Soft Toric Lens Fitting

1. 0.75 - 3.00 D cyl at corneal plane

2. GPs are not a good option

what makes a good soft toric lens candidate?

lens feel, dryness, contact sports, cyl isnt corrected by a GP

why might GPs not be a good option for some patients?

1. high myopes & hyperopes

2. pts highly critical of their vision

3. low sph & cyl

what makes a poor soft toric lens candidate?

1. prism ballasting

2. thin zones

what are the 2 methods of lens stabilization?

prism ballasting

• watermelon seed principle: the lens is thicker at the base & upper lid squeezes it down

• lens can be further stabilized by eccentric lenticulation or periballasting

thin zones

• double slab off, lens is thinned at apex & base

• can be unstable in low minus lenses

• comfortable due to thinner lens, but more likely to rotate

prism ballasting

what method of lens stabilization do PureVision torics use?

prism ballasting

what method of lens stabilization do AirOptixAstig torics use?

prism ballasting

what method of lens stabilization do Proclear torics use?

thin zones

what method of lens stabilization do AdvanceAstig torics use?

thin zones

what method of lens stabilization do OasysAstig torics use?

thin zones

what method of lens stabilization do FocusDaily torics use?

1

many toric lenses are available in ____ BC

-0.75, -1.25, -1.75 (sometimes -2.25 and -2.75)

cyl powers available are usually:

find something that is as close as possible to the lens you will order so that it will fit & rotate the same

what is the goal when finding a trial soft toric lens?

1. close in sph power

2. close in axis (± 10-15deg)

3. close in cyl power

order of considerations when picking a trial lens:

no

does the selection of a soft toric trial lens really matter that much?

1. is the lens a good fit?

2. what is the ballpark rotation of the toric axis?

3. is the rotation stable?

4. assess the rotation to order the lens

what are the steps in evaluating a soft toric lens fit?

good fit

upon misalignment, the marking will quickly return to its axis

tight fit

the marking makes a slow return to its axis or does not return at all

loose fit

the marking is unstable & mobile

add

if the lens is rotated to the left, then ____ the rotation to the pt’s Rx to order

subtract

if the lens is rotated to the right, then ____ the rotation to the pt’s Rx to order

still rotated exact same amount

if a lens has a certain rotation at fitting, what do you expect at the F/U or dispensing?

1. check spherical OR

2. lens is not stable enough

3. check sphero-cyl OR

4. lens is defective

5. vision problem due to dry eye

6. pt may be too picky to wear soft torics

what are some reasons that vision may be off even with a good fitting toric lens?

1. Avaira Vitality toric

2. Biofinity toric

3. Clarity 1day toric

4. MyDay toric

5. Proclear toric

6. Precision 1 for astigmatism

7. Dailies Total 1 for astigmatism

8. Total30 for astigmatism

what lenses have this type of alignment marking?

1. Ultra for astigmatism

2. Ultra multifocal for astigmatism

3. BioTrue for astigmatism

what lenses have this type of alignment marking?

1. Oasys 2 week for astigmatism

2. Oasys 1 day for astigmatism

3. Moist 1 day for astigmatism

4. Vita 1 month for astigmatism

what lenses have this type of alignment marking?

Dailies AquaComfort Plus Toric

what lenses have this type of alignment marking?

Air Optix Plus HydraGlyde for astigmatism

what lenses have this type of alignment marking?

1. single line at 6

2. 3 lines around 6

3. lines at 3 & 9

4. lines at 3, 6, & 9

5. lines at 6 & 12

6. dot(s) at 6

7. dots at 3 & 9

8. letters at 6

what are some examples of toric lens markings?

tight lids, large corneas

what are 2 reasons to choose a larger diameter lens?

6 & 12

in general, all J&J lenses have their toric markings at __________ o’clock

5,6&7 or just 6

in general, all B+L lenses have their toric markings at _________ o’clock

6, 6 +15deg, 3&9

in general, all CooperVision lenses have their toric markings at ________ o’clock, except for Proclear toric which are marked at ______ o’clock and Proclear MF toric which are marked at _________ o’clock

3, 6, & 9

Alcon AirOptix/Focus toric lenses are marked at ________ o’clock

3 & 9

Alcon focus dailies are marked at _______ o’clock

6

Alcon Precision 1s are marked at ________ o’clock