Over my previous posts I’ve generally focused on the technical aspects surrounding what SynergEyes hybrid lenses are, why they should be included in a modern practice and how they can improve patient outcomes and your business. We’ve also looked at some of the myths that still hang on from the past which no longer apply to a modern hybrid lens.
It is time we moved on from the “what, why and how” and have look at some real cases that have crossed my desk from colleagues who have been fitting hybrid lenses for, in some cases, many years.
This month we’ll look at a regular astigmatic patient. These people have the potential to cost you a fortune in chair time if you fit with the usual first choice lenses, whereas, as I indicated in my past newsletters, fitting empirically with a hybrid could mean they are out of your door, delighted, within one to two appointments…
Although this patient is presbyopic, she had several other issues including macula changes and dry eyes. She wanted to be specs free for some of the time but had not had success with any other lenses. It was felt that going for the best distance we could achieve would work better than the EDOF version of this lens.
Prescription details and lenses supplied:
R. -12.00 / -4.00 x 17 6/15
HVID 11.63 BVD 12mm
L. -12.00 / -5.50 x 165 6/15
HVID 11.41. BVD 12mm
The lenses supplied were SynergEyes iD (Single vision)
R. BOZR / Skirt / Power
7.84 / 44 / -12.50 / EP*
L. BOZR / Skirt / Power
7.87 / 43 / -12.50 / EP*
There was negligible residual astigmatism in the RE but -1.18DC in the LE (once the powers were adjusted for BVD).
After checking with the practitioner regarding the residual astigmatism in the LE we proceeded. The macular changes were more advanced in the LE and the increased stability of vision would be beneficial over alternatives already tried.
*EP is enhanced profile, used for higher levels of astigmatism to stop flexure.
Results with SynergEyes iD
At collection the lenses centred well, and vision seemed good with the RE achieving 6/12, an improvement on her spectacle Rx and LE 6/15 – so only slightly down. She did have a slight sensation of the lens in her RE but not what could be described as discomfort.
At the one week check, the VA’s remained as before as did the sensation in the RE. The right lens was replaced free under the guarantee with a skirt one step steeper (45), and this resolved the problem with the lens now completely comfortable.
What is also interesting to see in the pictures below is how well these lenses centre and even with a temporal pinguecula, the skirt wraps happily over the area without causing issues to the patient or compromising the lens fit.
What could have been a lengthy process of fitting a custom soft toric has been managed with an empirically fitted lens that will give stable consistent vision with no rotational issues.
With thanks to Beth Ralph FBDO CL MBCLA, Elliott & Heath Opticians for providing the case, pictures etc.
Next time we will look at what happens when we fit the Extended Depth of Focus (EDOF) version of this lens to an astigmatic presbyope.
If you have any questions or are keen to introduce these innovative lenses, that are not available on the internet, in your practice or would like some advice, contact us on firstname.lastname@example.org.