Optometrists’ PerspectivesLet’s now hear from two optometrists about how they have applied Total1 for Astigmatism and Precision1 for Astigmatism contact lenses in their practice.A FASCINATING JOURNEY

Josh Clark, an optometrist in Sydney, has been fitting Total1 contact lenses since 2014 and says, “It has been fascinating to see Alcon’s journey with daily disposable contact lenses. Following the launch of Total1 contact lenses in 2014, with watergradient technology, and Precision1 contact lenses in 2019, with SmartSurface technology, Alcon has now launched Total1 for Astigmatism and Precision1 for Astigmatism contact lenses. Over the past month, I have fitted 30 astigmatic patients with these lenses. Below are my experiences with two recent patients.”

Mr Clark presented the following case studies to demonstrate his experiences with these new technologies.

Case One

Ms Anton* is a 28-year-old nurse who has been wearing Total1 contact lenses seven days a week since 2014. She presented to clinic complaining of distance blur and increased headaches at the computer, which she blamed on her increased workload over the last two years. Ms Anton has a history of irritated eyes and felt as though Total1 lenses had improved her contact lens related dry eye symptoms, particularly at the end of the day.

I explained to Ms Anton that her symptoms were due to uncorrected astigmatism and that she again needed to try toric contact lenses. Due to her poor experience with astigmatic lenses, she was aware of how toric lenses work in terms of rotation, weight distribution and stability. I was surprised by her resistance and apprehension towards trying Total1 for Astigmatism contact lenses, but she agreed to be fitted. I believe that it was only brand recognition that swayed Ms Anton to try Total1 contact lenses.

I am pleased to report that the contact lenses fitted well in both eyes, with the single scribe mark located at six o’clock and no visible oscillation with a blink. Both lenses settled within 10 seconds with multiple attempts. Ms Anton was surprised with both initial comfort and vision and agreed to wear the trial lenses for five days. I saw Ms Anton on day five for an aftercare and she was very pleased with Total1 for Astigmatism contact lenses. She felt as though her symptoms of blur and headaches had improved markedly and she did not have any adverse symptoms such as discomfort, end-of-day dryness, or fluctuating vision. Ms Anton commented that the lenses were stable and she was happy.

Case Two

Ms Beatrix* is an active 30-year-old teacher who wears fortnightly contact lenses on a full-time basis. She presented to clinic for her annual eye examination with no symptoms. Having worn contact lenses for 20 years, Ms Beatrix had tried multiple toric lens options before settling with her current frequent replacement contact lenses.

“ I was surprised by her resistance and apprehension towards trying Total1 for Astigmatism contact lenses, but she agreed to be fitted. I believe that it was only brand recognition that swayed Ms Anton to try Total1 contact lenses ”“ This case has reinforced the importance of offering upgraded contact lens technology to patients with mild or no symptoms... ”I was pleased to report that there was no change to Ms Beatrix’s contact lens prescription of RE -5.50/-1.75x90 (6/7) LE -6.00/-0.75x90 (6/7). On slit lamp examination, I noticed that both contact lenses rotated about 10 degrees nasally with a blink and were loose fitting. Further examination revealed grade 1 papillae under all eyelids, mild blepharitis and inferior corneal staining with fluorescein near the limbus at six o’clock in both eyes. There were also small amounts of protein on the front surface of both contact lenses. These clinical findings were all visibly different to her last examination 12 months ago, showing the importance of regular contact lens examinations.

I explained to Ms Beatrix that I was concerned with her current contact lenses as they were moving excessively, had protein on the anterior lens surface and her eyes showed signs of inflammation (corneal staining, blepharitis and eyelid irritation). I fitted Ms Beatrix with Precision1 for Astigmatism contact lenses as I knew that she was price conscious and wanted a lens with value. This was the first daily toric contact lens that she had been willing to try in her 20-year journey with contact lenses.

Precision1 for Astigmatism contact lenses fitted well in both eyes, with the single scribe mark located at six o’clock. Both lenses moved approximately two to three degrees nasally with a blink and settled within 15 seconds. Both lenses were not as loose as her current fortnightly contact lenses.

Ms Beatrix returned to clinic on day five for an aftercare and she was very happy with her new contact lenses. She noted that her vision felt slightly crisper and that her eyes were not as tired when she went to the gym in the morning or worked on the computer at night.

Clinically, there was a reduction in both the size of papillae under her eyelids and the amount of inferior corneal staining in both eyes. There were no signs of protein on both lenses. Visual acuity was 6/6 in both eyes, which I believe is due to improved lens stability and corneal health, and the absence of protein.

During the aftercare consultation, Ms Beatrix told me that she was so pleased that she did not need to use lubricating eyedrops at night. I was not aware that she had these end-of-day symptoms requiring drops! This case has reinforced the importance of offering upgraded contact lens technology to patients with mild or no symptoms as new technology can make a large difference to their quality of life.
Case One. Total1 for Astigmatism lens orientation on eye.Case Two. Precision1 for Astigmatism orientation on eye.
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