Published in Contact Lens

The New ACUVUE ® 1-Day MOIST® Brand Multifocal: The Best Option Yet for Presbyopes

This post is sponsored by Johnson & Johnson Vision
9 min read

ACUVUE ® 1-Day MOIST® Brand Multifocal lenses combine Lacreon technology with pupil optimized design. It is the premium option for presbyopic patients.

The New ACUVUE ® 1-Day MOIST® Brand Multifocal: The Best Option Yet for Presbyopes
This is a sponsored post by Johnson & Johnson Vision Care, Inc., a supporter of CovalentCareers & new graduate optometrists! 😎
As Optometrists know, the 40+ age demographic is the most difficult to fit in contacts for two major reasons: symptoms of dryness and presbyopia. The multifocal patient base is increasing, yet so is the contact lens dropout rate. We have counseled many patients, “This is just as good as it is going to get. We just don’t have many options.”

Well, we do now! Johnson & Johnson Vision Care, Inc. has recently given us a new multifocal option to help meet the needs of this patient demographic.

https://covalentcareers3.s3.amazonaws.com/media/original_images/Screen-Shot-2015-07-02-at-10.10.20-AM.png

How does the technology work?

Comfort:

The 1-DAY ACUVUE ® MOIST Brand MULTIFOCAL is part of the 1-DAY ACUVUE ® MOIST Family of products with LACREON® Technology. This patented technology consists of a wetting agent permanently embedded into the matrix of the lens. This technology improves end of day comfort and doesn’t decrease with blinking. One hundred percent of the wetting agent remains at the end of the day, providing your patients with all day comfort.
https://covalentcareers3.s3.amazonaws.com/media/original_images/wetability-graph.jpg
Wettability: Creates a cushion of moisture throughout the day.

Health: Breathability and UV Protection†*

ACUVUE ® Brand Contact Lenses are known for being the only major brand of contact lenses with UV protection†* across the entire product line. All 1-DAY ACUVUE ® MOIST Contact Lenses block on average 82% of UV-A and 97% of UV-B light. Additionally, 1-DAY ACUVUE ® MOIST lenses are made of etafilcon A and provide 88% of available oxygen to the eye during open eye conditions.1
https://covalentcareers3.s3.amazonaws.com/media/original_images/Screen-Shot-2015-07-04-at-10.00.48-AM-1024x493.png

Vision:

The 1-DAY ACUVUE ® MOIST MULTIFOCAL is the only aspheric, center-near multifocal design with pupil optimization. This means that the optical design takes into account the natural variation of pupil size that occurs with both age and refractive error, and is the only lens of this kind to do so.1 In a clinical study, 90% of patients achieved 20/30 vision or better at near and 80% of patients were able to see 20/20 at distance. Most exciting, 95% of patients achieved 20/25 vision or better at an intermediate distance.1 In this technological age, clear vision at an intermediate distance is very important for a majority of our patients.
https://covalentcareers3.s3.amazonaws.com/media/original_images/Screen-Shot-2015-06-23-at-8.01.21-PM.png
1-DAY ACUVUE ® MOIST Brand MULTIFOCAL also has a unique hybrid back curve, which helps ensure that the design aligns with the pupil.
https://covalentcareers3.s3.amazonaws.com/media/original_images/Screen-Shot-2015-07-02-at-12.27.45-PM.png
-94% of patients were fit with 2 pair of lenses or less.1

Parameters:

Base Curve: 8.4 mm
Diameter: 14.3 mm
Power ranges: +6.00D to –9.00D (0.25D steps)
ADDs:
  • Low (+0.75D to +1.25D)
  • Mid (+1.50D to +1.75D)
  • High (+2.00D to +2.50D)
Wear & replace schedule: Daily disposable

Fitting Guide:

  1. Start with a new subjective refraction
    • Push the maximum plus for distance to achieve desired functional visual acuity (VA required to perform tasks)
    • Determine spherical equivalent
    • Apply vertex distance for +/-4.00
  2. Determine eye dominance – +1.00D blur test recommended
  3. Determine minimum add requirement based on the patient’s visual demands and range of vision – a good rule of thumb: Use the guidelines for Low adds for patients in their 40’s, Mid for 50’s, and the High add combo for 60’s
  4. Refer to the fitting guide to select appropriate lenses
  5. Allow 10 minutes of “real-world exposure” (outside of exam room) before making changes to lens powers – avoid making changes too quickly, and remember that very small tweaks (0.25D change in distance or changing add in one lens) can make a dramatic difference.
  6. Allow 10 minutes of “real-world exposure” (outside of exam room) before making changes to lens powers – avoid making changes too quickly, and remember that very small tweaks (0.25D change in distance or changing add in one lens) can make a dramatic difference.
https://covalentcareers3.s3.amazonaws.com/media/original_images/Screen-Shot-2015-06-29-at-11.56.32-AM.png
6. Consult the fitting guide for enhancements
https://covalentcareers3.s3.amazonaws.com/media/original_images/Screen-Shot-2015-06-29-at-11.56.47-AM.png

