Johnson and Johnson Vision has announced the discontinuation of several prescription ranges for it's popular Acuvue Oasys for Astigmatism brand of lenses. Please note, the Acuvue Oasys for Astigmatism contact lens is still available in the majority of the power ranges; only specific prescriptions are affected. In a letter to practitioners across the United States, Johnson and Johnson Vision cited the decision was based on a number of factors affecting industries around the world in 2022: short staffing at their distribution and contact center, supply chain issues, and increased product demand. The Acuvue Oasys MAX 1 Day brand of lenses recently launched in summer of 2022. In order to divert resources to the most needed prescription ranges (the company serves 43 million people globally with their Acuvue brand contact lens products), the discontinued parameters listed below were chosen because they were the least ordered prescriptions currently offered by the company. 

The following powers are no longer available:

➡️ Plus Powers (+0.25D to +6.00D)
All -2.25D & -2.75D Cylinder

A. A well fit contact lens showing good centration and full corneal coverage via. B. A poorly fitting contact lens showing inadequate corneal coverage and fluting of the edge via

Prior to disposable contact lenses entering the market in 1987 with the introduction of Johnson & Johnson Vision Care's Acuvue, soft contact lenses were custom designed for a patient's unique corneal shape, size, and prescription. When we average out corneal shape and size for most patients, we do find that the majority of patients fit into an "average" shape, which is why mass-produced soft contact lenses have become the predominant modality of soft contact lens wear. In fact, a 2017 mathematical analysis revealed that a 8.6 base curve and 14.2 mm diameter contact lens achieved a successful fitting relationship in 90% of patients. 

Most patients fall into an "average" range of eye size and shape that provides a successful contact lens fit from an average contact lens shape of 8.6 mm base curve and 14.2 mm diameter. via

To better understand the factors at play, we need to define the two measurements listed on your prescription contact lens box that dictate how a contact lens will fit. Base Curve is the curvature of the lens, and diameter is the overall size of the lens. 

Base Curve of the contact lens. In this example, base curve is 8.5 mm

 

Diameter of the contact lens. In this example, diameter is 14.3 mm

It is tempting to think that the base curve number will define how tight or loose (steep or flat) a contact lens will fit, but in actuality, how a contact lens fits is dictated by a relationship between the base curve and the diameter together, called the sagittal depth. Research shows that the base curve number written on a box of contact lenses is actually a poor predictor of how a contact lens will truly fit on the eye, and to complicate matters, the labelled base curve of a lens on the box many not even truly reflect the curvature of the lens as manufacturers often incorporate mathematical modifications to adjust how a contact lens fits in the periphery versus in the center. Base curve can also change as you wear a contact lens based on environmental factors like the lens drying out, temperature changes, and exposure to makeup or soaps.

As a doctor, selecting a contact lens for best fit is also challenging because the sagittal depth of any contact lens is not notated on the packaging. Additionally, research shows that base curves and diameters as they relate to sagittal depth is not universal across contact lens manufacturers. You would assume that two lenses made by two different companies but both with a 8.6 base curve and a 14.2 diameter would be nearly the same, but that is not always the case. Luckily research done in 2021 has shed some light as to the actual sagittal depth of popular daily disposable contact lenses on the market.

To use this data as a tool for improving contact lens fitting outcomes, there are a few key take-aways:

• Smaller corneal diameters (smaller than 11.7 mm) are associated with lower sagittal depth
• Larger corneal diameters (larger than 11.7 mm) are associated with higher sagittal depth
• Troubleshooting poor vision
• A lens that is moving excessively or rotating with an astigmatism lens will exhibit better stability with a higher sagittal depth
• A lens that is too tight may be warping or vaulting as the patient blinks. In this case you would see minimal to normal lens movement, and a toric lens for astigmatism would look stable with no visible rotation. You can check for vaulting by using an autorefractor, topographer, or keratometer to assess the mire rings as the patient blinks. If the mires alter between blinks, the lens is vaulting and you need a lower sagittal depth lens.

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Which screen is the best for your eyes? Studies show that smaller screens with lower brightness settings, like e-readers or smartphones are the best for visual comfort and ocular surface health!

It's all about the blinking when it comes to keeping eyes happy. Study link here

Have you ever had the experience of leaving the doctor's office with a great contact lens - excellent comfort and perfect vision - only to have the vision and comfort take a marked turn for the worse a few days or weeks later?  As an optometrist, I've seen this issue present itself many times.  The lenses perform and move beautifully on the eye in office, but a few days later I'll get a phone call from the patient that they need to be seen because their lenses "don't fit."  What changed?  New research shows that the products we use around our eyes, from makeup to facewash and makeup remover, can cause significant changes to both the physical shape and performance of contact lenses.

How Does Makeup or Makeup Removers Come in Contact With Your Contact Lenses?

