Never before have we had such a great variety of multifocal spectacle and contact lenses at our disposal. This can make choosing the best options for each patient challenging, yet incredibly rewarding. Now, more than ever, it pays to stay informed and right up-to-date on the latest offerings.
It’s no secret or surprise that the presbyopic sector is growing. This demographic is becoming ever more discerning and aware that they have a variety of options. They also tend to be well heeled, often sitting on some serious assets, rental income streams and superannuation. With their wings clipped by the current world order, they have disposable income burning a hole in their collective pockets.
Colleagues far and wide tell me this group is spending up large on high end frames and lenses. COVID-19 has also reinforced the fact that life is short, and you can’t take your assets with you to the grave.
THE TIME IS RIGHT
Despite the general doom and gloom, all of this makes now a great time to offer premium progressive lenses (PPL) with the latest designs, features and benefits.
Patients suited to PPLs range from those in their forties to nineties, though young people may also need them for vision therapy and myopia control. Most postcataract patients require top-up spectacles – even premium multifocal or extended depth of focus (EDOF) IOL recipients may still need supplementary spectacles for some situations. Many will have worn progressive lenses prior to cataract surgery, so even though they could be spectacle free much of the time, they often prefer the all in- one convenience of progressive lenses.
The visual needs of potential PPL users are increasingly demanding. In the car we’re faced with multiple large displays in various positions – including heads-up displays. We need to quickly and easily switch between the speedometer and the GPS, the road, pedestrians, a plethora of confusing traffic signs, signals and lights of various intensity; all while moving from bright concrete roads to darkened tunnels. There’s no room for error.
At work – and increasingly at home – visual demands are also ramping up. Many are faced with a multitude of ever-larger, brighter, high-resolution computer screens, tablets, smartphones, ultra-large TVs and equipment control panels. This requires complex visual posturing and may involve rapidly shifting gaze from one screen in a Zoom meeting, while poring over spreadsheet data on another.
It’s up to us, as optometrists, to discuss the variety of premium options available and to determine what’s best to optimise our individual patient’s vision. Many will, out of choice or necessity, opt for premium multifocal lenses in order to cover all scenarios.
PREMIUM MULTIFOCAL CONTACT LENSES
Significant numbers of people simply refuse to be seen wearing spectacles, or find them impractical or limiting in certain professions and situations. To this end we have an ever-expanding range of premium multifocal contact lenses. These are typically simultaneous-vision, disposable soft lens multifocals, with clever designs such as blended optical zones, concentric rings and EDOF. A growing number of these contact lenses are manufactured from specialised, highly-wettable lubricious materials. Such contact lens materials help manage dry eye, which is increasingly prevalent among this aging group. We also have a variety of lens materials on offer, ranging from tried and tested hydrogels, to multi-generational silicone hydrogels that boast ever improving comfort and vision.
By way of example, Bausch + Lomb’s premium presbyopia contact lens designs (Ultra Monthly and Biotrue One Day) have benefitted from a broad investigational approach using a proprietary Virtual Image Resolution Testing System (VIRTS). Computer modelling analysed data of key biometric variables – in a diverse population of patients – that may influence vision, including refractive error, higher order aberrations, corneal curvature, pupil diameter, axial length and residual accommodation across nine viewing distances. The Ultra Lenses include MoistureSeal technology for dry eye management and the offerings cover both silicone hydrogel and hydrogel material options in monthly, daily and even extended wear options.
We’re also seeing an increasing trend toward multifocal designs that include toric options to enhance vision in astigmatic presbyopes. CooperVision’s Biofinity Toric Multifocal provides over 200,000 unique prescriptions to satisfy a wide range of patients. Their unique centre distance/ centre near Biofinity D&N multifocals also satisfy premium multifocal wearers as they age, with four increasing near additions, ranging from +1.00D to +2.50D.
The Brien Holden Vision Institute (BHVI) developed a lens design that delivers stable visual performance that’s less affected by pupil size and lens centration. This patented EDOF design is available in a 1-day modality from SEED Contact Lens. With three lens profiles for different depth-of-focus ranges, it is characterised by a combination of multiple higher order aberrations tuned to optimise retinal image quality over a wide range of viewing distances.
There are also a variety of other providers and lens options, ranging from inventory dailies to conventional and custom presbyopic lenses. When it comes to rigid gas permeable lenses – including corneal and scleral designs with aberration control – there are some amazing bespoke options for even the most complex eyes with presbyopia.
