If you’ve been wanting to wear silicone hydrogel contact lenses but couldn’t because they weren’t available in your prescription, your wait is over: Custom-made silicone hydrogel lenses are now available in the United States.

The 2002 introduction of lenses made from new-generation silicone hydrogel materials was welcomed by contact lens wearers and eyecare practitioners alike, because silicone hydrogel lenses deliver more oxygen to the eye than traditional hydrogel lenses, which can mean improved comfort and better eye health.

But until now, silicone hydrogel lenses have come only in limited sizes from manufacturers such as Bausch + Lomb, CIBA Vision, Johnson & Johnson and CooperVision. If you have an unusual prescription, such as one with very high amounts of astigmatism, silicone hydrogels weren’t an option for you.

Now Contamac, a U.K.-based supplier of contact lens materials, has FDA approval for a silicone hydrogel material that they’ll be supplying to smaller U.S. lens manufacturers who can fabricate custom lenses. Read more…

After years of wearing your contact lenses comfortably, you might be dismayed to learn that your favorite brand has been discontinued.

If you don’t want to change what has worked so well for you, you might consider a new program by Alden Optical that provides custom-made contact lenses as duplicates for your preferred brand.

Alden Optical President Tom Shone told Contact Lens Headlines that the cost may be about the same in certain cases as what you paid when your favorite contact lenses were available commercially.

Even when custom contact lenses are more expensive, certain contact lens wearers may have special needs that can be met only by a discontinued brand. Read more…

In her recent music video, “Bad Romance,” pop star Lady Gaga’s appearance is more arresting than usual thanks to a bit of computer magic: Her eyes were digitally altered to appear bigger.

Not surprising, the doe-eyed look she has in the video has inspired a fad among many teenage girls and young women: wearing special color contacts that mimic the anime-style look. These so-called “circle” contacts have a darkly tinted zone that makes the wearer’s pupil look much larger than normal.

The problem is that circle contact lenses are being sold illegally via the Internet without a contact lens prescription, which eye doctors say could cause serious eye problems ranging from minor eye discomfort to serious eye infections, including potentially blinding infections such as Acanthamoeba keratitis. This especially is true when contact lenses are not properly cleaned and disinfected after each use and/or are shared among friends.

Today, the American Academy of Optometry (AAO) and American Optometric Association (AOA) issued a joint statement titled, “Concern Regarding Cosmetic ‘Circle’ Contact Lenses.”

In the document, the organizations point out that all contact lenses, whether they correct vision or are used simply for cosmetic purposes, are classified as medical devices by the U.S. Food and Drug Administration (FDA) and cannot be obtained legally in the United States without a prescription, which requires a contact lens fitting by a licensed eye care practitioner.

The joint statement also says studies show individuals who purchase contact lenses via the Internet or mail order have a four times greater risk of eye infections than those who purchase their lenses from an eye care professional.

The AAO and AOA also warn of the dangers of sharing or swapping contact lenses with friends and advise consumers desiring cosmetic contact lenses to alter or enhance their appearance to do so only after consultation with their eye care provider.

The AAO/AOA joint statement follows a similar warning about circle contacts issued earlier this month by the American Academy of Ophthalmology.

Keratoconus, a degenerative eye disease, generally causes vision problems that cannot be adequately corrected with eyeglasses.

But specially designed contact lenses often provide excellent visual acuity for people suffering from mild or even moderate stages of keratoconus.

In the January 2010 issue of Optometric Management, Gregory W. Denaeyer, OD, reviews four contact lens strategies for correcting vision problems caused by keratoconus:

Specialty soft contact lenses. This option often works well for individuals with mild keratoconus. Several contact lens companies produce specially designed soft contacts to fit the steep curvature of mildly keratoconic eyes, and these lenses also can correct significant amounts of keratoconus-induced astigmatism, according to Dr. Denaeyer.

Bi-aspheric gas permeable contacts. Gas permeable contact lenses that are aspheric on both surfaces (bi-aspheric) offer two advantages for keratoconus patients. The aspheric back surface helps the lenses stay centered for a more comfortable fit, and the aspheric front surface helps reduce higher-order aberrations for sharper vision, Dr. Denaeyer says.

“Piggybacking” contact lenses. This strategy involve fitting a gas permeable (GP) contact lens over the top of a soft lens. The GP lens can be specially designed to provide optimal vision for the keratoconic eye, and the underlying soft lens provides a cushioning effect for greater comfort. The soft lens also may help improve the fit of the GP lens and protect the cornea from friction caused by the GP lens that could otherwise lead to corneal scarring.

Scleral contact lenses. Specialty gas permeable lenses called scleral contact lenses are much larger in diameter than regular GP lenses so they can vault over the entire cornea and rest on the white of the eye (sclera). The large size of scleral lenses reduces pressure on the cornea and enables the lenses to stay centered, even on highly irregular keratoconic eyes.

Eye doctors who can offer their keratoconus patients all four of these contact lens strategies will help improve the fit and comfort of their contacts and help provide optimum vision, Dr. Denaeyer says.

