comfortable lens .. and great for people who experience some dryness when wearing lenses!! I'm sure you'll love 'em ... everyone I've fit has .... except for the high astigmats. I believe the cutoff is somewhere around 175 cyl (correct me pls if I'm wrong).

Just an aside ... although Softlens 66 is a good choice.... I have to say that how B&L treats the optometric profession makes me weary of recommending their products .... It's almost a case of biting the hand that feeds you .... and from most docs I've talked to B&L reps are probably the least eager to work with you ... unless you are a very big CL practice.

Well good to be posting again ....! Take care everyone!

 

[TomOD]

Hey Freddie,

Proclear makes great contacts both spherical and toric. I was given a free fitting set of contacts by most manufactures when I first opened my practice. At my one year mark, the Proclear rep. popped into my practice unexpectedly one day and said I wasn't fitting enough of his lenses and he wanted the fitting set back. I tried to explain to him that I had a brand new practice opened from scratch and it was unrealistic to expect me to fit a hundred of his lenses per month (or whatever he expected). Anyway he took the lenses and promised to send me a smaller fitting set. This was 11 months ago and I have not gotten one yet. I do not fit Proclear any longer just because of that. They are real butts to work with.

Ciba Vision supplied me with a free (large) fitting set of Focus 1-2 week, Focus 1 month, Focus softcolors, and Focus Progressive. (I am really not a big fan of Focus lenses though).

Vistikon charged me $500 for a fitting set of Acuvue 2's and another $500 for a set of Acuvue Bifocals. They are the only company that charge me.

Bausch and Lomb has been good to me. They gave me a free fitting set of Soflens Torics (and as many extra trial as I need), and an excellent trial kit of Purevision (my favorite lens).

Some of the other small companies have supplied me with sample kit like Extreme H2O and Frequency 55's.

B&L also send me alot of ReNue soln. about every 4 months without me asking. They keep me well stocked.

Btw, other the the idiot Proclear C.L rep and a single Vistikon rep when I first opened, I have not seen or heard from a contact lens rep in almost 2 years. They really don't pay you much attention when you are small....but then again, I really don't fit alot of contacts lenses.

FWIW

 

[Ballew21]

It's funny that you mention Proclear torics, because our office JUST (as in today) received our fitting set for those lenses. I play contact lens technican/O.D. Wannabe with all of my co-workers, with the doctor's approval of course ... they taught me how to refract, how to use a slit lamp so check rotation on torics, the little LARS check for rotation, and how to determine adequate movement on contacts ... so I use them as guinea pigs to try out all of the new lenses. I like Proclear Sphericals, so hopefully they're torics work as well.

Anyways, I have a question for you Tom. What do you think of the new 30-day extended wear lenses by Ciba and B&L (even though their lens technically isn't new)? Our Ciba rep has been really pushing our doctors to start fitting their lenses, but I think that most lenses made by Ciba are made out of poor quality material, and I wouldn't fit a patient unless I were forced to do so.

Nick

Edited to Add: After Biocompatibles merger with Cooper Vision (effective today), it'll be interesting to see how they marked the Proclear Toric amongst the 4 other torics made by Cooper; Frequency, Preference, Cooper and Encore.

 

[TomOD]

I have had great result with B&L Purevision as both a daily wear and extended wear. As a matter of fact, I have worn the Purevision for the last 3 years (mostly daily wear....I have just gotten used to taking my lenses out every night after 17 years of CL wear). They are great for dry eyes as well.

I haven't had much experience with Focus Day and Night except to order a trial pair for myself. They didn't compare to the Purevision as far a fit, comfort and acuity is concerned but I really haven't given them a fair chance yet. I just don't want to pay $1000 or so for a fitting set so that I can fit patients with them so Ciba can make more money. As far as I am concerned the PV is the standard for a 30-day continuous wear lens.

 

[canuck_OD]

Up here in Canada we've had the luxury of having these silicone hydrogel lense for a few more years than the US .... that damned FDA of yours!!

Anyhow I have to say that both Purevision and Night&Day are great lenses ... I personally have been wearing the N&D's on an extended wear basis ... taking them out on the odd day to give my eyes a rest ... all I have to say is that my eyes are just as pearly white after having worn the lenses for 3 days straight!

It's also interesting to note that Australia has also been fitting the Si-Hy lense for a long time .... recently a few cases of MK have arisen ... most in patients who swam (??) in their lenses!!

Here in Ontario there's no advantage of selling one lens over another because of our college's rules on dispensing (all materials to be sold at cost) ... so it runs the pt. about $128CND /6 months .... (not including the fitting fee)

 

[rpames]

I agree with most of the posters, B&L softlens 66 is the most stable and comfortable I have ever had. Since my dad is a OD I have tryed several types and found the B&L the best. I really am an avocate of it. My dad has alot of success with the Acuvue toric also. Those are two we use the most at our office. But like Tom said, check with your OD/OMD, every eye is different.