PREMIUM MULTIFOCAL SPECTACLE LENSES
As technology evolves, multifocal spectacle lenses are increasingly the go-to option for presbyopes seeking flexibility and hassle-free vision in their day-to-day lives. As alluded to, the premium end of the progressive spectacle lens market offers fantastic growth opportunities and a great deal of satisfaction to wearer and prescriber alike. Happy patients are the best source of referrals, further adding to practice and revenue growth which, in the current climate, is an important, if not essential, goal.
Real World Experience
There’s no doubt that PPLs offer opportunities for success across the board, but particularly in cases where there was previously dissatisfaction and/or failure.
My own journey through presbyopia is a great example. In my first decade of presbyopia I valiantly tried a variety of progressive lenses, all of which ended up in a drawer. Non-adaption – caused by extreme irritation – resulted from very limited, narrow and shallow, near and intermediate vision aggravated by spatial distortion. It was simply too much to bear. Like some others, I gave up.
I understood why a patient who spends significant money on something that doesn’t work can get somewhat irritated…
Around five years ago, one of my respected colleagues challenged me to try a new customised premium progressive lens, with all the bells and whistles. When the day of reckoning arrived I duly put them on and was blown away. Despite my bias and low expectations, they were just fantastic! From day one I became – for the first time in my life – a full time spectacle wearer.
I’ve never looked back and wear them all my waking hours with very high levels of satisfaction. Not bad for a former patient from hell.
Imagine being able to do that for many of your presbyopic patients?
Speaking of the bells and whistles, PPLs offer an almost infinite combination of front and back surface shapes, with a broad range of prescription options.
There are a wide variety of materials, refractive indices, Abbe numbers and aberration controls. Photochromics, tints and polarised options can also be had. Premium multilayer antireflection coatings – with bloom-controlled, smudge free, easy-clean, hard-coated surfaces – are usually part of the offering too. Broader range UV spectrum and selective blue light filters can also be applied.
Beyond these choices PPLs can be further enhanced and customised with a variety of channel lengths and widths, tailoring the lenses to suit specific frames and requirements. Once all these parameters have been decided they can be further fine-tuned and individualised for optimal visual comfort and optical performance by measuring and specifying things like pantoscopic tilt and wrap.
All told, we have amazing options at our disposal.
The offerings in the following product section range from the large multinationals to our local labs that design and manufacture lenses in Australia, or bring them in from specialist overseas labs. Whoever they may be, they all deliver exciting options. It’s all about vision.
Premium Contact Lenses
Oneday for Presbyopia
Biotrue Oneday for Presbyopia is an easy to fit1 daily disposable contact lens that features an innovative three-zone progressive design, combined with the bio-inspired hypergel material. This contact lens provides comfortable vision throughout the day and clear vision across near, intermediate and distance.1
The hypergel material2 is inspired by the eye, and designed to match the cornea’s water content3 with a dehydration barrier that retains moisture throughout the day.4
The proprietary three-zone progressive design is based on optimising visual outcomes across nine distances and the experiences of patients wearing the lens.5 It has been proven to provide clear, seamless transitions between key distances.1,6 This proprietary three-zone progressive design is also available in the Bausch & Lomb Ultra for Presbyopia monthly lens material.7
Contact: Bausch & Lomb Account Manager
References
- Bausch & Lomb data on file. Presbyopia Study 814 evaluate product performance.
- Bausch & Lomb data on file. D. Heiler, The Chemical, Physical and Spectral Properties of nesofilcon A (78 water).
- Hague, S., Dilly, N. and Thompson, G.M., 1987. Morphological changes in the human corneal epithelium associated with surgical corneal clouding. British journal of ophthalmology, 71(10), pp.729-733.
- Schafer, Jeffery, et al. Evaluation of surface water characteristics of novel daily disposable contact lens materials, using refractive index shifts after wear. Clinical Ophthalmology (Auckland, NZ) 9 (2015): 1973.
- Kinston AC, Cox IG. Predicting through-focus visual acuity with the eye’s natural aberrations. Optom Vis Sci 2013 Oct;90(10):1111-8.
- Reindel WT, Mosehauer G, Saxon J. Evaluation of a 3-Zone Progressive Multifocal Contact Lens Design on Wearer Experience in the Real World. Poster presented at: American Academy of Optometry Annual Meeting; October 2015; New Orleans, LA.
- Bausch & Lomb data on file. Lens Design Report – Ultra MF and PV2FP Optical Design Comparison
MyDay Multifocal
CooperVision’s MyDay multifocal features the innovative three ADD CooperVision Binocular Progressive System that uses different lens designs to optimise vision for all levels of presbyopia. With simplified fitting, optimal visual acuity at all distances and comfortable wear for exceptional performance, success is simple with MyDay multifocal.
