While lecturing at SeaVision earlier this year, I found myself sitting in a dining room enjoying the view of the Mediterranean. It was right about then that my colleague reached into each eye to extract a contact lens and place it in her napkin, as if none of the optometrists at the table would notice.
The irony is that I had done the same thing the night before. We sat and marveled at why there are not better lens options for post-LASIK corneas. This evolved into a discussion as to why there are not more toric multifocals, colored torics, or high-oxygen daily disposables in toric or multifocal powers.
The wish list can grow quickly, but let us take a minute to acknowledge and appreciate the latest entries into the contact lens space.
Acuvue Oasys with Transitions Light Intelligent Technology
It is not often that a contact lens finds itself on the Time Best Inventions list, but that is exactly what happened in 2018 with Johnson & Johnson Vision’s Acuvue Oasys with Transitions.
Most patients experience strain and discomfort in bright light, but few complain. This is likely because it is expected. One of the conversations in which I come across most emphatically is when I am speaking to patients about prescription sunglasses. I am swinging my hands about explaining that until a patient has experienced being able to see clearly outside without squinting, she just does not know what she is missing. Perhaps the same is true here.
However, because outdoor light sensitivity is expected, there are likely more ocular surface disease (OSD) patients complaining about the lights inside big box stores than the sunlight.
Fortunately, Acuvue Oasys with Transitions work indoors too. Of course, the conundrum is that patients who are that light-sensitive inside may not be able to tolerate contact lens wear of any kind, especially a reusable lens.
Inside Acuvue Oasys with Transitions,1 photochromic molecules are bonded to the lens matrix. The light exposure causes a chemical reaction that changes the physical structure of the molecules, allowing them to absorb visible light.
Because this lens is not a coating, its effects should endure the two-week wearing period— provided it is stored away from light. The lens blocks up to 15 percent of light in normal indoor conditions and up to 70 percent in outdoor conditions.
While the lens protects the eye by blocking ultraviolet (UV) light, it also has blue light-blocking capabilities and claims to reduce halos and starbursts at night.
Lens darkening begins immediately when exposed to light. The fade to clear occurs within 90 seconds of reducing the stimulus. Photochromic spectacle lenses tend to be influenced by temperature, getting darker when it is cold outside. However, a contact lens is always at the ocular temperature, making the outside temperature irrelevant.
As for the aesthetics of the lens when activated, it is noticeable that the tinted lens overlaps the limbus. Also with light-colored eyes, there is a noticaable but not always dramatic change in the perceived color of the iris.
Acuvue Oasys with Transitions is made of senofilcon A, which has a Dk/t of 147 and water content of 38 percent. The lens is available in an 8.4 mm base curve, 14.0 mm diameter, and powers ranging from -12.00 D to +8.00 D in 0.25 D steps.
1. Johnson and Johnson Vision. Acuvue Oasys with Transitions Light Intelligent Technology.
Available at: https://www.jnjvisionpro.com/how-transitions-contact-lenses-enhance-visu.... Accessed 7/24/19.
2. Bausch + Lomb. Contact lens parameters: Prescribe the Bausch + Lomb Ultra family of contact lenses. Available at: https://www.expectultracomfort.com/ecp/lens-parameters. Accessed 7/24/19.
3. CooperVision. MiSight 1 day. Available at: https://coopervision.ca/practitioner/our-products/misight-1-day/misight-.... Accessed 7/24/19.
4. Pucker AD. How to build a myopia control practice. Optometry Times. Available at: https://www.optometrytimes.com/practice-management/how-build-myopia-cont.... Accessed 8/12/19.