AOA 2024: Comfort attributes and astigmatism


Christi Closson, OD, FAAO, details unique products from Johnson & Johnson, including a new contact lenses designed specifically for patients with astigmatism.

Christi Closson, OD, FAAO, spoke on behalf of Johnson & Johnson at this year's AOA's Optometry's Meeting in Nashville, Tennessee to educate other eye care providers about the unique product offerings of the company, including how to properly fit contact lenses specifically designed for patients with astigmatism.

Video transcript

Editor's note: This transcript has been lightly edited for clarity.

Christi Closson, OD, FAAO:

Hi. My name is Dr. Christi Closson, and I am the associate director of professional education at Johnson & Johnson. I was able to do a lunch symposium discussion here at the AOA conference about comfort driven technology with our eye inspired designs of Acuvue, specifically with our Blink Stabilized technology. And so we talked about the material and the design. So we talked about all the features in our Invisible Edge, that is this tapered edge that the eyelid glides really easily over. And then we also talked about our wetting agent, which is PVP, and the differences of that versus other manufacturers.

Going back to the Invisible Edge, our lens technology with that is different than anything else on the market. And so just educating the doctors on the differences, because we're all so busy seeing patients every day that we don't really get the opportunity to dive down into the manufacturing differences. And then going back to our wetting agent with PVP, that is just totally different than any other wetting agent that's on the market. It's a long chain, high molecular weight, and it is different because it's embedded throughout our entire lens matrix. And so that is really unique and different. Those 2 things are foundational for all Acuvue lenses and it makes really, honestly, some of the best comfort and elevated patient experience because of that. And then we got into our Blink Stabilized design. And that, again, is a design unlike any other toric lens on the market. So it has 4 stability zones, it's inspired by the eyelids and harnesses the power of the blink to keep that stabilized. We also have equal symmetry vertically and we have a no prism optics zone. So all of those things make that technology really unique and different. So we talked about all of that during lunch. And it was a great discussion ending with that we are increasing our skew parameters that we had a temporary setback during our post-pandemic supply chain difference, that we're getting all of those back. And they were really excited for that.

Like I was saying before, ours is called Blink Stabilized. So we use the eyelids and the most significant area of where we harness that is at 3 and 9, as opposed to peri- or prism-ballast lens. The thickest part of those lenses at the bottom of the lens. And again, it's based on gravity for those systems. It also has a lot of change with the comfort at the lower lid with those designs because they have the thicker area there. So people are very aware of that when they're blinking, and ours has minimal lower lid interaction. So there's a lot of differences.

The other big thing is that prism free optic zone, we have that. And looking at just this comparison for spectacles, if we look at what is the allowance for amount of vertical prism in spectacles, there's actually zero for vertical prism. And that's where we are matched with a spectacle allowance there for ANSI standards. Peri- or prism-ballast design actually can have up to .79 in a prism disparity there. And that really can affect the comfort and vision that people are experiencing.

Well, for the best possible fit, I think the best thing to do is to fit all skews of astigmatism. And what I mean by that is an astigmatism lens starts with fitting three-quarters of the diopter of cylinder. I've always done that, but we do that with spectacles, again. So I recommend fitting that three-quarters of a diopter of cylinder, and then of course, higher amounts of astigmatism up from there, because people have their best vision with that. And when patients come in, oftentimes, they'll say something about comfort. Sometimes they're referring to their vision and we're not really aware of that. What we automatically think as a doctor is that if we are getting someone complaining about comfort, we automatically are thinking that they mean the physical lens on their eye is uncomfortable. And sometimes it means vision. So I think that's one of the best tips and tricks. And our technology is so amazing. If you just go right off of a refraction and fit like that, you are going to knock it out of the park on pretty much the first lens all the time.

So we've been able to show over and over that masking doesn't work a lot. I don't know where a lot of people are still holding on to these myths, but we do collectively in our profession. And we've been able to show that taking a low-modulus hydrogel lens or even maybe a little more thick modulus silicone hydrogel and looking at the amount of astigmatism afterwards, masking doesn't work. So what's happening is they're just taking a spherical equivalent and using that to kind of mathematically cover the prescription. That doesn't work either because the vision isn't very sharp. So we know from a few aspects that masking just doesn't work. And we also know from some studies that have been done on the amount of chair time and the ease of fit that those are both misnomers and myths as well. So there's a lot of data out there. I think it's just changing the perception around astigmatism, knowing the specific design elements that make it so great, that we don't have to do those things that we can give our patients, that lower amount of astigmatism. It doesn't matter for their vision, it really makes a difference on the happiness and quality and outcome for them. And it doesn't take extra time, it's easy to fit, and just knowing the differences in technology makes a big difference. Because every single one of us have had patients in our chair where they'll look at the chart, and they'll say, "Well, I can see it, but it's not quite clear," and that's where we don't have their full amount of astigmatism correction in there. And also if they're in a different design that is based on gravity, and they're moving their head, as we all do, from looking down to check a text message, golfing, sporting, driving, whatever it is that our eyes are going to be in a different direction, that lens has to get into place and takes longer when it's based on gravity. So having all of those things and knowing that it's very simple when you have the right technology, you don't have to mask or do some spherical equivalent to mathematically account for the prescription, you can just give them their full prescription and let them be happy.

Well, first of all, it's been an amazing meeting and having the opportunity to do peer to peer education is always so beneficial. Because I've been right there in the trenches along with my fellow peers that are fitting lenses on patients all day long. The other last thing I would say is giving them the opportunities that we have as a company, we're able to look at the whole of the market, holistically seeing that we have this amazing opportunity because we have a ton of people that are interested and open to wearing contact lenses. And we know that we're working hard to get them in and then there's some reasons or our patients drop out. So giving them all that information, it's just such a great reminder over and over because we're also busy seeing patients every day that those things really bring that back up to the surface, bubble that backup to the front of their thoughts and something that we think is easy every day. It gives them all that credibility with all the technology behind our lenses.

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