Introducing Acuvue 1-Day Moist Multifocal

5:15 PM

Contact lens wear after 40 can be a challenge; today's multifocal contact lens designs often leave patients with compromised distance or near vision, or both.  The reason?  Multifocal contact lenses rely on a layered ring design, where rings of distance and near powers through the center of the contact lens create multiple images on the back of the eye that the brain must interpret.  The pattern and width of these rings is different with every contact lens brand design, which is why you can't expect to see the same out of Air Optix Multifocal as you do out of Freshday Multifocal.  One of the biggest limitations of this multiple ring design is that depending on the size of your pupil, you may get too much or not enough of each ring of vision.  And because these lenses are not custom made for your eyes, they either work or they don't -- there's no way to manipulate the ring design for your individual pupil.


Here's where the new Acuvue 1-Day Moist Multifocal design comes in -- researchers at Johnson and Johnson have designed this lens with a variable ring pattern based on the concept that average pupil size changes as we age.  The older we get, the smaller our pupil gets -- which is often one of the reasons that when you need higher reading prescriptions in multifocal contact lenses it tends to be less successful than at low reading adds.  And depending on if you are a -6.00 myope or a +4.00 hyperope, the average person's pupil size at these prescriptions is quite different.  The new Acuvue design incorporates population averaged pupil sizes for these various prescription needs to try to maximize vision at the culprit -- how to match the ring pattern for vision delivery to the amount of room your pupil provides for.



The Lens:
Available +6.00 to -9.00 in low, medium, and high add powers
Acuvue 1-Day Moist platform (8.5 base curve)

The Fitting Guide:
You don't have to measure pupil size or make any pupil determinations -- everything with pupil size is designed into the lens.  

Start with spherical equivalent (vertexed if necessary)
Avoid astigmatism amounts greater than -1.00 DC
Determine dominance
Let the patient have 10 minutes to adapt before checking vision
Select Low, Medium, or High add based on spec Rx add


Trouble Shooting:
Need more distance or near vision?  Johnson and Johnson reports a 94% success rate with < 2 pair of lenses if you follow this guide to enhancements instead of doing your normal +0.25/-0.25 over refraction routine.


My review:
I've had the lens at my office for less about 1 week and have successfully fit one very happy patient who has tried Air Optix Multifocal, Biofinity Multifocal, Synergeyes Duette Progressive, and Freshday Multifocal without satisfactory vision.  Within 2 lenses, he was set and feeling encouraged enough to say this was "the best one yet".  I'll have to try the lens out with a larger sample size of course, but I can feel confident in telling you that if your patients are unhappy with vision in their current lens, this is a real alternative to offer!

I am not affiliated with Johnson and Johnson in any way, and all opinions are my own.  All images are courtesy of education materials distributed by Johnson and Johnson.

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4 comments

  1. Hi. I came across this page after a search in furor trying to figure out if there was anything I could do about my first time prescription of my contacts. I am 47. Female. For the past three years my eyes have slowly deteriorated, mostly my near vision has been the problem. About a year ago I noticed my far vision also acting up. The last time my eyes were checked while they were bouncy and new, I was 20/15. So this has caused a bit of a shock for me. Anyway, I relented, after wearing reading glasses slowly creeping up to 2.50. I was prescribed a few Acuvue Multis and finally "settled" on one prescription. Left eye : 1.00 Mid, ADD 1.75 and Right eye : 1.00 Low ADD 1.25. This is the best she could come up with in the time allotted to me. However, while wearing them my near vision is not making me happy. My right eye is a tad better than the left but still, while I wear them the words I see overlap each other or there is some sort of double vision going on. Like the word has a twin on top of it slightly off. It's very strange. I tried switching my right contact into my left eye to see if that helped but it did not. Too complicated. My glasses, although she did warn me that the lenses would never be able to make my sight as clear as my glasses, are so much clearer. This is so sad. I understand that I will probably never be able to see as clearly again but I was so hopeful that I would at least be able to see a bit more clearer without all that strange ghosting going on. I also did some fishing around the web and found a contact lens that actually had a hard lens in the center with a soft gel rim. Have you heard of these? Hybrids? SynergEyes? I just want to know if I should just give up and wear glasses because it seems there is no real help with multis without another, yet significant con to wearing them. Should I try the hybrids? Should I do hard multis? Anyway, I realize this is a site for professionals but really, I'm at my wits end and so disappointed I can't see straight! Thanks for any advise you can give and for your time.

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    Replies
    1. You are experiencing a really common phenomenon in multifocal contact lenses called ghosting, caused by your brain seeing the rings of vision in the lenses that correct for both distance and near. For most people ghosting gets better after wearing lenses for 3 days to 2 weeks, so if you are new to contacts keep wearing them for at least this long to see if things get better. Both Synergeyes and soft multifocal lenses use a ring design, so both have ghosting as a side effect (Synergeyes calls it 'simultaneous vision' which makes it sound nicer, but it's ghosting). If you just can't adjust to this type of vision, you may be a better candidate for mono vision contact lens options where 1 eye has only distance correction and the other has only reading correction, or wearing distance contact lenses and using OTC readers over top for reading. It's true that vision in glasses is always better than in contact lenses when you are using mutifocal or monovision correction, but most people are able to find a compromise that works for them. You may need to try a few different types of lenses before you find your best possible compromise.

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  2. Thank you Dr. L!
    I'm confused about the Synergeyes lenses as they say they are identical to wearing glasses because the middle is made just like glasses and the outside is made of the soft gel like material in soft contacts. I thought this might be a better option, but you state they are the same? That stinks! I was so hopeful.
    Thank you so much for your advice and I will definitely check out those other options. I may just stay with my readers since my near vision bothers me most. My far vision isn't bad, its just not what it used to be. Bummer.
    Have a great week!

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    1. Synergeyes lenses provide for better vision for people with astigmatism or irregular corneal shapes who are trying to use multifocal contact lenses (soft multifocal contact lenses don't correct for this), but they use the same general concept of a ring design for providing distance and near vision that soft multifocal contact lenses do. With that being said, you may experience less ghosting with different multifocal contact lens designs since every lens has a different ring pattern, so it would be worth trying a few others before giving up.

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