August 23, 2023
We’ve heard for years that dryness, discomfort, and vision are the major reasons for contact lens drop out,1 but I always thought “not in my practice.” Then I started asking about late day comfort and vision and realized that even though we have great lenses, a lot of patients still suffer. ACUVUE OASYS MAX 1-Day Contact Lenses, in my opinion, have taken what was already a high bar for ACUVUE products and raised it another notch, and my practice and patients have benefitted from this.2
The latest contact lens offering from Johnson & Johnson Vision Care, Inc., ACUVUE OASYS MAX 1-Day and ACUVUE OASYS MAX 1-Day MULTIFOCAL Contact Lenses, are designed to help meet the changing demands of today’s digital lifestyles by combining various technologies into the lens: TearStable Technology and OptiBlue Light Filter, along with PUPIL OPTIMIZED DESIGN in the multifocal lens. TearStable Technology is designed to help maximize tear-film stability and lock in moisture,3,4 while the OptiBlue light filter filters 60% of blue-violet light.† Like previous ACUVUE OASYS lenses, ACUVUE OASYS MAX 1-Day lenses also offer Class 1 UV-Blocking, but due to the chromophore, the exact percentages are now even higher at 99.9% of UVA rays and 100% of UVB rays.‡^5,6 The unique PUPIL OPTIMIZED DESIGN is the same across all ACUVUE Multifocal contact lenses, tailoring 100% of its parameters to pupil size variations across both age and refraction,**7 helping MAX Multifocal to provide crisp, clear vision at all distances and in all lighting conditions.8
I was surprised by what an impact this lens has had on my practice and how much demand there has been. These lenses have been fulfilling unmet needs in my practice. Below are my tips for introducing this lens to patients, how to talk about the technology, and fitting strategies that have led to patient satisfaction.
Lens Technology, Innovation, and Fulfilling Unmet Need
I think it’s important to recognize that contact lenses aren’t a traditional product, but instead they are a needs-based solution that can help patients achieve their goals. I’m excited about any contact lens with technology that can help it deliver exceptionally clear, comfortable vision throughout the day, in a variety of lighting conditions. When it comes to lens technology, I try not to overwhelm patients with details, but instead I talk about how the technology contributes to a lens that can meet their unique needs. For patients who want to learn about the innovation that makes blue-light filtering† possible, I’m happy to share the details, but I find that many of my patients care more about understanding how the lens will benefit them. So, I discuss how MAX can reduce light scatter,+9 block UV,‡^5,6 and deliver all-day comfort.4 When discussing lenses with patients, I like to say, “This is what I believe is best for your eyes and what I think you should be wearing to achieve your goals.” Then I let them ask questions.
Comfort and Dropout
Whether we like it or not, we are living in a world where nearly all patients look at screens. Data tells us that the average U.S. adult spends in excess of 13 hours in front of digital devices.10 As optometrists, we know that the use of digital devices results in a 60% reduction in blinking.11 And, when we blink less, the result can be a compromised tear film due to the reduction of our lipid layer.11 Additionally many of these patients may also be dealing with light scatter from computers, windows, and phones.
We know that when it comes to contact lens dropout in established wearers, dryness and discomfort are the most commonly cited reasons,12,13 but patients drop out of contact lenses for a variety of reasons. I find that it is mostly because their needs weren’t met, and we need to ask patients, “Why?”. Maybe it was dryness, difficulty with putting the lenses on or taking them off, or even that they just didn’t see as well as they wanted to. Sometimes it takes a bit of handholding, but I believe it’s our job to let them know about innovations that might make a significant difference in their contact-lens-wearing experience.
I’ve taken an approach in my practice of discussing and offering a trial of ACUVUE OASYS MAX 1-Day to patients who have previously dropped out of lenses for one reason or another and have received gratitude and appreciation from those patients that were able to finally get back into contact lens wear.
My optical shop has been suggesting blue-light filtering optical products for some time, so having access to this type of technology in a contact lens has been well received by my patients. It has been easy to introduce this lens to my patients, since many of them are already accustomed to wearing and are genuinely interested in blue-violet light filtering† products. What I typically tell patients is there is now a contact lens on the market that offers blue-violet light filtering.† This has been an easy way for me to introduce the lens to patients, and what has surprised me is how excited patients are, especially moms, who want blue-violet light filtering for their children.
