MiSight Myopia Control contact lenses - part 2

MiSight lenses were launched at the beginning of 2018, but the technology behind them has been thoroughly tested.

Firstly the lens material has been around for over a decade, we know that it performs well on the eye.  It is comfortable to wear and stable.  We also know that single use daily disposable lenses are the safest way to wear contact lenses.

When studying the lenses, CooperVision choose children from age 8 - 15 years old.  One factor they looked at was how successful the children were in taking care of their contact lenses, and after a month of wear with the contact lenses 100% of the children could easily remove their contacts, 85% also found them easy to insert.  Over the three year study, 100% of those that remained with using the contact lenses reported that they were "happy" with the overall experience.

In the same study, the myopia progression for those wearing the lenses was 59% less than those wearing regular one day single use lenses of the same material, but without the ActivControl Technology.  Importantly this coincided with the measurements of the elongation of the eye, which was 52% less.

It is this eye elongation which we think leads to many of the risks of ocular side effects including retinal detachment and glaucoma.  To be clinically successful in protecting the health of the eyes, the contact lenses don't just need to manage the focus of the eyes, but also the elongation.

The lenses work by providing the retina with different focusing zones, this use of peripheral de-focus has been an emerging concept which we have followed with interest over the last few years.  It completely changes some of our thoughts and models relating to how myopia develops, but it also provides an exciting opportunity to start to understand how we can slow myopic progression.

It must be noted that this may provide some minimal ghosting or a soft-focus type effect on the overall vision, studies have found that this is not unacceptable and doesn't impact on the overall quality of vision experienced by children wearing the lenses.

If you are interested in finding out more about this exciting development in the world of contact lenses and children's vision then don't hesitate to make an appointment.  We will go through all of the information about the contact lenses, starting with a comprehensive eye examination to assess the prescription and the health of the eyes.

MiSight Myopia Control contact lenses - Part 1

A brand new contact lens has been launched onto the market with some pretty bold claims, we wanted to find out more about it.

There is no doubt that myopia (or nearshightedness) is becoming increasingly common.  Studies have shown that in the US over 40% of the population are nearsighted and in some Asian countries this level can be over 80%.  With the current trends, these numbers seem set to continue to rise.

Myopia doesn't just inconvenience someone by requiring them to wear glasses or contact lenses to see distant objects clearly, but also makes the eye more prone to serious sight threatening conditions.  It is this concerning aspect of myopia which makes controlling its development of particular interest.  If we can reduce the risk of retinal detachment, glaucoma, cataract development and myopic macular degeneration then we can make a real impact on the health of our patients' eyes.

Currently we do not fully understand why myopia develops, although we are aware of various risk factors.  It is also common to find that once myopia starts in childhood, it tends to continue to progress developing throughout the teenage years and even in to the early twenties.

There have been various different systems for slowing myopia progression used over the years including rigid contact lenses, orthokeratology, bifocal and multifocal spectacle lenses, bifocal contact lenses and even specific eye drops.

Studies have also shown that if children spend consistent time outdoors in natural daylight, myopia progression is significantly reduced, so we do encourage making lifestyle changes to try to minimise myopic changes.

All of the various systems that have been used previously have advantages, but significant hurdles, which has kept their use to a minimum before.  CooperVision's new single use daily contact lens, MiSight, has the possibility of being a real game changer!

So our first piece of advice is to ensure plenty of outdoors time for children!

Our next post will look more at the actual technology of the lenses themselves.

Contact lens wearers are all idiots!

There, he said it!

A series of recent encounters with contact lens wearers coming to us for the first time has led our optometrist, Dr. Euan McGinty, to this conclusion, shall we find out why?

Dr. McGinty writes:-

The eye is perhaps the most exquisitely sensitive organ in the body, one which provides information that we are highly dependent upon.  Lets take some cold hard facts - 40% of all nerve fibres connected to the brain are linked to the retina.  More of our neurons are dedicated to vision than the four other senses combined.  When our eyes are open, vision accounts for two thirds of the electrical activity in our brain.

