Alcon launches TOTAL30, a revolutionary daily disposable multifocal lens, addressing presbyopia with exceptional comfort and vision correction․ This guide details fitting procedures․
Fitting aging eyes requires a nuanced approach, and TOTAL30 offers a solution for patients seeking both clear distance and near vision in a daily disposable format․
This introduction sets the stage for a comprehensive understanding of the Daily Total One Multifocal fitting process, ensuring optimal patient outcomes and satisfaction․
What are Daily Total One Multifocal Contact Lenses?
Daily Total One Multifocal lenses are silicone hydrogel daily disposable contact lenses designed to correct presbyopia – the age-related loss of near vision․ These lenses feature Alcon’s unique Water Gradient Technology, creating a lens with a high water content at the surface for exceptional comfort․
Unlike traditional multifocal designs, TOTAL30 utilizes a progressive addition design, providing a smooth transition between distance, intermediate, and near vision․ The lenses are made from Neurofilcon A material, known for its breathability and ability to retain moisture․ This technology aims to minimize end-of-day dryness and discomfort, offering a consistently comfortable wearing experience throughout the day․
They are intended for daily wear and disposal, promoting optimal hygiene and reducing the risk of complications associated with extended wear․
The Growing Need for Multifocal Daily Disposables
The demand for multifocal daily disposable contact lenses is rapidly increasing, driven by the aging global population and a growing desire for convenient vision correction․ Presbyopia affects a significant portion of the population over 40, creating a substantial market for multifocal solutions․
Patients are increasingly seeking the convenience and hygiene of daily disposables, minimizing the need for cleaning and reducing the risk of infection․ TOTAL30 addresses this need by offering a comfortable, healthy, and easy-to-use option for presbyopic patients․
Furthermore, advancements in lens technology, like Alcon’s Water Gradient, are enhancing the performance and comfort of multifocal daily disposables, making them a compelling alternative to glasses․
Understanding the Patient
Successful multifocal fitting hinges on a thorough patient assessment, including detailed history, refraction, and corneal evaluation to tailor the TOTAL30 lens․
Comprehensive Patient History
A detailed patient history is paramount before initiating a Daily Total One Multifocal fitting․ Inquire about the duration of presbyopia, prior contact lens wear (including successes and failures), and any ocular surface disease symptoms like dryness or allergies․
Understand the patient’s visual demands – near, intermediate, and distance work, as well as hobbies and lifestyle․ Crucially, document any systemic health conditions like diabetes or autoimmune diseases, and current medications, as these can impact contact lens comfort and fit․
Specifically, ask about visual complaints, such as glare, halos, or difficulty with specific tasks․ This information guides lens selection and ensures realistic expectations․
Refraction and Visual Needs Assessment
Perform a thorough refraction, including distance and near visual acuity, with and without correction․ Monocular and binocular refraction are essential to understand the patient’s true refractive error and potential add power needs․
Assess accommodative amplitude and facility to gauge the patient’s ability to focus at near․ Determine the patient’s preferred reading distance and intermediate working distance․
Question the patient about specific visual tasks and challenges – computer use, reading, driving – to tailor the lens design and power to their lifestyle․ Document all findings meticulously to inform the initial lens selection․
Corneal Topography and Evaluation
Corneal topography is crucial for assessing corneal health and identifying any irregularities that may impact lens fit and visual performance․ Evaluate corneal astigmatism, as it influences multifocal lens design and power selection․
Assess corneal diameter to aid in determining appropriate lens diameter․ Look for signs of dryness, staining, or other corneal abnormalities that may contraindicate contact lens wear․
Record the K-readings accurately, as these values are fundamental for initial lens selection․ A healthy cornea is paramount for successful multifocal lens fitting and long-term comfort․
Fitting Philosophy & Parameters
Prioritize patient comfort and visual acuity, utilizing a diagnostic lens approach․ Precise refraction and corneal data guide initial parameter selection for optimal results․
Initial Lens Selection: Power and Base Curve
