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Morgan PB, Efron N, Papas E, Barnett M, Carnt N, Dutta D, Hepworth A, Little JA, Nagra M, Pult H, Schweizer H, Shen Lee B, Subbaraman LN, Sulley A, Thompson A, Webster A, Markoulli M. BCLA CLEAR Presbyopia: Management with contact lenses and spectacles. Cont Lens Anterior Eye 2024:102158. [PMID: 38631935 DOI: 10.1016/j.clae.2024.102158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.
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Affiliation(s)
- Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom.
| | - Nathan Efron
- Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Eric Papas
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Nicole Carnt
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Debarun Dutta
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom
| | - Andy Hepworth
- EssilorLuxottica Europe North, Bristol, United Kingdom
| | - Julie-Anne Little
- Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom
| | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Young Street, Cambridge, United Kingdom
| | - Heiko Pult
- Dr Heiko Pult - Optometry and Vision Research, Weinheim, Germany
| | - Helmer Schweizer
- CEO Helmer Schweizer Consulting Group (HSCG), Bassersdorf, Switzerland
| | - Bridgitte Shen Lee
- Vision Optique and Ocular Aesthetics dba Ocular Clinical Trials, Houston, TX, United States
| | | | - Anna Sulley
- CooperVision International Ltd, Chandlers Ford, United Kingdom
| | | | | | - Maria Markoulli
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Martínez-Pérez C, Villa-Collar C, Santodomingo-Rubido J, Shinde L, Thite N, Wolffsohn JS. Opportunities and threats to contact lens practice in Spain. JOURNAL OF OPTOMETRY 2023; 16:116-127. [PMID: 35821106 PMCID: PMC10104793 DOI: 10.1016/j.optom.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/21/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE An international survey evaluated the opportunities and threats related to contact lens practice reported by eye care professionals worldwide. This study reports on the results specifically found in Spain and how these compare with those from other regions of the world. METHODS A questionnaire was distributed to eye care practitioners around the world through professional associations. The questionnaire consisted of 9, 5 and 12 questions about opportunities, interventions, and potential threats related to contact lens practice, respectively. RESULTS A total of 2,408 responses were obtained from practitioners worldwide, of which 436 responses were obtained from Spanish practitioners. Spain was found among the regions with the highest perception of opportunities (median: 6.5/10) along with Australasia, North America, Europe, and South America. Spanish (median: 7.3/10), along with South American practitioners, also reported the highest perception of threats. Continuously updating of knowledge/skills, recommending contact lens wearing options to potential patients, creating an efficient recall system for follow-up examinations and being competent in managing contact lens-related complications were reported as important interventions for contact lens practice growth by Spanish eye care practitioners. CONCLUSIONS Spain is one of the regions in the world with the highest perception of both opportunities and threats regarding future contact lens practice. As such, Spanish practitioners consider it important to continuously update knowledge/skills and to recommend and educate patients on the benefits of contact lens wear. Online sales were found to be one of the most important concerns reported by both Spanish and eye care practitioners worldwide.
