In the third episode of Toric Talks, John L. Ellis II, OD, sits down with Ashley K. McFerron, OD, and Kelsi Sawatzky, OD, FAAO, to review how optometrists can provide optimal comfort to patients wearing toric soft contact lenses.
Dr. Ellis is the owner of University Vision Centre in El Paso, Texas; Dr. McFerron practices at Canby Eyecare in Canby, Oregon; and Dr. Sawatzky is an optometrist at Elite Eye Care in Waukee, Iowa.
Strategies for maximizing comfort in toric contact lens wearers
To increase the chances of success when fitting first-time contact lens wearers, Dr. McFerron recommends using a daily disposable lens with good rotational stability, ensuring a comfortable fit and clear, consistent vision.
As the MyDay toric lens (CooperVision) features expansive parameters, Dr. Sawatzky highlighted that the majority of astigmatic patients can be successfully fit with the lens. Additionally, the Optimized Toric Lens Geometry provides improved visual acuity, lens stability, fit, and comfort—aiding in going above and beyond patient expectations.
Of note, studies have found that about half of all contact lens wearers have 0.75D or more of astigmatism in at least one eye,1 but toric options are only fitted in about 25% of those patients,2 meaning there is a significant unmet demand for astigmatism correction in soft contact lens wearers.3
Key parameters of the MyDay toric contact lens include:4
- Sphere power: +8.00D to -10.00D (0.50D steps after +/- 6.00D)
- Cylinder power: -0.75, -1.25, -1.75, -2.25
- Axis: Full circle in 10° steps
- Toric Technology: Optimized Toric Lens Geometry, which features:
- Uniform horizontal thickness
- A large toric optic zone
- A smooth, continuous ballast and optimized ballast toric design
Converting patients to toric lenses with newer designs
For patients who wear contact lenses but are unsatisfied with their current lens, Dr. Sawatzky recommended having the patient try on a lens with newer design / technology in the office. Often, these patients were prescribed a contact lens years ago when they were young and they have simply stayed in it.
Consequently, she compares contact lenses to cell phones and asks if they are using the same cell phone they had 10 to 15 years ago. Evidently, the answer is no, as there is now newer technology available, and similarly, there are better fitting lenses. In her experience, once she upgrades them, patients are often much happier.
Dr. McFerron explained that she tends to play the role of a cheerleader to get them excited about contact lens wear again because these patients frequently present to the clinic feeling defeated or fed up.
Dr. Ellis remarked that he maintains a positive attitude, highlighting that contact lens designs have changed, and now there are many options available, with the goal of giving the patient hope and peace of mind that his practice has the tools to address their concerns.
Approaches for patients who have dropped out of contact lens wear
For patients who have dropped out of contact lens wear, Dr. Sawatzky explained that she likes to bring up getting back into contact lenses as the weather starts to warm up. This way, they can use them during the summer or just for the weekends, so they can have freedom from their glasses.
She added that if they choose to start wearing contact lenses on a part-time basis, often they enjoy the experience so much that they eventually transition to full-time wear.
Do patients need a new contact lens or OSD treatment?
However, there are some instances where the issue is not with the contact lens itself, but the patient’s eye, such as dry eye, allergies, or other conditions that may cause persistent discomfort. Dr. McFerron emphasized the importance of assessing the patient’s ocular surface health during comprehensive eye exams to determine whether they require treatment or simply a different contact lens.
Otherwise, if they have ocular surface issues, they will continue to experience discomfort, which may have the unintended consequence of them losing trust in being able to wear contact lenses at all. As such, it is important to let the patient know that there is an existing problem that needs to be addressed before they will feel complete comfort while wearing contact lenses again.
Conclusion
In the past, there were some patients who simply couldn’t be fit into toric lenses due to issues with rotational stabilization, limited parameters, and subsequent visual discomfort.
However, updated toric technology in daily disposable modalities like the MyDay toric lens offers optometrists the opportunity for practice growth and patient satisfaction that paves the way for increased trust and loyalty.
