Inspire your View – Premium Multifocal Options

Nicole Grasso reviews the options for multifocal lenses and contact lenses.

Since 1959, we have been able to mimic natural vision in a seamless design, providing a blend of function and fashion in a single pair of spectacles.

Manufacturers use advanced computer-aided design and simulation tools to create and refine progressive lens designs. Additionally, advancements in manufacturing technologies, such as freeform surfacing, allow for customisation and precise control over the lens’s optical properties, further improving the performance and comfort of progressive lenses. Overall, the science behind progressive design ophthalmic lenses combines optics, geometry, and a deep understanding of the visual system to provide wearers with clear vision at all distances. From the incorporation of artificial intelligence (AI) to neuroscience studies on how our brains detect distortion, the production of lenses has evolved, and we should evolve our dispensing along with it.

As Adam Fletcher from CR Surfacing said, “The introduction of freeform over the last 15 years has provided a freedom in lens design, manufacturing processes, and end user satisfaction. Benjamin Franklin created the bifocal – freeform is the single greatest achievement since.”

With a multitude of lens designs available, lifestyle requirements play a huge role in selecting the best progressive design for your patient. We should never assume that the lens they are currently wearing is their lens of choice; the patient may not be aware of a lens that is better suited to their needs. There are specific progressive lenses with biased focal lengths depending on the patients’ main visual concerns. Progressive lenses are also now available in an array of corridor lengths, opening a wider range of frames to patients rather than the traditional deep-set lenses.

Lens Distortion

In all progressives, the main concern is distortion in the lens. Advanced digital lens designs use sophisticated algorithms to reduce this distortion and improve visual clarity.

Justin Chiang, of Tokai, said it was “impossible” to eliminate distortion from progressive lenses. “However, using neuroscience, it is possible to drive the distortion to a level where the brain does not care or is unaware. By using neuroscience principles, Tokai Optical has been able to develop lenses that are both comfortable and effective,” Mr Chiang said.

Rodenstock has taken tailored lenses to another level with its B.I.G. Norm lenses. Nicola Peaper of Rodenstock explained, “the DNEye scanner takes measurements so that Rodenstock can build a biometric eye model of the patient’s individual eye and then use that to calculate the spectacle lens”.

“It takes over 500,000 DNEye scans that we have in our database and uses AI to calculate an approximate biometric eye model from just the patient script, add, and PD (pupillary distance).”

Zeiss has harnessed Augmented Design technology in the production of its progressive lenses with the Zeiss SmartLife Progressive Individual.³

“The lenses make use of Zeiss Intelligence Augmented Design technology to match an individual wearer’s data to a set of more than 12.5 million data points of visual behaviour in specific age groups. This allows us to predict how an individual will use their eyes in daily life and we are able to create their best matched lens design,” said Jess Kingsley of Zeiss.

Almost three-quarters (73%) of presbyopes have a different prescription for their right and left eyes. Hoya uses Binocular Harmonization Technology and 3D Binocular Vision to balance the addition power difference between the lenses. This innovative 3D Binocular Vision significantly reduces distortion and swaying effects along all dimensions. The Hoyalux iD MySelf premium progressive lens is easy to adapt to and gives more accurate vision corrections.

Selecting high quality, digitally optimised lenses, and consulting with lens representatives, will ensure that you get the best progressive lenses for your patients’ needs, providing clear and comfortable vision at all distances.

Important Measurements

Traditionally labs needed monocular PDs and monocular fitting heights to edge and fit a pair of lenses into a selected spectacle frame.

With the improvement in lens technology, some extra measurements may be required for these lenses to perform as intended. An ‘as worn’ progressive lens needs tailored measurements to compensate for the prescription to suit the customers’ visual needs. The back vertex distance, pantoscopic angle, and face form angle should all be measured to account for the patient’s facial anatomy when in the position of wear. Potentially, the most critical part of progressive spectacle lens measurements is adjusting the frame into final fit to ensure all your tailored measurements are taken in the correct position.

For each lens design we should consider the patient’s posture, direction of gaze, and head and body movement to analyse how best to position the lens for their specific movements.

The Shift to Contact Lenses

Keep in mind, however, that spectacles may not be a patient’s first choice of progressive correction anymore. As Amelia Haywood from Bausch and Lomb explains, “we have really noticed a shift in the market with upward trend in multifocal contact lenses penetration”.

“This correlates to the contact lens millennials now hitting presbyopia stage and wanting more options,” she said.

From a store front perspective, we are seeing an uptake in presbyopic patients trying contact lenses for the first time. With an increased variety of progressive contact lens designs available, more customers are willing to ditch the face furniture and experience the freedom progressive contact lenses can provide.