Begin with the patient’s most recent spectacle prescription, converting to contact lens power using standard conversion tables․ For established contact lens wearers, start with their current power as a baseline․ Consider the patient’s add power; a lower add may necessitate a slightly stronger distance power․
Base curve selection is crucial for optimal fit and comfort․ TOTAL30 is available in a limited range of base curves; typically, a steeper base curve is preferred for plus powers and a flatter base curve for minus powers․ Evaluate corneal topography to guide base curve selection, especially in cases of astigmatism or irregular corneas․ A well-fitted base curve ensures proper lens centration and minimizes complications․
Diameter Considerations
Lens diameter significantly impacts comfort and centration․ TOTAL30 multifocal lenses are offered in a limited diameter range, generally suitable for most corneas․ Assess the patient’s pupillary diameter in both photopic and mesopic conditions; the lens diameter should provide adequate coverage of the pupil in all lighting environments․
Observe for decentration, especially during primary gaze and dynamic movements․ A lens that is too small may decentrate nasally, while a lens that is too large can cause edge lift and discomfort․ Consider corneal diameter measurements to refine diameter selection, ensuring optimal lens stability and minimizing dry eye symptoms․
ADD Power Selection Guidelines
ADD power selection is crucial for successful multifocal lens fitting․ Start with the patient’s reading addition, typically determined from their spectacle prescription․ Consider their visual demands; near-intensive tasks may require a slightly higher ADD power․ Utilize a monocular fitting approach initially, assessing near vision acuity at various ADD powers․
Employ a trial lens set to fine-tune the ADD power, aiming for clear and comfortable near vision without compromising distance acuity․ Remember that binocular balance is essential; adjust ADD power in each eye to achieve symmetrical vision and minimize asthenopia; Document all ADD power trials and patient responses․
The Fitting Process
Begin with trial lens insertion, evaluating visual acuity at distance and near․ Refine the fit subjectively, prioritizing patient comfort and clear vision at all distances․
Trial Lens Insertion and Evaluation
Begin by thoroughly explaining the trial lens process to the patient, emphasizing the importance of honest feedback regarding comfort and vision quality․ Insert the selected trial lenses, ensuring proper handling and allowing sufficient time for adaptation – typically 10-15 minutes․
Assess distance visual acuity first, followed by intermediate and near vision․ Utilize a standardized distance chart and a near addition chart at the typical reading distance․ Inquire about any visual disturbances, such as halos or glare, and note any lens awareness or discomfort․ Observe lens centration, movement, and overall fit on the cornea․
Record all findings meticulously, as this data will be crucial for subsequent refinements and adjustments during the fitting process․ Encourage the patient to perform their usual daily activities while wearing the trial lenses to simulate real-world conditions․
Subjective Refinement
Following the initial trial lens evaluation, subjective refinement is paramount․ Present the patient with a spherical power over-refraction chart, asking them to identify the clearest power for distance․ Repeat this process for near vision, utilizing a near addition chart․
Employ a binocular balancing technique to ensure equal clarity between both eyes at all distances․ Consider small adjustments to ADD power if the patient reports difficulty with intermediate vision or experiences eye strain․ Listen attentively to the patient’s preferences and concerns․
Document all changes made and the patient’s responses, guiding you towards the optimal prescription for comfortable and clear vision․
Binocular Vision Assessment
A thorough binocular vision assessment is crucial when fitting multifocal contact lenses․ Evaluate cover testing at distance and near to identify any phorias or tropias․ Assess fusional ranges to determine the patient’s ability to maintain single binocular vision under stress․
Check stereopsis using a stereo fly test or similar method, as reduced stereopsis can impact depth perception․ Investigate accommodative function to ensure adequate accommodation for near tasks․ Address any binocular vision anomalies before finalizing the prescription․
Proper binocular function ensures comfortable and efficient vision with Daily Total One Multifocal lenses․
Troubleshooting Common Fitting Challenges
