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Initiating conversations with his astigmatic patients about vision has uncovered unmet visual needs, according to the author.
In the past, I had certain toric lenses in mind, especially for fitting patients with corneas that were in the steeper ranges of corneal curvature. Now I find myself reaching for PV2HDA as my toric trial lens of choice. I have had success fitting it on a wide range of corneal curvatures.
Asking open-ended questions that require more than yes or no responses has provided more information, allowing me to offer patients much sharper vision than they had with their previous toric lenses. I am surprised by how appreciative a toric patient can be when I fit him or her with the PV2HDA. It turns a relatively happy toric contact lens wearer into an excited referral source.
For stability, the PV2HDA incorporates a hybrid of prism and peri-ballasting that allows for significantly reduced thickness in the area over which the ballasting occurs. This design, known as Auto Align Design, also incorporates a large lens diameter and a large optic zone. I have found that the hybrid ballast design stabilizes the lens, giving the patient consistently clear vision all day long. Patients have commented on how this lens does not seem to rotate like their previous contact lenses did. A physician who wore the lens was very grateful that he no longer has to put his finger in his eye to "fix" his vision during his procedures at the hospital.
Ease of fit
As for the ease of fitting the PV2HDA, the new design of this lens has made it quick and easy to fit. I have noticed a significant savings in chair time-both from its rapid stabilization and the ease of being able to see the lens markings. The lens orients on the eye quickly and tends to be remarkably stable, and the lens fit can be assessed within a minute after inserting the lens on the eye. Most patients leave the office with amazingly clear vision at the first visit.
PV2HDA was designed with advanced aspheric optics, known as High Definition Optics, to reduce spherical aberration in every lens across the power range. PV2HDA is the only silicone hydrogel toric soft contact lens that reduces positive spherical aberration in both the spherical and cylinder meridians of the lens. I have had patients tell me that they have noticed improved clarity overall and especially with night driving while wearing PV2HDA compared to their previous toric lenses.
Features to improve comfort
One patient remarked that billboards and street signs are much easier to see in the dark. A 63-year-old nurse who had dropped out of contact lenses told me she was "so happy to be able to see so well while wearing contact lenses!" I also recently had a patient tell me that wearing these lenses was like when he got his first pair of glasses in the third grade. He could see the details in the distance like for the first time.
PV2HDA has two key features to improve comfort: a thin lens design to provide a natural feel throughout the day, and poloxamine, a moisture-rich packaging solution, to provide excellent comfort upon insertion. The new lens design also features reduced lens markings providing a more continuously smooth surface. When you have enough patients coming back telling you how well they can see, it is very compelling. My approach to fitting toric lenses is different now. I can now get patients excited about their vision.
J. Bradley Oatney, O.D.
Dr. Oatney is a consultant to the Center for Patient Insights and speaker for Bausch + Lomb.