Case Study Series Biofinity® toric multifocal, from CooperVision CASE #2: 44-year-old teacher with active lifestyle
Grow with your astigmatic presbyopes Patient background A 44-year-old female presented to the practice as a new patient. She was a teacher with demanding needs for near and computer screen viewing and was also keen to avoid compromising the quality of her distance vision at work. Outside of work, her hobbies included playing the piano, reading and running. She mentioned she liked the freedom of contact lenses, and the fact that they were unnoticeable when worn.
Previous lens wearing experience The patient was a lapsed contact lens wearer and currently, albeit somewhat reluctantly, relying on spectacles. She had previously worn single vision toric contact lenses, giving up wearing them a few years ago when she could no longer comfortably focus on small print while reading. She had previously tried monovision but was unable to tolerate the disparity in focus even with a modified monovision option. She continued for a while using single vision toric contact lenses plus top-up reading spectacles to manage the near work, however, this solution did not last long; it was too inconvenient, and she did not like how using reading spectacles made her feel and look ‘old’. She had ultimately stopped wearing contact lenses, reverting to full-time spectacle wear.
contact lenses that could help with clear vision for near tasks as well enable her to see at distance. She had heard about multifocal contact lenses and was hoping that switching to a multifocal design could help achieve these aims, however, she had previously been told that multifocal contact lenses would not be a viable option because of her astigmatism.
She ideally wanted to be able to wear
Based on the fitting guide the following
Biofinity® toric multifocal lens fitting notes This patient’s high level of motivation suggested she would be a good candidate for Biofinity® toric multifocal. Her up-todate spectacle refraction was: R -2.50/-1.50 x 75 L -2.75/-0.75 x 85 with +1.00D reading addition
Case outcome and lessons learned This case describes a patient who had dropped out from lens wear who was highly motivated to return to contact lenses. Her experience illustrates the positive benefits that toric multifocal contact lenses can offer astigmatic presbyopes. However, the learning from this patient translates to all emerging presbyopic contact lens wearers in practice. They should be counseled early on about their contact lens options, making them aware that there are lenses available for them to help with near vision when the time comes. This proactive approach helps keep patients feeling happy, with corrected vision that performs for their active and youthful lifestyles. The multifocal part of this lens behaves exactly like the spherical Biofinity® multifocal lens and the toric part exactly as the Biofinity® toric lenses. Eye care professionals can have confidence in the performance of the lens, with simple, time-efficient fitting possible too. Following the fit guide led in this case to the final prescription being achieved with just one pair of trial lenses. The patient in this example mentioned the lenses were life changing, making her feel that she had her “normal eyes” back.
initial Biofinity® toric multifocal lenses were trialed:
Biofinity® toric multifocal final lens prescription RIGHT LENS
LEFT LENS
Sphere power
Sphere power
-2.50
-2.75
Cylinder power
Cylinder power
-1.25
-0.75
Axis
Axis
75
85
Add power
Add power
+1.00 (D lens)
+1.00 (D lens)
The lenses settled quickly and when assessed after fifteen minutes showed less than five degrees of rotation. They also had optimal centration and fit and, importantly, were rotational stable even after large eye and head movements. The patient immediately noticed the difference in her visual experience. She achieved both distance and near binocular vision of 6/6 and N4 (distance and near). She was extremely happy with the overall quality and clarity of vision at distance, intermediate and near, reporting that they all exceeded her expectations. She was also very happy with the comfort of the lenses and indicated that she wanted to continue with the lenses. AVAILABLE PARAMETERS Sphere power (DS)
-10.00 to +10.00 in 0.25 steps or 0.50 steps beyond +/-6.50
Cylinder power (DC)
-0.75 to -5.75 in 0.50 steps
Axis
5° to 180° in 5° increments
Add power
+1.00, +1.50, +2.00, +2.50 in both D and N center designs
Ceri Lian Penson is a contact lens optician working for an independent group of 10 practices based in Norfolk and Suffolk. This is my 20th year in optics. I feel very lucky to be working in this time where I am spoiled for choice with lenses and have products available to allow me to fit almost any patient. I have a particular interest in presbyopic fitting as I enjoy giving patients their “old eyes back”.
For more information about Biofinity® toric multifocal contact lenses visit coopervision.com Biofinity® is a registered trademark of The Cooper Companies, Inc. and it’s subsidiaries. ©2021 CooperVision.