Addressing issues like over-minus, under-minus, or ADD power discrepancies is vital for successful Daily Total One Multifocal fitting․ Careful adjustments optimize vision and comfort․
Over-Minus/Under-Minus Issues
Identifying over-minus or under-minus presentations is crucial during Daily Total One Multifocal fitting․ Over-minus often presents as blurry distance vision with a comfortable near, while under-minus yields comfortable distance but struggles with near tasks․
Consider a slight power reduction for over-minus, and a power increase for under-minus․ Evaluate lens centration and movement; excessive movement can exacerbate these issues․ A thorough refraction, including monocular and binocular assessments, is essential․
Remember that patient feedback is paramount․ Subjective refinement, guided by the patient’s visual experience, will lead to optimal correction․ Diagnostic sets can aid in pinpointing the precise power adjustment needed for clear and comfortable vision․
ADD Power Adjustments
Fine-tuning the ADD power is vital for Daily Total One Multifocal success․ Start with the patient’s estimated ADD, then adjust based on subjective responses․ Incremental changes – typically 0․25D steps – are recommended for optimal comfort and clarity․
Monitor for symptoms like excessive accommodation or blur at intermediate distances․ If the patient reports difficulty with digital devices, a slight reduction in ADD power may be beneficial․ Conversely, struggling with reading may necessitate an increase․
Utilize a dynamic ADD power assessment, varying the task distance to pinpoint the ideal ADD for the patient’s lifestyle․ Remember binocular balance is key; adjustments should be made symmetrically unless clinically indicated otherwise․
Lens Centration and Movement
Optimal lens centration and movement are crucial for Daily Total One Multifocal performance․ Assess centration in all gazes – distance, intermediate, and near – ensuring the lens remains well-centered without excessive decentration․
Evaluate lens movement during blinks and primary gaze․ Adequate movement (1-2mm) promotes tear exchange and comfort, while minimal decentration ensures consistent vision correction․ Excessive movement can indicate a poor fit or incorrect parameters․
Consider lid tension and corneal topography when assessing centration․ Adjust diameter or base curve if necessary to achieve optimal centration and movement, maximizing visual acuity and patient comfort throughout the day․
Lens Care and Patient Education
Emphasize proper handling, insertion, and the critical importance of daily lens replacement with Daily Total One Multifocal lenses for optimal eye health and comfort․
Proper Handling and Insertion Techniques
Instruct patients to always wash and thoroughly dry hands before handling lenses, avoiding soaps containing lotions or oils․ Open the blister pack carefully, avoiding damage to the lens․ Gently place the lens on the tip of the index finger, ensuring correct orientation – it should resemble a small bowl․
Use the other hand to gently pull up the upper eyelid and hold it steady, then look straight ahead while using the middle finger of the lens-holding hand to pull down the lower eyelid․ Slowly and gently place the lens onto the colored part of the eye․ Release the eyelids slowly and blink a few times to ensure proper centering․
Remind patients to avoid using tap water for rinsing or storing lenses, and to never reuse lenses․
Daily Lens Replacement Importance
Emphasize to patients that Daily Total One Multifocal lenses are designed for single-use only and must be discarded after removal, even if they feel comfortable․ Reusing lenses significantly increases the risk of microbial contamination, leading to potentially serious eye infections like keratitis․
Daily disposables provide a fresh, clean lens every day, minimizing deposit buildup and maximizing oxygen permeability for optimal corneal health․ This routine promotes superior comfort and reduces irritation․
Reinforce the benefits of daily replacement – convenience, hygiene, and reduced risk – to encourage consistent compliance and long-term eye health․
Signs and Symptoms of Complications
Educate patients to immediately remove lenses and seek professional care if they experience redness, pain, blurred vision, excessive tearing, or light sensitivity․ These symptoms could indicate corneal inflammation, infection, or other adverse reactions․
Explain that any discomfort, even mild, should be reported promptly․ Delayed treatment can lead to more severe complications․ Emphasize the importance of avoiding lens wear during illness or when experiencing eye irritation․
Instruct patients to discontinue lens wear and consult an eye care professional if they notice any unusual discharge or foreign body sensation․ Early detection is crucial for successful management․