Makeup applied to the waterline can easily transfer onto your contact lenses. The waterline is where our tear glands (called Meibomian glands) sit, so every time you blink, these glands release oils that spread over the surface of the eye, transferring any makeup applied to the area with them. image via

You may be surprised to hear that contact lenses can be affected by your normal skincare products, because they typically aren't coming into contact with each other directly. No one rinses their contact lenses with makeup remover, or coats them with mascara purposefully (or if you do, you'd expect them to be extremely uncomfortable as a result!). The overwhelming majority of the time, contact lenses are exposed to makeup and soaps by accident when you are either inserting or removing your contact lens. Sometimes makeup or facewash residue is still on our hands when we touch our lenses, or if you are wearing your contact lenses when you apply eye makeup like mascara or eyeliner, small amounts of it can easily transfer into your eye and stick to the surface of the contact lens. The majority of monthly and biweekly disposable contact lenses are made from materials called silicone hydrogel, and the silicone in these lenses that helps make the contact lens more breathable is also very attracted to oils. Makeup and makeup removers are primarily oil based products, and once they come into contact with a contact lens, they bind tightly and are next to impossible to remove even with the strongest contact lens cleaners.

To best prevent makeup from sticking to your contact lens and causing blurry vision, redness, or build up on the lens, try this technique:

1. Apply all of your makeup
2. Wash your hands thoroughly
3. Instill a rewetting drop to rinse makeup particles off your eye.
4. Insert your contact lens.

By applying your makeup first and then using an artificial tear drop to rinse stray makeup particles away from the eye's surface, it's less likely that you'll inadvertently transfer makeup onto the contact lens.

The Science of What Makeup And Facewash Can Do to Your Contact Lens

Contact lens edge distortion caused by exposure of samfilcon A lens to Neutrogena Oil-Free Makeup Remover via

What Problems Do Mascaras Cause? These products primarily effect image quality and vision.

When a newborn first opens their eyes to the world, vision is a sense that is mostly dedicated to recognizing mom and dad (see Part 1 of this series about newborn vision). But as new parents know, babies develop rapidly over the first few weeks of life, and vision is no exception! In the first 1 to 2 months of life, your baby is learning how to focus and move their eyes to visually process the world around them.  InfantSEE providers refer to this stage of visual development as "Learning to Look". Your baby is actively learning how to use their eyes for the first time, and at this stage eye muscle movement development includes:

• Pursuits: slow, tracking movements 
• Accommodation: focusing on near objects
• Convergence: eyes turning inward as near objects are brought closer

Dr. L and her newborn daughter. photo credit to Melissa DeLorme Photography

Try to picture what the world is like for a newborn entering the world.  Suddenly they go from the warm, cozy, darkness of mother's womb to a loud, cold world of bright lights and blurry shapes. And yet, research suggests that newborns are not paralyzed by sensory overload, but their visual skills that have been developing throughout their time in the womb immediately are ready to kick into gear! Full term and even some premature infants can fixate their eyes on a near object immediately in the delivery room.  This early visual alertness is used by doctors and nurses in the delivery room to assess the robustness and function of the central nervous system.

We can separate visual development in infancy into 5 main stages:

1. Awakening to the World 
Visual alertness occurs in the first hours/days/weeks of your newborn's life. What your baby can see, and what you as parents can do to support visual development in this stage is the subject of this article!

2. Learning to Look
In the first 1-2 months the eyes are learning to move and work together by following and tracking objects.

3. Eyes/Brain/Hands
Around 4 months old, your baby is integrating vision into motor control. Hand-eye coordination and balance are all being developed at this stage.

4. Adjusting Focus
At 6 months old it's time for the baby's first trip to the optometrist! At this visit, the doctor will use retinoscopy to assess how your child is focusing on objects near and far, check for any differences between the two eyes, and determine if a prescription is needed to prevent against lazy eye (amblyopia) or strabismus (eye turn).

5. See to Move
At ages 8 months to 1 year old, babies are actively moving and navigating their world using visual cues like depth perception.

One pair of shoes doesn't go with every outfit, so why should we be restricted to making one pair of glasses work every single day for our personal style? As a glasses-wearing adult, I have a total of 6 pair in my current prescription - from versatile clear plastic to a bold black and white tortoise with red details for when I want my eyewear to make a statement.  But for kids, whose prescriptions can often change dramatically from year to year, investing in multiple pairs of glasses for stylistic purposes often seems like a luxury that can be hard for parents to justify.

Founder and President Jessica Darcy shares her Funoogles collection at Vision Expo West

Ella-Jane clearly has a strong sense of fashion and self identity, and her eyewear style is always on point as evidenced by the @Funoogles Instagram account.

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For more great style inspiration on how to make your Funoogles pop, head to @funoogles on Instagram