Sometimes, people expect multifocal contact lenses to provide perfect near and distance vision simultaneously, leading to disappointment. Multifocal lenses typically offer a balance between near and distance vision. Optometrist Dianne Duong described multifocal contact lenses as “a great alternative to spectacles when they work well”. However, she warned that “not everyone is suitable for them, and expectations need to be managed well”.

To provide simultaneous vision, your brain needs to select the right focus for what you need to see. This can take a few weeks of adaption and may require a follow-up visit in store.

Aspheric multifocal contact lenses consist of bi-aspheric surfaces to create an even transition from near to distance, being the closest adaption to progressive spectacles.

High quality materials are used to provide excellent oxygen permeability and moisture retention. These features promote ocular health, reduce dryness, and enhance wearing comfort, especially for extended wear. Bausch and Lomb’s Ultra for Presbyopia monthly silicone hydrogel lenses use Advanced MoistureSeal Technology to achieve oxygen transmissibility. The lens offers moisture retention for a full 16 hours, and helps to prevent dehydration blur. In a study conducted by Bausch and Lomb, out of 441 patients, 90% agreed their near and distance vision was clear and 91% of patients agreed intermediate vision was clear when using a computer.¹

Alcon’s Dailies Total1 Multifocal is a great option for those presbyopic patients that want an occasional break from wearing spectacles. The lens has a silicone hydrogel core that allows for breathability and is almost 100% water at the outer surface of the lens to for comfort. Its SmarTears technology features the release of an ingredient found naturally in tears that helps stabilise the eye’s tear film.

With the increasing range of multifocal lenses and contact lenses hitting the market, you may want to try out some of the offerings below.

“The introduction of freeform over the last 15 years has provided a freedom in lens design, manufacturing processes, and end user satisfaction. Benjamin Franklin created the bifocal – freeform is the single greatest achievement since”

 

Nicole Grasso is a trainer at the Australasian College of Optical Dispensing and has worked in the optical industry since 2015. She is a qualified optical dispenser and a qualified trainer and assessor.

Reference

1. baush.com.au/contact-lenses/monthly-contact-lenses/ultra-monthly.

Premium Contact Lenses

Dailies Total1 by Alcon

Alcon Dailies Total1 is the first and only water gradient daily disposable multifocal contact lens for exceptional comfort¹ and seamless vision.²

To address the varying needs of your presbyopic customers, an adaptive minus power profile provides negative power at the periphery of the optic zone, allowing you to ‘push plus’ at distance. This premium contact lens is designed to improve near vision without compromising distance.³

Contact: Alcon (AUS) 1800 224 153 or (NZ) 0800 101 106

 

References

1. Lemp J., Kern J., Alcon multifocal contact lenses for presbyopia correction. Paper presented at the Canadian Association of Optometrists Congress; June 28-30, 2017; Ottawa, ON.
2. Kern J., Jackson B., Kannarr S., Miller J., Clinical outcomes for Dailies Total1 multifocal lens in symptomatic patients. Cont Lens Anterior Eye. 2018;41(Suppl 1): S51.
3. Alcon data on file, 2008. P-319-C-005. Pg5. Evaluation of lotrafilcon B Multifocal vs. PureVision multifocal in emerging presbyopes.

 

ANZ-DTM-2300003

Acuvue Oasys Multifocal by Johnson and Johnson

Acuvue Oasys multifocal contact lenses with pupil optimised design offer exceptional visual performance^{1^} for patients with presbyopia.

These lenses have been designed to provide patients with clear vision at all distances: near, far, and in-between.¹ According to Johnson and Johnson, Acuvue Oasys is never beaten in comfort^† and helps provide excellent quality of vision when using digital screens.²

 

Contact: Johnson and Johnson Vision Account Manager

^{^Compared to prior Johnson and Johnson Vision multifocal design; technology optimised for both the parameters of refractive error and add power for a multitude of viewing distances and light levels.}

^{†Helps protect against transmission of harmful UV radiation to the cornea and into the eye.}

 

References

1. JJV Data on File 2022. Acuvue pupil optimized design technology: JJVC contact lenses, design features, and associated benefits.
2. JJV Data on File 2017. A four-week randomised, masked, controlled, cross-over, dispensing daily wear study with Acuvue Oasys vs Ultra; n=127 subjects who spent greater than or equal to eight hours per day using digital devices during the study period.

 

Ultra for Presbyopia by Bausch and Lomb

Bausch and Lomb’s Ultra for Presbyopia monthly silicone hydrogel lens uses Advanced MoistureSeal Technology¹ to create a lens with unsurpassed oxygen transmissibility² and a Dk/t of 163.² The technology also optimises wettability and creates a high-water content of 46%.² Bausch and Lomb Ultra for Presbyopia offers a 3-Zone progressive design which provides a seamless transition between three zones³ to allow easy adaptation between key distances.

