Presbyopic Correction in Silicone Hydrogels

Discussion in 'Optometry Archives' started by MS, Jan 28, 2006.

  1. MS

    MS Guest

    I know that currently there are no multifocal silicone hydrogel lenses on
    the market. (Anyone know if there are any in the works?) What I am referring
    to is something I read here, I think from Larry, to the effect that Focus
    Night and Day lenses have some inherent presbyopic correction (I think due
    to being aspheric), that someone with a small amount of presbyopia might
    find that enough of a correction for that problem.

    I am wondering whether that same inherent presbyopia correction also exists
    in other silicone hydrogels, in particular Purevision and Oasys?

    At 53 I certainly have much more presbyopia than that small amount of
    correction mentioned can handle. I am currently wearing N&Ds, but prescribed
    monovision. The presbyopia is getting worse, so I think I will need further
    correction for it (unfortunately further weakening distance vision) in my
    next contacts. I'm wondering though, if that small amount of presbyopia
    correction in the N&Ds is a factor, whether the monovision correction would
    have to be more severe, if it were not for that presbyopia correction
    inherent in the N&D lenses?

    Therefore, I'm wondering if I switched to other silicone hydrogels, such as
    Purevision or Oasys, whether there would be a loss of that inherent
    presbyopia correction in N&Ds,, or whether it would be about the same, or
    whether perhaps one of them might even give better presbyopia correction
    than N&D?

    Please let us know how these different silicone hydrogels stack up in
    regards to inherent presbyopia correction. Thank you.
     
    MS, Jan 28, 2006
    #1
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  2. MS

    LarryDoc Guest

    We might see the Purevision Multifocal in March or April.
    O2Optix, yes, as Night&Day
    Purevision, yes, but less available plus power than the previously
    mentioned.
    Oasys, not aspheric.

    Remember, there are a number of non-silicone aspheric lenses and true
    multifocals currently available. Another unique hybrid multifocal is
    due out this Spring, too----high DK rigid center with soft periphery.

    LB, OD
     
    LarryDoc, Jan 28, 2006
    #2
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  3. MS

    MS Guest

    Thanks for the detailed knowledgeable reply, Larry! :)

    So, do you think if I changed from N&D to Oasys (which has occurred to me,
    as I have dry eyes, of course I would need to try them out first) (I have my
    eye exam next week), I would need a stronger monovision correction (meaning
    a still weaker minus lens in the non-dominant eye, in order to be able to
    read with them) than I would if I continued with N&Ds? Would that therefore
    contribute to still weaker distance vision (through having a still weaker
    distance lens in one eye), than if I continued with N&D? Would you recommend
    that presbyopes not use Oasys, but better to go with N&D or O2?

    Yes, I know there are several non-silicon multifocals available. In fact, I
    wore RGP multifocals for over a year. (I don't recall the brand at the
    moment. I remember corresponding with you about it at the time.) Now I have
    become accustomed to the comfort of the soft lenses though, and I really
    like the convenience of EW, for instance, not having to fumble for glasses
    when getting up at night or in the morning. So I'll probably stick with SH
    for now. (Did Menicon Z ever come out in a decent multifocal version in the
    US?)

    The Purevision Multifocal sounds interesting, as well as the unique hybrid
    multifocal. (What is the name of the latter?) (Have you been able to test
    prototypes of either of these, or heard about clinical trials, etc.?) I
    wonder if I should perhaps postpone my eye exam for a few months, order
    another six month's supply of N&Ds (I'm on my last lenses from the current
    boxes now), as when I get my eyes checked in June or so, there will probably
    be more presbyopic alternatives to choose from. Will there be more and
    better contact lens choices for presbyopes in the summer than there are now?
     
    MS, Jan 28, 2006
    #3
  4. MS

    LarryDoc Guest

    So, do you think if I changed from N&D to Oasys (which has occurred to me,
    as I have dry eyes, of course I would need to try them out first) (I have my
    eye exam next week), I would need a stronger monovision correction (meaning
    a still weaker minus lens in the non-dominant eye, in order to be able to
    read with them) than I would if I continued with N&Ds?
    Likely.

    Would that therefore
    contribute to still weaker distance vision (through having a still weaker
    distance lens in one eye), than if I continued with N&D?[/QUOTE]

    Possibly. You'd have to try it.
    Early presbyopes, yes, but not always. Later presbyopes---it depends
    upon how much over-plus power they can tolerate. Sometimes
    non-aspherio lenses provide *better* distance vision than aspherics. And
    if a pt was to be using near vision specs over the contacts, the best
    combination might well be with a non-aspheric. I often trial fit both
    Oasys and Optics/Night&Day to see which works best. You often can't tell
    until you actually try it on the eye.
    The Menifocal is due out shortly. I don't know if it wil be "decent"
    :)
    I have great hopes for the Purevision Multi as it is molded based on the
    SL66 and trials in other more civilized countries look very good.
    Actually, any silicone hydrogel multifocal should be better than any
    mushy/spongy HEMMA lens. In theory.

    The hybrid is made by Synergeyes. I've not tried either so I withhold
    judgement until then.
    My crystal ball is a bit cloudy these days, but I can see a number of
    new products coming in the next six months, including those mentioned
    previously and a couple more.

    LB, O.D.
     
    LarryDoc, Jan 28, 2006
    #4
  5. MS

    MS Guest

    Thanks for all the interesting info, Larry!

    Yes, I read (after reading your posts yesterday) that the Multifocal
    Purevision will be the exact same multifocal design that B&L has out now
    (Soflens 66?), just using the Purevision material. Is that a good multifocal
    design? Have many patients had success with it? ("Success" being a relative
    term, of course, as it seems that any contact lens fitting trying to
    accommodate both myopia and presbyopia without the use of glasses, whether
    by multifocal contact lenses or monovision, is a compromise, and will
    certainly not provide perfect vision both near and far. It sure would be
    great if some day they could create a solution, whether surgical or via
    lenses, that would create perfect near and distance vision!) How does the
    current B&L soft multifocal compare in visual results with other multifocal
    lenses?

    Well, now I'm seriously thinking of calling the eye doc's office Monday and
    cancelling my appt for an exam this Friday, buy another two boxes (one for
    each eye) of N&D in my current prescription, and go for my eye exam in June
    or so, when there are these additional possibilities to try out (especially
    the Purevision Multifocal).

    Possibly. You'd have to try it.
    Early presbyopes, yes, but not always. Later presbyopes---it depends
    upon how much over-plus power they can tolerate. Sometimes
    non-aspherio lenses provide *better* distance vision than aspherics. And
    if a pt was to be using near vision specs over the contacts, the best
    combination might well be with a non-aspheric. I often trial fit both
    Oasys and Optics/Night&Day to see which works best. You often can't tell
    until you actually try it on the eye.
    The Menifocal is due out shortly. I don't know if it wil be "decent"
    :)
    I have great hopes for the Purevision Multi as it is molded based on the
    SL66 and trials in other more civilized countries look very good.
    Actually, any silicone hydrogel multifocal should be better than any
    mushy/spongy HEMMA lens. In theory.

    The hybrid is made by Synergeyes. I've not tried either so I withhold
    judgement until then.
    now?

    My crystal ball is a bit cloudy these days, but I can see a number of
    new products coming in the next six months, including those mentioned
    previously and a couple more.

    LB, O.D.[/QUOTE]
     
    MS, Jan 29, 2006
    #5
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