There's no denying it, we like to see!

Contact lenses can be a great way to correct our vision and we now have options available to cover most prescriptions and eye-curvatures.

Over the years I have been practicing as an optometrist, perhaps the best single factor in contact lens development has been the move disposable contact lenses.  Compared to years ago, the frequent disposal of contact lenses has dramatically reduced the number of complications I see day-to-day related to the wear of contact lenses.

Disposable lenses are much safer

Studies have shown the compliance with proper contact lens care improves dramatically with the use of disposable lenses and, by a long margin, the best regime is single-use daily disposable lenses.

I was recently discussing this with a contact lens patient who we were refitting with new lenses.  This person had been running in to problems with discomfort, red eyes and variable vision with his regular contact lens regime.

As we discussed all of the options, two things became apparent - firstly, that the idea of single-use daily disposable lenses was something this patient was very keen on and; secondly, that although the current lenses being used were monthly disposable lenses, these had routinely been used for in excess of a month.

Let's make one thing clear, daily lenses are to be used for one day, two-weekly lenses for two weeks and monthly lenses for one month.  That's from when you open the packet until you throw them away, it is not two-weeks' or a month of "wears".

There was no doubt that a lot of issues had arisen for this patient due to the poor contact lens regime and that sorting out the routine, in terms of lens renewal, hygiene and cleaning and also ensuring a good contact lens fit would resolve a lot of the issues.

We really were tempted to switch out to a single-use daily disposable lens, for him the fresh-lens comfort every day was great and for me the excellent safety profile was highly desirable.

The stumbling point? 

Price.

This then caused quite a moment of humour as we realised that purchasing daily disposable lenses would be a third less in cost compared to the cup of coffee that he had come in with and that he picks up every day.  The difference is that you don't buy a year's worth of coffee all in one transaction.

He'd never thought about it in those terms, however, with a bit of perspective it became apparent that great vision and healthy eyes were at least as important as his daily cup of Joe.

If you hear hooves, don't think of zebras

The second encounter which really led me to the conclusion that all contact lens wearers are idiots was a lady who was scheduled for an eye examination.  She contacted us on the day of the eye examination to cancel and reschedule, she had a red-eye.  We suggested that this would be an ideal time to see her optometrist, however, for whatever reason, she didn't want to do so.

I then saw her two weeks later.  We were chatting about her eyes and her recent red eye, she was quite frustrated by it.  She was sure that there must have been a faulty contact lens, or an issue with her solutions.  She had just opened up a new set of lenses and put them in, so they must be to blame.  She stopped wearing them, used some over the counter antibiotic eye drops and it had eventually resolved.  So, in her mind, it was definitely the contact lens's fault.

I examined her eyes and noticed a corneal scar in her eye that had been the affected one.  In my assessment this had been a recent corneal ulcer and she was fortunate that it had resolved, as they have the potential to be quite damaging, especially when associated with contact lens wear.

I discussed my findings and again we went through the lead up to the red-eye to see if we could tease out what had gone wrong.  It was only at this point that it turned out that this patient had slept in the contact lenses and worn them for almost 48 hours straight - something they were never intended for!

We like to have cause and effect, and somewhere to lay the blame.  In this patient's opinion it was the new contact lens which had caused the issue.

This was a contact lens which, until it was opened, had been in sterile packaging.

This was a contact lens which then had been used inappropriately.

I politely suggested that this may not have been the contact lens which had caused the issue, however, it was much more likely to have been caused through "user-error"!

Okay, maybe not all contact lens wearers

These are just two stories of recent encounters which reminded me again how much we take our eyes and vision for granted ... until something goes wrong.  There is no doubt that there are many successful contact lens wearers who run in to no problems whatsoever.

I'll admit it, of course not all contact lens wearers are idiots, but there are some things we should think about.

