We, as eye care practitioners, are fortunate to practice in a time when there are new technologies, materials and modalities consistently emerging in the contact lens marketplace. There are many more options available for today’s contact lens wearer, especially in the single-use daily disposable category.

Daily disposable contact lenses, and the latest introduction of the toric designs, offer many advantages—starting with convenience. It is important that practitioners discuss the new materials and new modalities available with their patients, starting with the daily disposable option for your astigmatic patients.

Consider making a unified approach to growing this market in your practice. The perception of high costs may appear to be a barrier, but instead focus on the savings your patient would see in contact lens solution purchases throughout the year and the manufacturer rebates available. Many patients appreciate the convenience and the comfort of having a new lens every day. Many practitioners believe this modality is safer than their two-week and one-month counterparts for a variety of reasons, especially a much higher compliance rate.

The upper and lower eyelid of our allergy suffering contact lens patient who presented with intermittent blurred vision and difficulty wearing her contact lenses seasonally.
For the Allergy Sufferer
By utilizing a proactive approach with diligent allergy history questioning, you may be surprised to learn how many allergy sufferers are currently not wearing their contact lenses, not being diagnosed or treated in your practice. A diligent data gathering process will help reveal these potential contact lens dropouts due to allergy-induced comfort issues.

Studies have shown these allergy patients are excellent one-day disposable candidates. Mary Jo Steigemeier, O.D., and Stuart Thomas, O.D., described significant increases in comfort for patients with ocular allergies when they were fit with daily disposable contact lenses.1 Often times, patients were self-treating during periods of allergy-induced contact lens discomfort by simply not wearing their lenses at all.

As a modality, the daily disposable contact lenses may be a perfect solution for this patient. They have a new, clean lens placed on their eye every day. There are no cleaning, compliance or depositing issues that need to be considered with this modality. (Tip: Don’t ask about allergy symptoms only while collecting the patient’s history, but continue the questioning while you are looking through the slit lamp at the lower lids.)

The Ideal Candidate
Daily disposable contact lenses offer patients the convenience of a fresh lens each time, without the hassle of cleaning and monitoring a replacement schedule. If a patient is looking for part-time wear, (i.e., while participating in sports, over weekends, while traveling) or simply looking for a more convenient alternative, then daily disposables are probably the best choice. One-day contact lenses are very useful for patients who have had a history of non-compliance, solution or material sensitivity or toxicity. This lens modality may also be the best choice for our less responsible pediatric and teen population. By offering this opportunity to your astigmatic patients, you can potentially add a significant number of contact lens wearers to your office.

The Astigmatic Patient
Our astigmatic patients are typically delayed when it comes to availability of contact lens technologies. In fact, we still occasionally see astigmatic patients who are told they cannot wear lenses due to their astigmatism. In reality, a significant portion of our astigmatic patients wear spherical equivalent contact lenses. This technique is used to mask the uncorrected cylinder, but often does not provide optimal vision correction for these patients.

There are several one-day disposable options for patients with astigmatic refractive correction: Focus Dailies Toric Contact Lenses for Astigmatism (nelfilcon A, Alcon), ClearSight 1 Day Toric (ocufilcon B, CooperVision), Soflens Daily Disposable Toric for Astigmatism (hilafilcon B, Bausch + Lomb) and Acuvue 1Day Moist for Astigmatism (etafilcon A, Vistakon). The limited power availability is the primary restriction with one-day disposable toric lenses (see “Power Availability in Daily Disposables,” above).

A Case Study
Melanie, a 39-year-old white female, lives with her three kids and one dog. She is a new patient in for her annual eye health check, and reported using one-month disposable toric contact lenses. She wanted to renew her contact lens prescription and had no allergy complaints when giving her history.

During the anterior examination, I discovered moderate amounts of papillae on her inferior palpebral conjunctiva in both eyes. When prompted, she revealed intermittent blurred vision and difficulty wearing her contacts during the spring and fall. She said she usually cuts back on her contact lens wear, and instead uses her six-year-old back-up glasses for a period of four to six weeks. This has been consistently happening for the past few years, and she usually treats her symptoms with over-the-counter allergy drops.

She was refit with daily disposable toric contact lenses, along with a prescription for a dual-acting topical antihistamine/mast cell stabilizer.
Keep in mind that new technologies are important to the bottom line of a contact lens practice, and that they are the most profitable early in the product’s life cycle. Early adopters will typically reap larger benefits with respect to contact lens technologies. One-day disposable contact lenses are one of the fastest growing segments in the contact lens marketplace and practices need to consider this lens as an opportunity.

From single-use daily disposable contact lenses to two-week, one-month and the less common quarterly or yearly replacement schedules, today’s contact lens wearers have many options to consider when choosing a lens modality. But ultimately, the eye care practitioner is responsible for selecting a proper contact lens modality, material and solution combination to ensure lens wear success. Consider one-day disposable toric contact lenses next time you see an astigmatic corrective patient in your exam chair.

1. Stiegemeier M, Thomas S. Seasonal allergy relief with daily disposable lenses. CL Spectrum. 2001 Apr;16(4):24-8.
2. CooperVision. Available at: www.coopervision.com (accessed April 2012).
3. Vistakon. Available at: www.jnjvisioncare.com (accessed April 2012).
4. Bausch + Lomb. Available at: www.bausch.com (accessed April 2012).
5. Ciba Vision. Available at: www.cibavision.com (accessed April 2012).
6. Brujic M, Miller J, Chou B. Controversies in Care webinar series: Daily Disposables. Rev Cornea Cont Lens. April 4, 2012. Available at: www.reviewofcontactlenses.com/controversies-in-care (accessed April 2012).