When it comes to my multifocal contact lens wearers, this lens has made an immediate impact on these patients. Part of what makes this lens so good in my opinion is the unique PUPIL OPTIMIZED DESIGN approach. We know that pupil size changes according to age and refractive error,13 so having an optical approach that leverages this can result in a lens that maintains the distance-to-near ratio even as the pupil size changes.
In my experience, PUPIL OPTIMIZED DESIGN makes it easier to successfully fit more presbyopes.^^14 I achieve great fit success just using my vertexed correction and the simple fit guide.***15,16 I don’t have to remember to apply any additional changes or “fudge factors,” which helps me to manage chair time and patient experience.
In addition to suffering from blurring near vision, trouble driving at night, or focusing from near to far and far to near, in my clinical experience, many of my presbyopes suffer with symptoms of contact lens dryness, and that is another area of need where this lens has filled a void.
When introducing this lens to my presbyopes, I tell them that in my opinion, these lenses deliver superior near and intermediate vision without compromising distance, and they are exceptionally comfortable,8 and I go on to discuss TearStable technology, which is designed to help maximize tear-film stability and designed to lock in moisture for all-day comfort. After all, patients are looking to me to understand new lenses and technologies and how they will benefit them and ultimately make those recommendations to improve their lifestyles and fulfill their needs.
I’ve actually had presbyopic patients purchase this lens in the chair. It wasn’t, “Let me think about it.” It was, “I want this lens. It is so incredibly comfortable.”
Experiencing how easy these lenses were to fit17 and that immediate wow factor from patients has also helped me gain confidence when presenting this lens to other presbyopes, and it has truly been a game changer for my patients and my practice.
Quick Tips on Fitting and Presenting the ACUVUE OASYS MAX 1-Day Lenses
- Ask your patient targeted questions to understand their unique visual needs.
- Discuss the UV filtering‡^ the lens offers and its importance.
- Educate about blue-violet light.
- When fitting your presbyopes, use the digital fitting calculator designed for ACUVUE MULTIFOCAL Contact Lenses to avoid common missteps.**** It also makes suggestions on how to proceed if I need to optimize for improved near or distance vision.
- For multifocal patients, introduce the lens by talking about how the lens is engineered for clear, comfortable vision at all distances.8
- If a presbyope has dropped out of contact lens wear due to vision or discomfort, offer a free* trial pair to see if this might be a solution.
- If a patient is content with their current lens, mention that lens technology is continuing to evolve, and that they might be surprised by new advancements.
- If a patient has multiple needs for a lens, don’t hesitate to provide boxes with slightly different prescriptions for different activities (i.e. looking at a screen vs. an activity that requires clear distance vision).
- Train your staff so that every touchpoint a patient has with your practice is consistent and encouraging.
- Don’t overcomplicate your conversations. Explain to patients why you believe this lens is a solution to their vision challenges. Then, invite them to ask questions.
* Free trial lenses available from participating eye doctors. Exam and fitting fees not included.
** Compared to competitor’s designs, technology optimized for both the parameters of refractive error and add power.
*** Four total lenses
**** Disclaimer: The Calculator is provided to clinicians for educational and convenience purposes only, in conjunction with the labeling for 1-DAY ACUVUE MOIST and ACUVUE OASYS MULTIFOCALS. Johnson & Johnson Vision Care, Inc. does not engage in the practice of prescribing, and this Calculator is not a substitute for appropriate professional education and training or for the exercise of independent professional judgment. Johnson & Johnson Vision Care, Inc. cannot warrant the accuracy or completeness of information that this Calculator provides. Each clinical situation should be considered unique to each patient, and all treatments individualized accordingly. Johnson & Johnson Vision Care, Inc. does not endorse or recommend any particular technique beyond what is contained in the product labeling, and other techniques may be appropriate in a clinician’s judgment.
† Filtering of HEV light by contact lenses has not been demonstrated to confer any health benefit to the user, including but not limited to retinal protection, protection from cataract progression, reduced eye strain, improved contrast, improved acuity, reduced glare, improved low light vision, or improved circadian rhythm/sleep cycle. The Eye Care Professional should be consulted for more information.