It doesn't really matter if you believe in all-powerful being, in evolution, or in some other explanation of how we got here, if we were meant to have contact lenses in our eyes, we would have.  We don't!  Contact lenses are a foreign body, to our eyes, they're not meant to be there.

Therefore, when we wear contact lenses, we have to accept we are increasing the risks of having something adverse happen to our eyes.  We need to ensure that we follow simple care steps to make it as safe as possible.

Preferably we should look at single -use daily disposable lenses.

Even with all of these steps, things can go wrong, a recent news story on the BBC website highlighted this: http://www.bbc.com/news/uk-england-nottinghamshire-32797394

More information about our contact lenses can be found on our website here: http://www.oceanoptometry.ca/index.php/the-collections/the-contacts-collections

UV protection and You!

We are all much better now at using sunscreen to protect ourselves from the damage that can happen through UV rays.  Can the same be said about protecting our eyes?

The harmful effects of ultra-violet radiation on the eyes has now been well documented, however, what many do not appreciate is how important it is to protect children's eyes.  Children spend more time playing outside, their pupils are larger allowing for more light (including non-visible light) to enter the eyes.  Research has also shown that a significant amount of our total lifetime UV exposure now happens by the age of 18 and we know that the damage adds up over time.

So how can we protect our eyes?

UV protection -definitely cool

There's obvious steps which can be taken, common with general sun protection, like wearing a wide brimmed hat.  We can not, however, put sun cream in our eyes, so how do we ensure that they are fully protected?

Sunglasses

The most obvious choice would be to use sunglasses, as long as they have UV protection.  You can look for certain marks like UVX or UV400 to ensure that the sunglasses will do the job properly.  Without proper UV protection, sunglasses could actually make sun damage worse as the pupils will dilate behind the dark lenses allowing more UV to enter they eye than without.

Sunglasses should be well fitting and thankfully current trends of either wrapped style or over-sized sunglasses definitely help to max out the protection and reduce peripheral light from entering the eyes.

Prescription Glasses

It may not be obvious that your prescription glasses can actually help to reduce the amount of UV light getting to the eyes.  Higher index plastic lens materials have inherent in-built UV protection as part of their optical characteristics and even standard plastic (1.5 index) can have a UV blocking treatment applied to it. 

With added benefits of being robust and durable, it is easily argued that 1.6 index plastic should now be our standard lens material of choice.  It is thinner and lighter than standard plastic, safer for the eyes with the UV protection and particularly beneficial in children's glasses as it is incredibly tough.

While prescription glasses wouldn't replace good sunglasses for overall sun protection, it is worthwhile taking the time to discuss your requirements with your optician to make sure that you are making the best choice overall.

Contact Lenses

We are increasingly finding contact lenses coming with built in UV protection and it is a feature of the lenses manufactured by Acuvue that all of their lenses have a UV blocker.  The big advantage of contact lenses in UV protection is in reducing peripheral light which gets in to the eye from oblique angles, light coming from the sides, above or below.  This Peripheral Light Factor can cause real problems for glasses and sunglasses as the light can "creep" around the edges of the glasses or be reflected from the skin and then from the back surface of the lens.

Acuvue lenses with UV protection as standard

While contact lenses will not protect the whole eye, as they only cover the cornea in the center, they will add a level of protection which is a great supplement to good quality sunglasses.  They will also allow you to choose from non-prescription sunglasses, perhaps opening up options in style, selection and having multiple pairs to suit your mood or the environment.

Whatever you are doing, whatever time of year, when you are going outside make sure that you have the best protection available and if you are unsure of what works for you, speak to your optician or optometrist for the best advice.

Students - change your underwear!

At this time of year we have many students filling the streets of our fair city.  The sense of excitement the arrive with is almost visible in the air, their heads are filled with big thoughts, big dreams, great plans and (hopefully) a thirst for knowledge.

