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Specialty Contact Lenses For Presbyopia

As we get older our vision starts to change. Between the ages of 40 and 50, almost all people develop presbyopia (age-related farsightedness), which makes nearby objects appear blurry.

Reading glasses used to be the only option for contact lens wearers with presbyopia who wanted to perform tasks that require good near vision such as reading a book or menu.

Nowadays, several specialty contact lenses offer patients with presbyopia clear near and distance vision for ultimate visual comfort and convenience.

Contact Lenses for the Farsighted

Monovision

This is a vision correction technique in which the contact lens in one eye corrects for distance vision and the other eye for near vision. Basically, each lens has a different prescription.

Scleral Lenses

Scleral contacts are large-diameter gas-permeable contact lenses that vault over the entire corneal surface and rest on the white part of the eye (sclera) instead of the cornea.

Scleral contacts can also be designed as multifocal contacts for presbyopic patients to correct both farsightedness and nearsightedness. When compared to regular multifocal lenses, scleral lenses are firmly positioned on the eye, offering substantially better stability and comfort.

Multifocal

Patients who wear multifocal contact lenses are able to see at all distances without sacrificing depth perception. Those who participate in outdoor activities, use the computer regularly or don’t like using reading glasses to view their smartphone, tablet, or newspaper might consider multifocal contact lenses.

There are two basic types of multifocal contact lenses: simultaneous vision design and segmented vision design.

1. Simultaneous vision design – Concentric rings of distant and near powers encircle a primary viewing zone in the lens’s center. The central viewing zone is typically used to view distant things, although there are also center-near designs. Under other circumstances, the dominant eye is fitted with a center-distance design, whereas the non-dominant eye is fitted with a center-near design. These multifocal contacts are similar to concentric multifocal lenses, but instead of discrete rings of distance and near power encircling the lens’s center, the multifocal lens power gradually changes from distance to near (or near to distant) from the lens’s center to the periphery. Aspheric multifocal contact lenses are similar to progressive eyeglass lenses in this way.

2. Segmented vision designs – Bifocal and trifocal eyeglass lenses have a similar design to segmented multifocal contact lenses. The upper and center zones of the lens feature a zone for distant vision, while the lower half of the lens has a zone for near vision. A noticeable line in the lenses separates the distant and near zones.

These contact lenses are made of rigid gas permeable (GP) contact lens material. These lenses have a smaller diameter than soft contact lenses and rest above the edge of the lower eyelid on a layer of tears. A segmented multifocal contact lens stays in place as your look shifts downward for reading or seeing close objects, allowing you to see through the lower, near-correction part of the lens.

Rigid gas-permeable (RGP)

RGP contact lenses are composed of rigid silicone polymers that allow oxygen to pass through the cornea. Unlike soft contact lenses, they hold their shape and can often provide clearer vision than soft lenses.

Orthokeratology

Orthokeratology, also called ‘ortho-k’ lenses, are lenses that are worn overnight to reshape the cornea. Ortho-k can be used to correct both eyes for distance vision and be used as monovision and multifocal vision.

If you have presbyopia and are looking into your contact lens options, contact Family Eye Care to learn more about which specialty contact lenses are right for you.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
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Call Us 844-450-6850

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Scleral Contact Lenses for Sjogren’s Syndrome

What Is Sjogren’s Syndrome?

Sjogren’s syndrome is an autoimmune disease that causes extreme dryness that affects much of the body, including the eyes. In addition to dryness of the mucous membranes, Sjorgren’s syndrome can cause pain, exhaustion, nerve damage and blood cancer.

About 4 million Americans have the disease, 90% of them women. An additional 3 million may be living with the disease without knowing it, according to the Sjogren’s Syndrome Foundation. In fact, an estimated 1 in 10 patients with dry eye symptoms have Sjogren’s syndrome.

Why Sjogren’s Syndrome Causes Dry Eyes

Individuals with the syndrome have inflammation of the lacrimal glands, which causes them to produce a lower quantity of tears. Lower tear volume means that irritants that would ordinarily be washed away by tears remain on the ocular surface, leading to inflammation, irritation and, if left untreated, corneal scarring.

Many individuals with Sjogren’s syndrome also have other autoimmune diseases, such as lupus, celiac disease or rheumatoid arthritis.

Eye Symptoms Related to Sjogren’s Syndrome

In those with Sjogren’s syndrome, having dry eyes is a given.

dizzyOther common symptoms include:

  • Burning eyes
  • Sensitivity to light
  • Blurry vision
  • Eye strain and fatigue
  • Blepharitis – an inflammation of the eyelids
  • Discomfort while wearing regular contact lenses

How Is Sjogren’s Syndrome Diagnosed?