A general rule of thumb:

  • Reduce the add in one eye to improve distance performance (creates a sharper retinal image)
  • Add +0.25 to the distance power in one eye to improve near performance

Things to consider:

  • Has your patient failed with traditional multifocal designs?
  • Has your patient had symptoms of dryness with current monthly replacement lenses?
  • Has the amount of chair time spent on fitting multifocal lenses led you to substitute monovision instead?
  • Has your patient been wearing distance only correction for sports due to binocularity over monovision?
  • The cost factor: This product is governed by the Johnson & Johnson Vision Care, Inc. Unilateral Pricing Policy (UPP). Boxes of 30 lenses have a UPP of $45.00, boxes of 90 lenses have a UPP of $99.00.

What does this mean for your practice?

  • Increased annual contact lens exams.
  • Reduced time between annual exam (studies show from 18 months to 14 months for daily lens wearers).
  • Daily lens = most profitability of any lens modality.
  • More referrals from the friends and family of excited patients.
  • Offers competitive pricing due to UPP.

Personal Success

I have traditionally fit monovision as the first option for my presbyopic patients. Despite most studies conducted by manufacturers, I have found that patients prefer their distance to be the clearest and traditional monovision options have delivered better distance acuity. I have also fit primarily monovision due to increased daily lens options.
I’ve already experienced a lot of great success with this lens since I’ve been fitting it. In every patient I have fit thus far, the fitting guide has provided the perfect lens selection every time. It completely eliminates the need to overplus the distance after putting the initial lenses on the eye and has delivered distance vision similar to monovision. It has become my go to lens in both hyperopes and myopes.
The 1-DAY ACUVUE ® MOIST Brand MULTIFOCAL is from the 1-DAY ACUVUE ® MOIST Brand that we as doctors already know and trust. We know our patients appreciate the comfort and lens technology. This new lens enables us to provide our most difficult presbyopes with excellent vision and comfort. In turn, we will be able to expand our base of contact lens wearers due to fewer contact lens dropouts. Furthermore, due to Johnson & Johnson Vision Care, Inc. unilateral pricing policy, our offices can offer the same prices as other sellers.
Sources:
  1. 1- DAY ACUVUE ® MOIST Brand MULTIFOCAL.” 1- DAY ACUVUE ® MOIST Brand MULTIFOCAL Contact Lenses. Johnson & Johnson Vision Care, Inc, 2015. Web. 01 July 2015.
http://www.acuvueprofessional.com/moist-multifocal-contact-lenses
ACUVUE® Brand Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching or discomfort. Lenses should not be prescribed if patients have any eye infection, or experience eye discomfort, excessive tearing, vision changes, redness or other eye problems. Consult the package insert for complete information, available from Johnson & Johnson Vision Care, Inc. by calling 1-800-843-2020 or by visiting www.acuvueprofessional.com.
†Helps protect against transmission of harmful UV radiation to the cornea and into the eye.
*WARNING: UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. You should continue to use UV-absorbing eyewear as directed. NOTE: Long-term exposure to UV radiation is one of the risk factors associated with cataracts. Exposure is based on a number of factors such as environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV-blocking contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other eye disorders. Consult your eye care practitioner for more information.
ACUVUE ®, 1-DAY ACUVUE ® MOIST, and LACREON® are trademarks of Johnson & Johnson Vision Care, Inc.
Courtney Dryer, OD
About Courtney Dryer, OD

Courtney Dryer is a 2011 graduate of SCO. She opened 4 Eyes Optometry in her hometown of Charlotte, NC in February of 2013. After 5 years, the practice name was changed to Autarchic Spec Shop to renew the practice's commitment to independent optometry. In addition to consulting with new graduate optometrists on start-up practices, she contributes regularly to New Grad Optometry and has guest blogged for Invision Magazine. The unique design of her boutique practice was featured in Women in Optometry. In 2015, Vision Monday named her a Rising Star, and one of the most influential women in optical.

Courtney Dryer, OD
Eyes On Eyecare Site Sponsors
Iveric Bio LogoOptilight by Lumenis Logo