It can also be a somewhat scary time for the young students.  Taking their first real steps towards adulthood and independence and starting to make their way in the world.  Amazing opportunities will be open to them, the ability to create their own rules, the fun of making new friends and bundled along with this comes the boring bits of life - the responsibilities.

We all have these day-to-day mundane tasks put upon us.  They are chores, every day necessities, perhaps even the drudgery of life, but without them life's a whole lot less pleasant.  To some of the students it's perhaps a bit of a shock to the system that these items just don't seem to magically take care of themselves, a recent conversation on our twitter feed was a perfect example!

@OceanOptometry @ILOVELOCALHFX Awesome! My 1st yr Uni student just phoned in a panic- 2 weeks of dirty laundry & no coins for the machine :)
— ScaryReads (@skodejs) September 4, 2013

Ah, bless them, the little darlings!

What's this got do with optometry, you may wonder.  One of our challenges in the office, though, is in making sure when we are discussing contact lenses we make sure we share our feelings about the importance of a good contact lens wear regime.

Contact lenses bring many advantages over glasses and many people enjoy wearing their contact lenses, either as an almost full time alternative or as an option for sports or social occasions.  One of the main drawbacks of contact lenses, though, is that you are placing a foreign object on to perhaps the most important and sensitive organ of the body.  If our vision becomes compromised the results can be devastating, and yet the approach that some people take to contact lens wear can often be shocking.

When we start chatting about contact lens wear we often ask current wearers simple questions about how often they change their lenses, their lens cases, do they always use fresh cleaning solution.  Many wearers follow good care with their lenses, however, there are unfortunately those that don't.  People may answer that they wash their hands before handling the lenses ... but then they're putting the lenses in to week old stale solution in a case which is several years old! Worst still, people maybe try to get away with saline or some other solution!

As eye-geeks we're fairly protective towards people's peepers and this kind of thing just fills us with dread!  There are some really simple rules about safe contact lens wear:

1 - always wash and dry your hands before handling your contacts;
2 - always replace your lenses as per their proper schedule (most lenses are now either monthly, two weekly or single use daily lenses);
3 - always use fresh solution to disinfect your lenses overnight, allow for the minimum disinfection times necessary and swap out your case as per the solution recommendations;
4 - if you have a problem seek advice as soon as possible.

When we talk to people, reminding them of the basic rules they probably knew at the beginning of their contact lens wearing life, they often admit that they know they've just got in to bad habits, but they haven't had a problem yet.  The important word is the last one ... "yet".  Unfortunately, we have seen what happens when problems arise and they can take hold very rapidly without much warning.

A good contact lens regime can not guarantee that there will never be any adverse problems, but it will greatly reduce the risk of complications.  Just like changing your underwear and doing your laundry (students) will greatly enhance your general quality of life!

I know we've posted this elsewhere, but we do love this video from Acuvue also showing why regular replacement is important:

Up and running with contact lenses

We are now completely ready to fit and supply contact lenses for our patients.  There are many brands of contact lenses and sometimes choosing the right type of contact lenses can seem overwhelming, or perhaps you tend to think that they are all just the same, so what does it matter?

Being fitted for the correct type of contact lens doesn't just ensure that your lenses give you optimum vision, it also makes sure that the lenses fit correctly, are comfortable to wear and are not causing any issues with the health of your eyes.  As contact lenses have become an every day disposable item, it can sometimes be forgotten that you are placing a foreign body onto the surface of the eyes.

As part of our contact lens assessments we will make sure that the contact lenses that we recommended are most suited for your eyes and your lifestyle.  This greatly reduces the risk of complications and adverse effects.

We are very pleased to have decided to work with Cooper Vision and Acuvue as our principle contact lens providers.  Both companies offer an excellent range of lenses and we are delighted to be working with two companies who strongly promote daily lenses, arguably the healthiest option for contact lens wear.

If you would like to find out more about our contact lens services then please do not hesitate to get in touch.  In the meantime, here's a great video from Acuvue about the importance of healthy lenses: