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Medical Forum / General / Vision / February 2006Toric lenses for astigmatism - recent improvements?
Have been checking out my options for laser eye treatment in recent years, as I've grown so tired of only having around 8 hours of comfortable wear from my existing contacts, because of lack of oxygen to the cornea. I also still have to build up tolerance gradually, so after leaving them out for the recommended one day per week, I will then have to wear them 4 hours only the first day, 6 hours the second, before continuing with around 8 hours for the remaining days, which is a real hassle. To be honest, I'm not sure exactly what make of toric lenses I've been using in recent years (my last change was 2 years ago), but I've read about silicone hydrogel lenses and wondering if I should give these a try. Anyone with experience of these or any other newer types? Is it just hype, or are they actually major improvements? TIA Gary > Have been checking out my options for laser eye treatment in recent > years, as I've grown so tired of only having around 8 hours of [quoted text clipped - 15 lines] > TIA > Gary Not answering your question, but may I ask how bad your astigmatism is and how you feel about your quality of vision with contacts versus glasses? I've not tried contacts yet, but I'm skeptical that they would stay aligned properly to correct the astigmatism... if you sideways on the couch to watch TV, does the contact rotate? > Not answering your question, but may I ask how bad your astigmatism is > and how you feel about your quality of vision with contacts versus > glasses? I've not tried contacts yet, but I'm skeptical that they > would stay aligned properly to correct the astigmatism... if you > sideways on the couch to watch TV, does the contact rotate? Worked pretty well for me, although it is true that there is occasional rotation. Never thought about lying sideways. I've never found that to work well with glasses, either.  SignatureDan Abel dabel@sonic.net Petaluma, California, USA I've not tried contacts yet, but I'm skeptical that they > would stay aligned properly to correct the astigmatism... if you > sideways on the couch to watch TV, does the contact rotate? There are toric softcontaclenses who are stabilized ''dynamic'' and not "prismatic", they stay in position even when you are lying sideways. SignatureJan (normally Dutch spoken) > Not answering your question, but may I ask how bad your astigmatism is It's -3.5 in one eye and -2.25 in the other. > and how you feel about your quality of vision with contacts versus > glasses? Contacts have not been as good as glasses, but certainly acceptable. > I've not tried contacts yet, but I'm skeptical that they > would stay aligned properly to correct the astigmatism... if you > sideways on the couch to watch TV, does the contact rotate? Only time I suffer from rotation is when it's quite windy and my eyes water. HTH Gary > To be honest, I'm not sure exactly what make of toric lenses I've been > using [quoted text clipped - 3 lines] > Anyone with experience of these or any other newer types? Is it just hype, > or are they actually major improvements? Indeed there are improvements, talk it over with your eyecare specialist face to face. He or she can excamen your eyes and conclud if or not an improvement is likely. In other words putting some money and time by having your eyses checked is a good investment. SignatureJan (normally Dutch spoken) > To be honest, I'm not sure exactly what make of toric lenses I've been using > in recent years (my last change was 2 years ago), but I've read about > silicone hydrogel lenses and wondering if I should give these a try. > > Anyone with experience of these or any other newer types? Is it just hype, > or are they actually major improvements? As far as oxygen permeability, the si-hydros are indeed a major advancement in contact lens technology. The increase in oxygen availability to the cornea is between 5 and 12 times that of "conventional" soft lens plastics. Toric lenses for astigmatism available in the UK include Purevision Toric from B&L. I'm not sure what other brands are available to you folks on the other side of the pond. Another option to consider is the Proclear Toric. It is also made of a unique plastic that offers stable hydration and, although less oxygen than si-hydros, still more than all the other "conventional" plastics and is often an excellent option. LB, O.D. > As far as oxygen permeability, the si-hydros are indeed a major > advancement in contact lens technology. The increase in oxygen > availability to the cornea is between 5 and 12 times that of > "conventional" soft lens plastics. Thanks for the info. Are there limits in these lenses for the degree of astigmatism correction? Certainly sounds like a major improvement, if I could wear my lenses for double the existing time (say from 8 to 16 hours), and not have to bother with the incremental "toleration" regimen, then I may not bother with laser surgery. Regards Gary > Have been checking out my options for laser eye treatment in recent years, > as I've grown so tired of only having around 8 hours of comfortable wear > from my existing contacts, because of lack of oxygen to the cornea. Lack of oxygen is not the most common reason why contacts would be uncomfortable after 8 hours. > still have to build up tolerance gradually, so after leaving them out for > the recommended one day per week, I will then have to wear them 4 hours > only > the first day, 6 hours the second, before continuing with around 8 hours > for > the remaining days, which is a real hassle. And unnecessarily meticulous. This is the schedule recommended (only once) for people who have never worn contacts before. Each new pair shouldn't require such a schedule, nor should one day out of them create such a requirement. > To be honest, I'm not sure exactly what make of toric lenses I've been > using > in recent years (my last change was 2 years ago), but I've read about > silicone hydrogel lenses and wondering if I should give these a try. If your lenses are two years old it's time to change them. If you're already replacing them on schedule, there are at least two new torics, and more on the way. > Anyone with experience of these or any other newer types? Is it just hype, > or are they actually major improvements? Didn't you know? Newer is always better... :) Dry sensation that increases throughout the day is usually due to poor fit, not lack of oxygen. -MT > > Have been checking out my options for laser eye treatment in recent years, > > as I've grown so tired of only having around 8 hours of comfortable wear > > from my existing contacts, because of lack of oxygen to the cornea. > > Lack of oxygen is not the most common reason why contacts would be > uncomfortable after 8 hours. > Dry sensation that increases throughout the day is usually due to poor fit, > not lack of oxygen. You would have more experience than me. My experience, is that dry sensation is due to dryness. I did have a trial contact that didn't work, but it was just a trial, and so I said it didn't work, and got something different, which worked fine. There are several solutions to this: 1. drink water 2. use saline drops 3. use lubricant eye drops 4. quite your job #4 has worked best for me. :-) The air was very dry, and bothered both my eyes and my sinuses. SignatureDan Abel dabel@sonic.net Petaluma, California, USA Hi Mike > Lack of oxygen is not the most common reason why contacts would be > uncomfortable after 8 hours. If I use 'comfort drops' it makes very little difference, if any, so I'd assumed it was not due to dryness. > And unnecessarily meticulous. This is the schedule recommended (only once) > for people who have never worn contacts before. Each new pair shouldn't > require such a schedule, nor should one day out of them create such a > requirement. Well it seems to be for me, if I wear them for a longer period than specified on the first couple of days, then it's more uncomfortable than normal. > If your lenses are two years old it's time to change them. I was intending to change them before now, but have been looking at laser surgery options instead. > Dry sensation that increases throughout the day is usually due to poor fit, > not lack of oxygen. My torics have always been custom made, so I can only assume I've been given the 'best fit' for my eyes, but maybe there has to be a compromise between 'best fit' and best correction of astigmatism? Regards Gary > My torics have always been custom made, so I can only assume I've been > given > the 'best fit' for my eyes, but maybe there has to be a compromise between > 'best fit' and best correction of astigmatism? That's often true, for stock lenses. Custom lenses can be a different story. But dry sensation, increasing with time, is often alleviated by changing the fit or edge design. -MT If you have pre existing dry eyes, lasik will make the problem worse. Your -3.5 cylindar in one eye is getting near the limits of lasik and increases the risks. I dont know how myopic you are, but if its high(-6 or more) then you have a difficult script for lasik. I was right in thinking you needed special custom torics for your level of astigmastim. Have you given RGP contacts a try? They allow so much more oxygen and they are superb at correcting astigmastim, even large amounts of it. They can correct very, very large amounts of myopia. I talked to the optometrist who dispenses RGP contacts and hes yet to see someone have a pescription that was too high to be fully corrected! He said they will correct any pescription! They even reduce high order aberrations! If you give them a try and can tolerate them, youll love it! Just ask Ragnar! How well do you see with glasses? Hows the quality of vision? I got new glasses that correct my -1.5 astigmastim but I dont like them! They disort objects and cause eyestrain and make things even MORE blurry from near. I am much happier with my glasses which just ignore my astigmastim. Clearer from near, no disortions, no eyestrains and while a little blurry in the distance, the quality of vision is better. > If you have pre existing dry eyes, lasik will make the problem worse. Am not aware of any problem with dry eyes, I never feel the need to use drops. The only time they feel dry is if I accidentally nod off for a few minutes when wearing my lenses (they're not the type I can sleep in obviously!). > Your -3.5 cylindar in one eye is getting near the limits of lasik and > increases the risks. I dont know how myopic you are, but if its high(-6 > or more) then you have a difficult script for lasik. I've been given the go ahead for LASEK treatment. Yes, my myopia is high (Sphr - R: -5, L: -6.25), so I know that I may be left with a residual prescription. > Have you given RGP contacts a try? No I haven't, they've never been suggested to me. > How well do you see with glasses? Hows the quality of vision? I see fine, although I'm used to the distortion and minification after all these years... BTW, the old torics I used to wear when I first began wearing lenses back in about 1986 gave better quality vision than my present ones, but the latter are more comfortable. The former were more prone to rotation too. Regards Gary Keep in mind you may have a residual pescription if you choose to go with laser surgury. Theres enhancements but its additional risks. Expect a reduced dependancy on glasses. This is what every doctor and surgeon says so you can have relistic expectations. If you are planning to wear contacts after lasik, dont even bother with lasik in the first place. It might be wise to try RGP contacts first, if they work out, GREAT! If not, read about the risks and limitations of lasik and decide for yourself if its "worth it"
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