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Affiliation(s)
- Clara Martínez-Pérez
- Department of Pharmacy, Biotechnology, Nutrition, Optics and Optometry, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | - César Villa-Collar
- Department of Pharmacy, Biotechnology, Nutrition, Optics and Optometry, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | | | | | - Nilesh Thite
- International Association of Contact Lens Educators, Pune, India
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Barcala X, Vinas M, Ruiz S, Hidalgo F, Nankivil D, Karkkainen T, Gambra E, Dorronsoro C, Marcos S. Multifocal contact lens vision simulated with a clinical binocular simulator. Cont Lens Anterior Eye 2022; 45:101716. [PMID: 35606298 DOI: 10.1016/j.clae.2022.101716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose of this study is to compare the binocular visual perception of participants wearing multifocal contact lenses and these same lens designs viewed through a temporal multiplexing visual simulator. METHODS Visual performance and perceived visual quality at various distances were obtained in 37 participants wearing soft M-CLs and through the SimVis Gekko programmed with the same lenses. In a pilot study (n = 10) visual performance was measured in terms of LogMAR visual acuity (VA) at far (4 m), intermediate (64 cm) and near (40 cm) distances and through-focus VA (TFVA) curves with the simulated M-CLs. In the follow-up study (n = 27), LogMAR VA at far, intermediate and near distances were measured both with the actual and simulated M-CLs. Perceived visual quality was measured in both studies using the Multifocal Acceptance Score (MAS-2EV), and a Participants Reported Outcomes Vision questionnaire. Differences between the metrics obtained with simulated and actual lenses were obtained. RESULTS Both actual and simulated M-CLs increased depth-of-focus by a similar amount. Mean LogMAR VA differences with actual and simulated M-CLs ranged between 4 and 6 letters (0.08 ± 0.01, 0.12 ± 0.01 and 0.10 ± 0.01, for far, intermediate and near distances, respectively). MAS-2EV average score differences with actual and simulated M-CLs ranged between -1.00 and + 4.25. Average MAS-2EV scores were not correlated significantly with VA. However, MAS-2EV (average and individual scores) were highly correlated to visual quality questionnaire responses (p < 0.005). CONCLUSIONS A simultaneous vision simulator accurately represented vision with M-CLs both VA at various distances and perceived visual quality, as measured in a clinical setting. The MAS-2EV metric accurately captured participant reported outcomes of standard vision questionnaires. The combination of SimVis Gekko and MAS-2EV has the potential to largely reduce chair time in M-CLs fitting.
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Affiliation(s)
- Xoana Barcala
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain; 2EyesVision SL, Madrid, Spain.
| | - Maria Vinas
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain; Wellman Center for Photomedicine, Massachusetts General Hospital. Harvard Medical School, United States
| | - Sofia Ruiz
- Centro Boston de Optometría, Madrid, Spain
| | | | - Derek Nankivil
- Design Center of Excellence, Research & Development, Johnson & Johnson Vision Care Inc., Jacksonville, FL, United States
| | - Tom Karkkainen
- Clinical Sciences, Research & Development, Johnson & Johnson Vision Care Inc., Jacksonville, FL, United States
| | | | - Carlos Dorronsoro
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain; 2EyesVision SL, Madrid, Spain
| | - Susana Marcos
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain; Center for Visual Science, The Institute of Optics, Flaum Eye Institute, University of Rochester, NY, United States.
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Naroo SA, Nagra M, Retallic N. Exploring contact lens opportunities for patients above the age of 40 years. Cont Lens Anterior Eye 2022; 45:101599. [DOI: 10.1016/j.clae.2022.101599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/03/2022]
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Fogt JS, Kerwin T, Wrabel C, Schomer C, Fogt N. Driving performance and road sign identification by multifocal contact lens wearers in a driving simulator. Cont Lens Anterior Eye 2021; 45:101493. [PMID: 34315656 PMCID: PMC8784564 DOI: 10.1016/j.clae.2021.101493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to compare sign identification distances and driving performance metrics in presbyopic participants while wearing multifocal contact lenses (MFCL) and while wearing progressive addition lens (PAL) spectacles. METHODS 19 presbyopic participants completed PAL spectacle assessments and contact lens fitting and follow up visits before driving assessments began. These assessments occurred in a simulator equipped with a full-sized sedan on a motion platform and a 260 degree screen. Participants completed the driving task with PAL and with MFCL. Participants followed a lead car and identified signs at various distances from the road. For the two wearing conditions, comparisons of the distance along the road at which signs were identified were made using repeated measures ANOVA. Paired t-tests were used to compare driving performance for the two conditions. RESULTS There was no statistical difference in sign identification distance between PAL and MFLC for signs 32.0 m from the road side of the road (182 ± 46 m for MFCL; 205 ± 45 m for PAL; P = 0.07) or 51.4 m from the side of the road (204 ± 43 m for MFCL; 216 ± 36 m for PAL; P = 0.3). Only signs 70.2 m from the roadside showed a significant difference (207 ± 42 m with MFCL; 232 ± 39 m with PAL; P = 0.01), All distances were greater than those required to safely stop a vehicle. There were no significant differences in the driving performance metrics between the refractive corrections. CONCLUSION Driving performance metrics were similar for MFCL and PAL spectacles. Sign identification distances with both eyewear types were well within the distances required for safe vehicle stopping.
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Affiliation(s)
| | - Thomas Kerwin
- The Ohio State University Driving Simulator Laboratory, United States
| | - Cameron Wrabel
- The Ohio State University Driving Simulator Laboratory, United States
| | - Casey Schomer
- The Ohio State University Driving Simulator Laboratory, United States
| | - Nick Fogt
- The Ohio State University College of Optometry, United States
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Fogt JS, Weisenberger K, Fogt N. Visual performance with multifocal contact lenses and progressive addition spectacles. Cont Lens Anterior Eye 2021; 45:101472. [PMID: 34049808 DOI: 10.1016/j.clae.2021.101472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/14/2021] [Accepted: 05/23/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE As presbyopia occurs, new visual demands create a need for clear vision at multiple distances. Many spectacle wearers adapt into progressive addition lenses (PAL) in order to see clearly at distance, intermediate, and near. A multifocal contact lens provides the ability to see at these same distances without the prismatic effects of a spectacle lens or the peripheral obstruction of a spectacle frame. No studies have been done to date comparing the effect of these types of presbyopic vision correction on a variety of tests of visual performance representative of everyday tasks. METHODS A battery of visual performance tasks were completed by subjects while wearing their habitual PAL spectacles. These subjects were then fit with a multifocal contact lens and wore lenses for 2 weeks or more before completing the tasks again. These functional vision tests included assessments of coincidence anticipation timing, peripheral search and hand-eye coordination, and dynamic visual acuity. Following functional vision testing, subjects completed a preference survey comparing both types of refractive correction while performing common activities of daily living. RESULTS Performance on the majority of the tests of visual performance were equivalent (P < 0.05) when comparing PAL spectacles and multifocal contact lenses. Survey results demonstrated a preference for multifocal contact lenses overall. CONCLUSION PAL spectacles are widely prescribed for presbyopic patients. The findings of this study suggest that in addition to providing excellent vision, multifocal contact lenses provide functional vision performance equal to PAL spectacle wear and patients may prefer them over PAL spectacles.
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Affiliation(s)
| | | | - Nick Fogt
- The Ohio State University College of Optometry, United States
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Katz JA, Karpecki PM, Dorca A, Chiva-Razavi S, Floyd H, Barnes E, Wuttke M, Donnenfeld E. Presbyopia - A Review of Current Treatment Options and Emerging Therapies. Clin Ophthalmol 2021; 15:2167-2178. [PMID: 34079215 PMCID: PMC8163965 DOI: 10.2147/opth.s259011] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/11/2021] [Indexed: 01/07/2023] Open
Abstract
Presbyopia is a common age-related vision disorder characterized by a progressive inability to focus on near objects. If uncorrected or under-corrected, presbyopia can significantly impact patients' quality of life. Presbyopia represents an area of considerable unmet need due to its rising prevalence worldwide as the population ages, the high proportion of under-treated individuals in some parts of the world, and the limitations of currently available corrective methods. Progressive or bifocal spectacles are associated with peripheral blur, a restricted visual field and impaired depth perception, which have been linked to an increased risk of falls in the elderly. Contact lens options can be difficult to maintain due to the development of age-related dry eye symptoms and reduced manual dexterity. Other corrective methods involve surgical interventions that modify the optics of the cornea, replace the crystalline lens, or attempt to restore active accommodation. While patients undergoing surgery report satisfactory outcomes post-operatively, many of them eventually require reading glasses. Non-invasive therapies with novel mechanisms of action are currently being investigated; these include miotic agents and UNR844, a lipoic acid choline ester. In this narrative review, available evidence on presbyopia prevalence, quality of life impact and risk factors are described, with a focus on observational studies in non-clinical settings. The diagnosis pathway and patient journey in presbyopia are outlined, and various treatment options are analyzed. The data reviewed herein reveals significant gaps in the provision of vision correction for this common condition, with a paucity of effective, non-invasive treatment options broadly accessible to presbyopic individuals.
