Help! Opinions with Multifocal CL's and Lenticular Astigmatism...?

Discussion in 'Optometry Archives' started by toddster63, Feb 10, 2008.

  1. toddster63

    toddster63 Guest

    At 45 years old, I just recently started with vision correction--
    multifocal soft contact lenses. I have taken to them like a duck to
    water, with no problems at all. I started with the ProClear
    Multifocals, but disliked the D & N monovison-esque system, and found
    the PC technology good for 12 hours, sometimes a little drying after
    12 hours.

    I am currently wearing PureVision Multifocals, and much prefer them
    over the Proclear--the Purevision has crisper optics, much better
    contrast and greater depth of field. I am myopic, and the Purevision
    with LOW add doesn't sacrifice too much of my great near vision while
    adding fantastic intermediate and decent distant. The silicone
    hydrogel material is great for me, and I can easily wear them for 16+
    hours with very little, if any, drying or lens awareness problems or
    the need for frequent applications of re-wetting drops. I have even
    slept in them a few nights. From what I have read with CL wearers, I
    am very lucky in this regard...

    Problem is that the Purevision Multifocals don't fully correct
    (spherical correction granted) for my against-the-rule lenticular
    astigmatism. My OD says it's around .75D per eye (maybe closer to
    1.00D on my dominate right eye), so I am right on the border of
    needing toric correction. The Purevision lenses do a decent job, but I
    can still see what I would call "slight" ghosts/shadows on some text
    and lights (traffic lights in particular), most notably in high
    contrast situations or with thin lettering. I can read the text and
    signs, but the ghosting is still there. The far distant vision is also
    affected, a tad blurry (which could also be just a multifocal thing).

    At the OD'S office, when she applies the handheld astigmatism
    correction over the Purevisions, the ghosting on the chart almost
    disappears, so I really think the problem is primarily my uncorrected
    astigmatism, and not the simultaneous vision design of the CL's.

    If I want crisper vision my options are pretty much Proclear
    Multifocal Toric (which I hear very poor reviews about, particularly
    with distance vision) with a double N design (emulating the Purevision
    design of near center for both eyes); RGP's; or the new Synergeyes
    coming out this spring. I am sure I would acclimate to RGP's as I am
    motivated, but my biggest concern is actually losing one (I am fairly
    active). The new Synergeyes hybrids sound promising, but the hydrogel
    skirt only has a dk rating of 9 (yes, nine!), and I wonder how safe
    that is for long hours and how comfortable they would be...

    I really do like so many things about the Purevision Multifocals, and
    wonder if the other options stated above with toric correction would
    provide that much more clarity and if it is worth the effort to pursue
    them? Being so new to vision correction and CL's, I have nothing to
    compare with...? I would like to eliminate the ghosting/shadows.

    My OD has been very noncommittal (and not much help) and essentially
    says that with against-the-rule lenticular astigmatism, compromise is
    a concept I should learn to live with...?

    For what it's worth, here is my eyeglass prescription:

    OD: -.75 / -.75 X 90
    OS: -1.00 / -.75 X 82
    toddster63, Feb 10, 2008
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  2. toddster63

    Dr Judy Guest

    Frankly, any other design (multifocal toric, skirted RGP) will also be
    time consuming to fit, expensive and likely will still have some
    ghosting. If the PVMF is good for most applications and you only
    notice the ghosting in high visual demand situations, I would suggest
    a pair of single vision glasses with the astigmatism correction to
    wear over the contacts for driving at night and when reading very fine
    print. Cheap and easy.

    Dr Judy, Feb 10, 2008
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  3. toddster63

    p.clarkii Guest

    pretty good suggestion IMHO.

    fitting multifocals is an exercise in finding the "20/happy" spot.
    sounds like you are pretty much there and to expect even more might be
    unrealistic. presbyopia just doesn't correct all that well using soft
    contact lenses.
    p.clarkii, Feb 11, 2008
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