[Ed. note: Another strategy not discussed by Dr. Denaeyer is the use of hybrid contact lenses. Essentially, the center of a hybrid contact is a gas permeable lens and the peripheral portion is a soft lens. Special hybrid lens designs are available specifically for keratoconus.]

SOURCE:  Four strategies for keratoconus. Optometric Management. January 2010.

Scleral contact lenses provide acceptable visual acuity and comfort in patients with keratoconus, according to researchers evaluating the effect of these extra-large gas permeable (GP) lenses on people with the corneal condition.

In a report published in this month’s issue of Eye & Contact Lens, researchers Muriel M. Schornack, OD, and Sanjay Patel, MD,  described the results of a study of 32 patients with keratoconus who were evaluated for scleral contact lens wear.

Of these, 12 patients (37.5 percent) decided not to be fitted with scleral lenses after an initial contact lens exam and consultation.

The remaining 20 patients (32 eyes) underwent the fitting process with Jupiter scleral contact lenses (Medlens Innovations, Front Royal, Va., and Essilor Contact Lenses, Inc., Dallas, Texas).

Mean best-corrected visual acuity (BCVA) of the keratoconic eyes prior to being fitted with the scleral lenses was 20/76, as tested on a standard eye chart. After being successfully fitted with the lenses, mean BCVA improved to 20/30.

One patient (two eyes) abandoned the fitting process because he needed cataract surgery. The remaining patients (95 percent) continued to wear the scleral lenses successfully over a follow-up period ranging from 3 to 32 months.

Scleral contact lenses differ from conventional gas permeable contacts in their size and design. Scleral lenses have a much larger diameter than regular GP lenses so they can vault over the entire clear front surface of the eye (cornea) to correct vision problems caused by severe corneal irregularities.

Researchers are developing contact lenses that darken automatically in sunlight, similar to photochromic lenses available for prescription glasses. The contacts are treated with sun-sensitive dyes that darken when exposed to ultraviolet light, which is harmful to eyes.

Earlier attempts to make photochromic contacts were few and unsuccessful. Now, researchers at the Institute of Bioengineering and Nanotechnology (IBN) in Singapore are making headway by using a contact lens material that contains a network of nano-sized tunnels that can be filled with photosensitive dyes. The structure of the flexible lens material allows the dye to react quickly and uniformly throughout the lens, according to the researchers.

Edwin Chow, IBN senior research scientist, says this technology has a faster response time than photochromic eyeglass lenses (such as Transitions lenses) currently on the market. While photochromic lenses can take minutes to fully react to light, the new photochromic contacts can respond in 10 to 20 seconds, he says.

Next the research team will test the contact lenses in animals. IBN Director Jackie Ying believes the contacts could be available commercially outside the United States within a year. Approval for use in the U.S. may take longer due to safety testing required by the Food and Drug Administration (FDA).

The study was reported this month in Technology Review, published by the Massachusetts Institute of Technology (MIT).

This week, Unilens Vision Inc. (Largo, Fla.) launched C-VUE Advanced Toric Multifocal contact lenses. These specialty lenses correct both astigmatism and presbyopia.

According to the 1999-2004 National Health and Nutrition Examination Survey (NHANES), approximately 36 percent of Americans ages 20 and older have astigmatism. Presbyopia is an age-related vision problem that affects virtually everyone some time after age 40.

Eye doctors can customize the new C-VUE Advanced Toric Multifocal lenses for their patients by specifying astigmatic and multifocal powers, multifocal zone size, lens diameter, base curve and more. The monthly disposable contact lenses also feature advanced hydration properties for all-day comfort, according to the company.

Unilens Vision Inc. offers a free trial program and a 120-day performance guarantee. The lenses are available exclusively from independent eye care professionals. Read more at www.unilens.com.

SynergEyes, Inc. (Carlsbad, Calif.) announced today that its new ClearKone hybrid contact lens for correction of vision problems associated with keratoconus is now available in the United States, Canada and Puerto Rico.

The new ClearKone lens is the second SynergEyes hybrid contact lens specifically designed for people with keratoconus — a degenerative disorder in which structural changes in the clear anterior portion of the eye cause the cornea to bulge forward into a cone shape.

Keratoconus frequently causes vision problems that cannot be corrected with conventional eyeglasses or soft contact lenses.

The company launched SynergEyes KC hybrid lenses in 2006, which have proven successful in restoring vision for certain types of keratoconic eyes. The ClearKone lens is designed to fit a much broader spectrum of cone-shaped corneas, according to the company.

Hybrid contact lenses feature a rigid, gas permeable central portion, surrounded by a ring of soft contact lens material. The lenses are designed to provide the sharp vision of gas permeable contact lenses and the all-day comfort and convenience of soft lenses, says Kellie Kaseburg, Vice President of Global Marketing for SynergEyes.

SynergEyes ClearKone and SynergEyes KC are the only FDA-approved hybrid contact lenses specifically designed for keratoconus vision correction in the United States. The company also makes hybrid contacts for the correction of nearsightedness, farsightedness and astigmatism in normal eyes.