‡ Helps protect against transmission of harmful UV radiation to the cornea and into the eye.
+ Versus ACUVUE OASYS 1-Day.
^WARNING: UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. You should continue to use UV-absorbing eyewear as directed. NOTE: Long-term exposure to UV radiation is one of the risk factors associated with cataracts. Exposure is based on a number of factors such as environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV-blocking contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other eye disorders. Consult your eye care practitioner for more information.
^^ The U.S. and U.K. data has been weighted based on incidence of contact lens wearers in both of these markets.
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1. Rueff EM, Varghese RJ, Brack TM, Downard DE, Bailey MD. A Survey of Presbyopic Contact Lens Wearers in a University Setting. Optom Vis Sci. 2016 Aug;93(8):848-54. doi: 10.1097/OPX.0000000000000881. PMID: 27232896.
2. JJV Data on File 2022: Master Brand Claims on Clinical Performance and Overall Material Properties for ACUVUE Brand Soft Contact Lenses.
3. JJV Data on File 2022. TearStable Technology Definition.
4. JJV Data on File, 2022. CSM Subjective Responses ACUVUE OASYS MAX 1-Day Contact Lenses- Retrospective Meta-analysis.
5. JJV Data on File 2022. Material Properties: 1-DAY ACUVUE MOIST, 1-DAY ACUVUE TruEye, ACUVUE OASYS 1-Day with HydraLuxe Technology and ACUVUE OASYS MAX 1-Day with TearStable Technology Brand Contact Lenses and other daily disposable contact lens brands.
6. JJV Data on File 2022: Master Brand Claims on Clinical Performance and Overall Material Properties for ACUVUE Brand Soft Contact Lenses.
7. JJV Data on file 2022. CSM- ACUVUE PUPIL OPTIMIZED DESIGN Technology: JJVC contact lenses, design features, and associated benefits.
8. JJV Data on File 2022: Subjective Stand-Alone Claims for ACUVUE OASYS MAX 1-Day MULTIFOCAL Contact Lenses —Exploratory Meta-analysis.
9. JJV Data on File 2022. Effect on Tear Film and Evaluation of Visual Artifacts of ACUVUE OASYS MAX 1-Day Family with TearStable Technology.
10. Tsubota K, Nakamori K. Dry eyes and video display terminals. N Engl J Med. 1993;328(8):584. doi:10.1056/NEJM199302253280817.
11. Patel S, Henderson R, Bradley L, et al. Effect of visual display unit use on blink rate and tear stability. Optom Vis Sci 1991;68(11):888-892. doi: 10.1097/00006324-199111000-00010.
12. Young G et al. A multi-centre study of lapsed contact lens wearers. Ophthal Physiol Optics 2002;22:516-27.
13. JJV Data on file 2022. CSM ACUVUE PUPIL OPTIMIZED DESIGN Technology: JJVC contact lenses, design features, and associated benefits.
14. JJV Data on File 2022: Stand-Alone Fit Success Claims for ACUVUE OASYS MAX 1-Day MULTIFOCAL Contact Lenses.
15. JJV Data on File 2020. ACUVUE OASYS MULTIFOCAL Fit and Performance Claims.
16. Dumbleton K, Woods CA, Jones LW, et al. The impact of contemporary contact lenses on contact lens discontinuation. Eye & Cont Lens 2013;39:93-9.
17. JJV Data on File 2020. ACUVUE OASYS MULTIFOCAL Fit and Performance Claims.
Important Safety Information: ACUVUE Contact Lenses are indicated for vision correction. As with any contact lens, eye problems, including corneal ulcers, can develop. Some wearers may experience mild irritation, itching, or discomfort. Lenses should not be prescribed if patients have any eye infection or experience eye discomfort, excessive tearing, vision changes, redness, or other eye problems. Consult the package insert for complete information. Complete information is also available from Johnson & Johnson Vision Care, Inc. by calling 1-800-843-2020, or by visiting www.jnjvisionpro.com.
Disclaimer: Patricia Poma, OD, is currently a partner in a successful, five-doctor practice in Bloomfield, Mich., as well as a consultant for Johnson & Johnson Vision Care, Inc.