Designed for a successful first time fit,⁴ the Ultra for Presbyopia offers two add powers⁵ for ease and simplicity of fit.

 

Contact: Bausch and Lomb Account Manager

 

References

1. Hoteling, A., et al., Characterization of bulk PVP content of samfilcon A silicone hydrogel lenses. ARVO Poster 2014 4648 – A0273.
2. Hoteling A., et al., Optimizing physical properties of a silicone hydrogel material with 2-phase polymerization processing. ARVO Poster 2014 4648-A0273.
3. Bausch and Lomb data on file (2015). Power profiles for Bausch and Lomb and competitor multifocal lenses. Nimo data 22 July.
4. Bausch and Lomb data on file, 2015. Dispensing cross over study with samfilcon A multifocal low and high add (test) and PV2 FP low and high (control) lenses.
5. Bausch and Lomb data on file, 2015. Lens design report – Ultra MF and PV2 FP. Optical Design Comparison.

 

MyDay Multifocal by CooperVision

When using the fitting guide, CooperVision’s MyDay multifocal contact lens has been reported to achieve first-fit success in 83% of patients, with 98% successfully fitted with two pairs or fewer.^1,2

 

Contact: CooperVision Account Manager

 

References

1. CVI data on file, 2021. Prospective, subject-masked, randomised, bilateral, two-week dispensing study at five US sites with MyDay daily disposable multifocal. N=58 habitual multifocal contact lens wearers.
2. CVI data on file, 2020. Prospective, double-masked, bilateral, one-week UK dispensing study with MyDay daily disposable multifocal. N=104 habitual multifocal contact lens wearers.

 

Miru 1day Flat Pack Multifocal by Menicon

Miru 1day Flat Pack multifocal contact lenses feature Menicon’s unique neuro adaptive design, which allows a low amplitude change in power, leading to a smooth transition along the optical focal path. This contact lens is 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 touch only the outer surface of the lens.

 

Available between +4.00D to -6.00D (0.25D steps) and -6.50D to -10.00D (0.50D steps), with low add.

 

Contact: Menicon Account Manager

 

NaturalVue by CLCA

NaturalVue (etafilcon A) multifocal one-day contact lenses are indicated for the correction of myopia, presbyopia, and myopia progression control.

This centre distance, extended depth of focus (EDOF) lens design, has +6D to +8D of relative plus power in the periphery. The high amount of rapid continuous plus power in the design creates the EDOF channel and defocus zones. The EDOF channel helps to focus vison across a wider range of vision for the patient.

The design is easily adapted by the brain without sacrificing vision quality.

For presbyopes, the lens delivers spectacle-level visual acuity and two times better stereoacuity. For myopes, the lens provides excellent vision and, according to CLCA, is proven to effectively reduce myopia progression.

 

Contact: CLCA Account Manager

^{* UV-absorbing contact lenses are not substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. Wearers should continue to use UV-absorbing eyewear as directed. Long-term exposure to UV radiation is one of the risk factors associated with cataracts. Exposure is based on a number of factors such as environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV-blocking contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other eye disorders.}

 

 

Premium Spectacle Lenses

Intuitiv by OSA

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 spectacle lens design allows for wider, more stable intermediate vision; an improvement patients will notice.

 

Contact: OSA Account Manager

 

Varilux XR Series by EssilorLuxottica

For the first time, EssilorLuxottica’s scientists have harnessed the power of artificial intelligence and combined it with their unmatched understanding of the visual needs of the consumer, to create the best overall progressive lens.*

Varilux XR series wearers benefit from instant sharpness, even when moving, with up to 49% more volume of vision compared to Varilux X series.** In an independent third party test, after trialling Varilux XR with the same prescription, 87% of subjects, (mostly premium progressive wearers), preferred it to their current lenses with no change in their prescription.

 

Contact: Essilor Account Manager

 

 

^{*Based on Essilor research and development simulations. 2022 calculation based on lens measurements weighted by the level of importance of each criteria for progressive lenses declared by users (quantitative consumer study, Ipsos: Q1 2022, BR/FR/IT/UK/US. N=4,000 progressive lens wearers). Simulations done on most relevant competitive brands with a good level of awareness among consumers (consumer lens brand tracking, Ipsos: Q3 2022, BR/CA/CN/FR/IN/IT/UK. N=8000) and offering premium progressive lenses.}

^{**Internal research and development simulations in 2022 vs Varilux X series and vs average performance of competitors’ most-known lens brands (consumer lens brand tracking, third independent party, 2022: BR/CA/CN/FR/ IN/ IT/UK/US. N=8000). Volume of vision considers sharpness and fluidity of vision.}

 

SeeMax by Nikon

Nikon’s all new insights technology enables wearers to 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 and 1.74. Options include clear, polarised and Transitions Gen 8, Transitions Xtractive NG, and Transitions Xtractive Polarized.