You can learn more about SynergEyes hybrid contact lenses by visiting the company’s website.

Soon people who need to use medications frequently for eye infections, glaucoma and other health problems may be able to wear contact lenses that provide a sustained release of the medicine they need.

Researchers at Massachusetts Eye and Ear Infirmary, Harvard Medical School and Massachusetts Institute of Technology recently developed and tested prototype drug-eluting contacts with promising results. If these contact lenses are proven successful and commercially viable, they may be a more convenient and reliable drug delivery system than eye drops.

The lenses were created by coating films containing test compounds with a soft contact lens material by using ultraviolet light polymerization.

One compound tested was ciprofloxacin (or “Cipro”), an antibacterial drug with multiple applications. After a brief initial burst, the prototype drug-eluting lenses demonstrated a controlled release of Cipro for more than 4 weeks, and the lenses inhibited ciprofloxacin-sensitive Staphylococcus aureus bacteria at all time-points tested.

Though additional testing is needed, the researchers concluded that it appears contact lenses like those produced in the study could be used successfully for ocular drug delivery with widespread therapeutic applications.

The full report of the study appears in the July 2009 issue of Investigative Ophthalmology & Visual Science.

Orthokeratology, or “ortho-k,” is the fitting of specially designed gas permeable contact lenses that are worn during sleep to reduce or eliminate myopia without surgery.

Ortho-k is an alternative to LASIK surgery for nearsighted individuals who want to see clearly without glasses or contacts and are too young for laser vision correction or for some other reason are not good candidates for refractive eye surgery.

Researchers in Japan recently evaluated the reversibility of orthokeratology. Reversibility is desirable, as teenagers who undergo ortho-k may want to have LASIK surgery later, and it is important for eyes undergoing laser vision correction to be healthy and have a stable refractive error. Also, the researchers wanted to know if ortho-k causes any long-term loss of best-corrected visual acuity after the treatment is discontinued.

The study evaluated 17 nearsighted subjects who underwent ortho-k for a period of 12 months. The following measurements were taken prior to ortho-k, 12 months after commencement of the procedure, and one week and one month after ortho-k was discontinued:

• Refractive error
• Corneal topography
• Wavefront aberrometry to evaluate higher-order aberrations
• Visual acuity with a standard eye chart
• Contrast sensitivity

The study showed that  after one week of discontinuing wear of the ortho-k lenses, all measurements returned to the pre-treatment levels. The researchers concluded that orthokeratology is completely reversible, as determined by measurements of corneal shape, refractive error, visual acuity and quality of vision.

Source:  Recovery of corneal irregular astigmatism, ocular higher-order aberrations and contrast sensitivity after discontinuation of overnight orthokeratology. British Journal of Ophthalmology. February 2009.

SynergEyes, Inc. (Carlsbad, CA) recently announced it has launched its next generation hybrid contact lens design for keratoconus. The new lens, called ClearKone, has a patent-pending design that vaults the irregularities of a keratoconic cornea and restores vision to a vast majority of patients without compromising comfort or eye health, according to the company.

Hybrid contact lenses have a central zone identical to a rigid gas permeable (GP) contact lens, surrounded by a peripheral zone made of a soft contact lens material. The lenses are designed to provide the optical clarity of a GP contact lens, with wearing comfort comparable to a soft contact lens.

The design of hybrid contact lenses makes them especially suited for fitting many types of hard-to-fit eyes, including those with misshapen corneas due to conditions such as keratoconus and ectasia following LASIK or other laser vision correction surgery.

“SynergEyes recognized the need to develop a hybrid contact lens design that could fit a much broader spectrum of keratoconus patients, including oval cones, highly advanced central cones, decentered cones and, depending on the specifics of the case, globus keratoconus and pellucid marginal degeneration,” says Kellie Kaseburg, Vice President of Global Marketing for SynergEyes. “The ClearKone lens does just that and will allow many more keratoconus patients to experience the benefits of hybrid technology.”

ClearKone is currently available in limited release in the United States, Canada and Puerto Rico. The lens will be more widely available starting in September 2009. For more information, visit www.synergeyes.com.

A new company called Eyenovations in Cambridge, MA, is developing a contact lens designed to continuously release medication to the eye. The contacts would be a great alternative for glaucoma patients, who often use medicated eye drops multiple times each day. The company also believes the lenses could deliver antibiotics after eye surgery, as well as help treat several other eye conditions such as dry eye.

The concept of medicated contacts has been explored by other research groups, but they were unsuccessful in achieving extended release of the drugs. The Eyenovations team discovered how to deliver high doses of medication for up to 100 days. The hydrogel lenses have a polymer film that contains the medication, and the film and lens properties control the release rate of the medication from the contact.

The company is patenting the process and plans to develop a commercial lens that delivers drugs for up to 30 days, which is the limit for single-use contacts determined by the Food and Drug Administration. Clinical tests are expected to be under way soon.