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Affiliation(s)
- James A Katz
- The Midwest Center for Sight, Des Plaines, IL, USA
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Visual function, ocular surface integrity and symptomatology of a new extended depth-of-focus and a conventional multifocal contact lens. Cont Lens Anterior Eye 2020; 44:101384. [PMID: 33243587 DOI: 10.1016/j.clae.2020.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate visual function, ocular surface integrity and dry eye symptoms with an extended depth-of-focus (EDOF) design and a conventional multifocal (MF) contact lens (CL) after 15 days of wear. METHODS A crossover single mask randomised clinical trial was conducted including 30 presbyopes who used an EDOF and a conventional MF CL (Biofinity MF) for 15 days each. Defocus curves, depth-of-focus range, contrast sensitivity (CS) under photopic and mesopic conditions (with and without glare) and subjective perception of halos and glare were evaluated. The ocular surface was evaluated through non-invasive Keratograph tear breakup time (NIKBUT), averaged tear breakup time (NIKBUT-avg), tear meniscus height (TMH), bulbar and limbal redness, and conjunctival and corneal staining. Dry eye symptoms were assessed with the OSDI questionnaire. RESULTS No statistically significant differences were found for defocus curves or depth-of-focus between the two CLs (both p > 0.05). Subjective perception of halos and glare was not significantly different between CLs. Statistically significant differences were observed for CS under mesopic conditions for low spatial frequencies (p = 0.008). None of the CL produced significant changes in NIKBUT, NIKBUT-avg, TMH or redness. No change in conjunctival staining was observed in 76.7 % and 73.3 % of participants for EDOF and Biofinity MF, respectively. No change in corneal staining was observed in 86.7 % and 83.3 % of participants for EDOF and Biofinity MF, respectively. No changes were observed in the symptomatology measured with OSDI questionnaire (p > 0.05). CONCLUSIONS Both CL for presbyopia offer good visual quality, preserve the ocular surface integrity and provide the patient with similar symptomatology levels after 15 days of lens wear.
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Factors That Influence the Success of Contact Lens Fitting in Presbyopes: A Multicentric Survey. Eye Contact Lens 2019; 45:382-389. [DOI: 10.1097/icl.0000000000000606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Lorente-Velázquez A, García-Montero M, Gómez-Sanz FJ, Rico Del Viejo L, Hernández-Verdejo JL, Madrid-Costa D. Comparison of the impact of nesofilcon A hydrogel contact lens on the ocular surface and the comfort of presbyopic and non-presbyopic wearers. Int J Ophthalmol 2019; 12:640-646. [PMID: 31024820 DOI: 10.18240/ijo.2019.04.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 12/13/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To assess and compare the impact of a daily disposable contact lens (CL) with high water content on the ocular surface and comfort of the presbyopic and non-presbyopic population after one day of use. METHODS Totally 20 presbyopes and 30 non-presbyopes non-contact wearers were fitted with nesofilcon A CLs. CL thickness was measured to assess material stability during daily wear, and ocular surface parameters were also assessed. Optical quality was analyzed for all cases. In addition, CL comfort was rated. RESULTS No significant differences were found in CL thickness, tear film osmolarity, average tear break-up time, bulbar redness, central corneal thickness, corneal volume, root-mean-square of higher-order aberrations (RMS of HOAs) and vertical and horizontal coma, either as a function of the group or time of use. A significant decrease in tear meniscus height and first break-up of the tear film was found in the presbyopic group (P=0.038; P=0.007 respectively). A decrease in spherical aberration coefficient was found after CL insertion (P=0.031 monofocal CL; P=0.023 low addition multifocal CL; P=0.016 high addition multifocal CL). Multifocal CL were thicker than monofocal CL (P=0.045). Comparison between groups showed more discomfort in presbyopes than non-presbyopes (P=0.003). CONCLUSION This study evidence that the behavior of the daily disposable CL with high water content seems to be stable during the day of use. Ocular parameters measured during wear show that CL behavior is the same for presbyopes and non-presbyopes, being more uncomfortable for presbyopes.
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Affiliation(s)
- Amalia Lorente-Velázquez
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - María García-Montero
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - Francisco Javier Gómez-Sanz
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - Laura Rico Del Viejo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - José Luis Hernández-Verdejo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - David Madrid-Costa
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
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