 

Contact: Nikon Account Manager

 

Unity Via Progressive Lenses

The Unity Via Progressive lens portfolio features three easy-to-fit and dispense lens designs that are enhanced for today’s demanding visual needs, providing clear vision at all distances. Patients will enjoy seamless transitions from near to far, and a wide, distortion-free viewing area that ensures sharp and clear vision. From entry level to the most sophisticated product offered in the industry, Unity Via Progressives are sure to meet the unique visual and lifestyle needs of any progressive patient.

 

Contact: VSP Optics (AUS) 1800 251 025

 

Personalised Progressive Designs by Hoya

Because one design does not fit all, Hoya offers a range of progressive lenses with various levels of customisation and technologies. These personalised progressives are easy to adapt to and offer a more comfortable visual experience:

Hoyalux iD Myself: A lens design beyond what has been possible before. These are Hoya’s best and most personalised, tailor-made lenses for extremely comfortable vision across all distances. Suitable for wearers with digital lifestyles, they’re powered by all of Hoya’s latest progressive lens technologies.

Hoyalux Myself Profile and Hoyalux iD Lifestyle 4 progressive lenses. Just launched, these lenses provide a high level of customisation with a simplified dispensing process.

Hoyalux Myself Profile: Available in five pre-defined design variants; Modern, Adventure, Stable, Detail and Expert; this design is combined with Hoya’s AdaptEase and 3D Binocular Vision premium progressive lens technologies.

Hoyalux iD LifeStyle 4: This new generation LifeStyle lens has three pre-customised design variations – Indoor, Urban and Outdoor – to match your patients’ individual vision needs. LifeStyle 4 is available with 3D binocular vision premium technology for easier adaptation, fewer distortion areas, and easier focusing in near and intermediate areas.

 

Contact: Hoya Account Manager

 

 

SmartLife Progressive Individual3 by Zeiss

The design of Zeiss’s SmartLife Progressive Individual3 lens is based on age-related differences in dynamic and activity-driven visual behaviour. It considers the wearer’s oculomotoric behaviour together with their individual parameters including anatomy, physiology and habituation, resulting in an ultra-refined lens.

Using Zeiss intelligence augmented design technology, Zeiss matches an individual wearer’s data to a set of more than 12.5 million data points of visual behaviour in specific age groups. This allows Zeiss to predict how an individual will use their eyes in daily life so that the best matched lens design can be created.

 

Contact: Zeiss Account Manager

 

AustralisVR by CR Labs

The AustralisVR is an innovative, progressive lens design that is customised for each wearer’s visual needs. Unlike conventional lenses, AustralisVR takes advantage of the expanding realm of virtual reality and harnesses gaze dynamics to engineer a lens design that offers unrestricted, natural vision. CR Labs states that this “first-of-its-kind” approach uses genuinely objective wearer information to craft a perfectly customised lens solution that will “transform the way our patients view the world around them”.

 

Contact: CR Labs Account Manager

 

B.I.G. Exact by Rodenstock

B.I.G. Exact is the first high-precision lens made from an exact biometric eye model, based on individual measurements with the DNEye Scanner.

The DNEye Scanner measures over 7,000 data points and more than 80 eye parameters. Combined with the standard prescription values, the result is 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.

Visit: rodenstock.com

 

Opticare

Near focus for a prolonged period combined with blue light emitted from digital devices may cause symptoms like headaches, nausea, neck or back pain, blurred vision, and dry eyes.

Opticare recommends ClearPro Relax. It is designed to help reduce the effects of digitally induced eye strain and near visual stress. It can be prescribed for young myopes and hyperopes. An available upgrade is the Blue Guardian, which blocks blue light and all other UVA and UVB rays to 420nm. Also recommended is Opticare’s anti-glare Skye Multicoat.

Contact: Opticare (AUS) 1800 251 852

 

Tokai Eye Assist Rest

Tokai Optical’s Eye Assist Rest series features an aspheric design that considers left and right eye movements to achieve a more comfortable field of vision. Additionally, this lens has Tokai Optical’s FP Super Clear Design for distance vision and an Assist area for amplitude of accommodation of the eyes. Tokai’s Rest series offers four shifts that accommodate the needs of moderate to constant digital device users. As an option, when combined with Tokai’s Lutina material, the Rest series absorbs 94% high energy violet light between 400nm to 420nm for visual comfort and clarity.

Contact: Tokai Optical (AUS) 1800 864 886