Contact: CooperVision Account Manager
Miru 1Day UpSide Multifocal and Miru 1Day Flat Pack Multifocal
Miru 1day UpSide multifocal and Miru 1day Flat Pack multifocal contact lenses by Menicon feature the company’s unique neuro adaptive design, allowing a low amplitude change in power, leading to a smooth transition along the optical focal path. Designed to support easier adaptation for new contact lens wearers and those upgrading from single vision.
Miru daily contact lenses are developed with smart touch technology for the most hygienic handling. Lenses are always the right way up and ready to wear, allowing wearers to only touch the outer surface of the lens.
Available between +5.00D to -6.00D (0.25D steps) and -6.50D to -10.00D (0.50D steps), with low and high ADD.
Contact: Menicon Account Manager
1dayPure EDOF
Fitting presbyopic patients with multifocal contact lenses has always been a challenge. This is because conventional centre-near and centre-distance designs are susceptible to pupil size change and lens decentration, both of which impact lens performance.
SEED 1dayPure extended depth of focus (EDOF) is a daily disposable soft contact lens that incorporates an innovative optical design patented by the Brien Holden Vision Institute. By constructively combining a series of specially selected higher-order aberrations on the front surface of the lens, retinal image quality is optimised regardless of pupil size change and lens decentration, providing good focus across distant, intermediate and near ranges. SEED 1dayPure EDOF gives your patients good vision at all distances while minimising ghosting and haloes.
1dayPure EDOF has three distinct nonmonotonic power profiles: “lo, mid and hi”, giving different depth-of-focus range options to suit your patients’ requirements. Power range is available from +5.00D to -12.00D in 0.25D steps.
Contact: SEED Contact Lens (AUS) 1300 373 718
Premium Spectacle Lenses
CR Surfacing Australis Progressive
The latest innovation of CR Surfacing Laboratories, the Australis Progressive, was launched to consumers on 1 August 2021, and has been a favourite since. Australis lenses use artificial intelligence technologies to develop a unique lens design around the patient’s individual needs, previous experience with lenses, lifestyle and preferences. By using six design technologies, the ergonomically optimised lenses are created with up to 20% less aberration, providing natural, sharp vision through the thinnest lenses possible. As a result of swim effect minimisation and improved fusion of lateral and vertical images, wearers experience instantaneous adaptation to Australis lenses. The singularity of the design and overall customer and practice journey distinguish the Australis from other lenses on the market.
Contact: CR Surfacing Laboratories (AUS) 03 8795 9111
OSA Intuitiv Progressive Lens
Intuitiv progressive lenses by OSA are a step forward for the visual freedom of progressive lens wearers.
Intuitiv’s ergonomic technology understands your patient’s vision by not only taking into account the preferential path used by hyperopes, emmetropes and myopes as they scan down the lens, but also the different physical and visual postures of right and left-handers. Intuitiv positions mid and near zones according to your patient’s handedness.
Using five-times more calculation points across the lens surface than previous progressives, plus new aspherisation techniques to further reduce aberrations, this exceptional design allows for wider, more stable intermediate vision, an improvement patients will notice.
Contact: OSA Account Manager
Essilor Varilux X Series
The modern presbyope is highly active and connected, constantly multitasking. To meet their needs, Varilux X series reinvents near vision, offering extended vision at arm’s length.
Near Vision Behaviour (NVB) tracks how presbyopes use their near vision to provide a totally personalised solution. This provides complete personalisation of the three-dimensional volume of vision for the individual wearer.
Varilux X series ensures the highest match with every wearer’s visual needs at arm’s length, regardless of their posture and visual behaviour. Wearers can clearly see multiple objects in a single line of gaze without having to move their head. Indeed, according to Essilor, nine out of ten wearers say they don’t need to move their head any more to see sharply.
Contact: Essilor Account Manager
Nikon SeeMax Ultimate
Like fingerprints, vision is unique. Thanks to Nikon’s all new Insights technology, wearers can now co-design their progressive lens with SeeMax Ultimate.
Every SeeMax Ultimate is tailored to their needs, preferences and viewing habits. A simple-to-use app makes the process of creating their own progressive a more powerful and personal experience.
SeeMax Ultimate is now available in 1.5, 1.6, 1.67 clear, polarised and Transitions GEN 8 Style Iconic and Style Colours, and 1.74 clear and Transitions GEN 8 Iconic.
Contact: Nikon Account Manager
Hastings Optical Supplies Infinity HD
The Infinity HD progressive – powered by Camber technology from Younger Optics and IOT – uses Camber lens blanks from a section of the ‘Elephant’s Trunk’ curve for a unique variable base curve front surface that continually increases in dioptre from top to bottom. This provides larger viewing areas in both the distance and near zones, along with improved cosmetics and easier adaptation.