Advanced Fitting Techniques
Diagnostic sets are vital for refining fits, especially with astigmatism or post-refractive surgery patients, optimizing vision and comfort with TOTAL30 lenses․
Using Diagnostic Sets Effectively
Diagnostic lens sets are crucial for successful TOTAL30 Multifocal fittings, allowing precise adjustments beyond standard parameters․ Utilize a comprehensive set encompassing varying powers, ADD values, and potentially toric options․ Begin with the initial fitting parameters, then systematically evaluate visual acuity at distance, intermediate, and near․
Over-refraction is key; small adjustments can significantly impact clarity․ Assess binocularity throughout the process, noting any induced astigmatism or compromise in stereopsis․ Carefully document each trial, recording patient feedback and objective measurements․ This iterative approach ensures a personalized and optimized lens fit, maximizing comfort and visual performance with TOTAL30․
Managing Astigmatism with Multifocal Lenses
Astigmatism presents a unique challenge in multifocal contact lens fitting․ TOTAL30 Multifocal offers limited toric power options; therefore, careful assessment is vital․ Low levels of astigmatism may be corrected with the spherical equivalent, while higher amounts necessitate consideration of hybrid or custom lenses․
Evaluate corneal topography to understand astigmatic axis and magnitude․ Trial lenses with varying ADD powers and astigmatic correction should be utilized․ Monitor for induced astigmatism during the fitting process․ Prioritize clear vision and comfort, balancing astigmatic correction with multifocal functionality for optimal visual outcomes․
Fitting Post-Refractive Surgery Patients
Post-refractive surgery patients often exhibit altered corneal topography and reduced corneal sensitivity, demanding a specialized fitting approach․ TOTAL30 Multifocal can be a viable option, but careful consideration is crucial․ Assess the patient’s residual astigmatism and higher-order aberrations using corneal topography․
Start with a spherical power based on the patient’s refraction, and minimize the ADD power․ Monitor for dryness and discomfort due to reduced corneal sensitivity․ Frequent follow-ups are essential to refine the fit and ensure optimal vision and comfort, addressing any unique challenges presented by their surgical history․
Alcon’s TOTAL30 Multifocal Technology
TOTAL30 utilizes Water Gradient Technology and Neurofilcon A material, alongside Smarthydrate™, for exceptional comfort and oxygen permeability, enhancing the multifocal experience․
Water Gradient Technology Explained
Alcon’s innovative Water Gradient Technology mimics the natural hydration of the cornea, transitioning from a high water content at the surface to lower content within the core․
This unique design minimizes friction during blinking, providing exceptional comfort throughout the day․ The lens maintains a high level of hydration where it matters most – at the ocular surface – reducing dryness and irritation․
This technology supports optimal lens performance and a consistently comfortable wearing experience, crucial for successful multifocal lens adaptation, especially for presbyopic patients․
The gradient also contributes to enhanced oxygen permeability, promoting overall eye health․
Neurofilcon A Material Benefits
Neurofilcon A, the material composing TOTAL30 lenses, is a silicone hydrogel specifically engineered for exceptional comfort and breathability․ It boasts a high oxygen permeability, exceeding many conventional materials, supporting corneal health during extended wear․
This material’s unique properties allow for a smoother lens surface, reducing deposit build-up and enhancing wettability․ This translates to reduced discomfort and clearer vision throughout the day for multifocal lens wearers․
Neurofilcon A contributes significantly to the overall wearing experience, promoting patient satisfaction and compliance with daily disposable wear․
It’s a key component of the TOTAL30 lens’s superior performance․
Smarthydrate™ Technology and Comfort
Smarthydrate™ technology, integral to TOTAL30 lenses, maintains a high water content throughout the lens’s lifespan, even as the day progresses․ This innovative approach prevents dehydration, a common source of discomfort in contact lenses․
The technology leverages a water gradient, with the highest water content at the surface, mimicking the natural hydration of the cornea․ This ensures consistent wettability and reduces friction during blinking, enhancing comfort․
Smarthydrate™ contributes to a remarkably smooth lens surface, promoting all-day comfort and minimizing end-of-day dryness, crucial for multifocal wearers․
It’s a key differentiator for TOTAL30․