This lens provides wearers with better peripheral vision and the benefit of superior image stability, even in dynamic conditions. Wearers also enjoy maximum visual fields for all distances and slight increased magnification at near distances.
Contact: Hastings Optical Supplies (AUS) 02 6581 3759
Hoyalux iD Myself
Hoyalux iD Myself delivers a progressive lens design with two new patented technologies – adapt ease and 3D binocular vision – that aim to address key problem areas consumers continue to have with progressive lenses today.
Adapt ease technology improves near and intermediate visual width and gaze transition without influencing distance vision. Deformation areas, that are an increasing adaptation challenge, are located mainly next to the reading area and peripheral parts of the lens. These areas cause significant discomfort and make day-to-day life more difficult. By adding controlled, very low astigmatism and controlling the axis of this within the near peripheral zones, Hoya achieves a significant improvement in the width of visual fields of the near and intermediate without influencing the far vision area.
3D binocular vision technology is a leap forward in providing stable image perception by controlling unwanted prismatic effect on the periphery of the lens. This allows progressive lens wearers to benefit from significantly reduced distortion and swaying effects along all dimensions.
Contact: Hoya Account Manager
Opticare Alpha and Beta Freefrom Progressives
Opticare’s two German-designed progressive lenses – Alpha and Beta freeform progressive lenses – are ideal for presbyopes.
The Alpha freeform lens is ideal for general use and has a maximum cyl of 1.86D. It is equally balanced for distance, intermediate, and near. This lens is also recommended for myopes.
Beta freeform lenses, with a maximum cyl of 1.69D, are ideal for computer and near use. This lens is mainly designed for intermediate and near use, although it is still excellent for distance. It is also recommended for hyperopes.
Contact: Opticare (AUS) 1800 251 852
Unity Via Progressive Lenses
Unity Via Progressive Lenses use the most advanced progressive lens technology to deliver exceptional vision in a lens that’s easy to fit and dispense. Featuring three lens designs, Unity Via gives your patients effortless vision from the moment they put them on. Unity Via is created using intelligent technology consisting of variable inset, automatic reading height optimisation, digital viewpoint technology and advanced fit technology.
Contact: VSP Australia (AUS) 02 9697 8080
Shamir Autograph Intelligence
Autograph Intelligence is Shamir’s top-ofthe- line, most advanced progressive lens and, it’s just been improved to provide a new dimension in optimally customised, patient-centred lenses.
Autograph Intelligence provides presbyopic patients at any age with a continuous lens design that’s unique according to their ‘visual age’ and visual needs. This allows for a unique user experience for presbyopes of all ages, with no need to compromise on visual comfort. Autograph III is a premium progressive lens for optimally personalised vision. Now improved, this balanced progressive lens is holistically adapted to the patient, ensuring a clear and comfortable visual experience.
The result is an amazing improvement in the visual experience of hyperopic presbyopes and unparalleled clarity for all.
Look out for exciting new updates to Autograph Intelligence and Autograph III announcements.
Contact: Shamir (AUS) 1300 553 465
Zeiss SmartLife Progressive Lenses
Zeiss SmartLife Progressive Lenses are integrated into the Zeiss Smartlife Lens portfolio and deliver effortless and comfortable vision at all distances and directions so your patients can take on everything their eyes face today, no matter their age.
Zeiss SmartLife Progressive Lenses are designed to meet the vision needs of people with a connected and on-the-move lifestyle. The optical performance in the lens periphery is designed for frequent changes of head and eye position, driven by how people interact with their handheld devices. This new design fingerprint provides a smoother transition into the lens periphery, with less perceived blur enabling peripheral vision in natural dynamic interaction.
Eight out of 10 consumers adapted within one day to their new lenses.*
Contact: Zeiss Account Manager
*External consumer acceptance test on the Zeiss SmartLife Lens Portfolio, n=82 study participants. Aston Optometry School, Aston University, UK, 2019.
DNEye PRO
Rodenstock has taken a decisive step forward, heralding a new era in the optimisation of progressive lenses with Impression and Multigressiv DNEye PRO.
Because every eye is different, Rodenstock has moved away from using a ‘standard eye model’ to calculate their lenses. Using measurements from the DNEye scanner, the biometrics of the whole eye are determined and this information is integrated directly into the lens. This provides people with the sharpest vision possible at any angle and in every direction of gaze, both in the lens’ peripheral zones and at distances from mid, near and far. The benefits include quick adaptation due to sharper vision, and increased visual comfort and improved contrast – improved contrast leads to better vision in low light levels, especially for driving at dusk.
Contact: Rodenstock (AUS) 02 9748 0988