Because the symptoms are varied and develop gradually, it can take several years for those with Sjogren’s syndrome to be diagnosed with the disease.

However, eye doctors are often the first to suspect the condition since dry eyes are a key symptom of the disease.

After taking your medical history and providing a thorough eye exam, your eye doctor may perform the Schirmer’s test to see whether your tear glands are working properly.

During the test, the eye doctor will place special paper inside your lower eyelids while you keep your eyes closed for a few minutes. Once the paper is removed, the doctor will measure the amount of liquid on the paper.

Another test, which uses dye to make your tears more visible, measures how quickly your tears evaporate.

How Scleral Lenses Alleviate Dry Eyes

Individuals with dry eye syndrome, whether caused by Sjorgren’s syndrome or another condition, often complain that traditional contact lenses irritate their eyes. That’s because traditional contacts dry out easily and compensate by drawing moisture away from the eye.

Scleral lenses, which are gas-permeable, do the exact opposite. They form a protective dome over the cornea that conserves saline solution. The solution acts as a liquid buffer between the lens and the cornea’s surface. That, in turn, alleviates the irritation, itchiness and redness that are the hallmarks of dry eye.

Due to their larger diameter and custom fit, scleral lenses don’t move around as much as conventional lenses. This boosts visual acuity and reduces irritation.

If your eyes feel parched and gritty, contact Dr. Moshe Roth and Dr. Steffani Tiomno for a comprehensive eye exam to determine whether you have dry eye syndrome and to discuss whether your symptoms could be due to Sjorgren’s syndrome.

Call the Family Eye Care today to schedule your consultation.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.

References:

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Scleral Lenses for Giant Papillary Conjunctivitis (GPC)

Giant Papillary Conjunctivitis (GPC) is an inflammatory reaction that occurs on the eyelids when proteins are secreted in your tears. These proteins then form a filmy coating on contact lenses that not only makes wearing them uncomfortable but also irritates the eyelids, causing an inflammatory reaction.

In the initial phase of the condition, the inside of your eyelid may become red, itchy, swollen and irritated, but as time goes on, bumps (also called papillae) will develop, occasionally growing to the size of a pimple. GPC can thus make wearing contact lenses irritating and uncomfortable.

Fortunately, GPC isn’t permanent. Wearing scleral lenses not only reduces GPC’s effects but, unlike other lenses, can prevent a recurrence. If you suspect that you have GPC or are simply interested in seeing whether scleral lenses are right for you, speak with Dr. Moshe Roth and Dr. Steffani Tiomno today.

What Causes GPC?

  • Wearing certain types of contact lenses heightens the risk of developing GPC
  • Protein deposits or other substances on the contact lenses
  • A contact lens, artificial eye, or exposed stitches that rub against the lower eyelid
  • An allergic reaction to either contact lenses or their cleaning products
  • Asthma, hay fever, or other allergies coupled with the use of contact lenses

Can People With GPC Wear Contact Lenses?

Yes. However, those with GPC have more difficulty finding a contact lens that doesn’t further exacerbate the irritation.

Gas permeable (GP) lenses, such as scleral lenses, are highly recommended since proteins don’t accumulate on GP lenses the way they do on soft lenses. This ensures that gas permeable lenses remain cleaner and are therefore less likely to cause an inflammatory reaction.

Another alternative is daily disposable lenses, as they are discarded after a single day of wear. This prevents protein deposits from accumulating on the lenses.

Monthly soft lenses tend to retain protein deposits over time, no matter how well they’re cleaned on a daily basis.

Scleral Lenses for GPC

Due to their large size, scleral lenses are more stable on the eye than conventional GP lenses, and are therefore less likely to dislodge from the eye. Moreover, all scleral lenses are customized and made with highly breathable gas permeable material so that plenty of oxygen reaches the front of the eyeball. The reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a moist environment. It’s no surprise that scleral lenses consistently rank at the top of the charts when it comes to providing sharp visual acuity, comfort and healthy eyes.

Why Do Scleral Lenses Help Prevent GPC?

The customization of scleral lenses is one of the key factors in preventing GPC. Because the lens is properly fitted to the specific eye, and the vault over the cornea is filled with artificial tears, it prevents debris from entering while soothing GPC symptoms simultaneously. Furthermore, those who have highly sensitive eyes and are prone to experiencing allergic reactions can benefit from wearing scleral lenses, as they protect both the tear film layer and are easier to clean than other GP lenses.

Speak with Dr. Moshe Roth and Dr. Steffani Tiomno to learn how to care for your lenses and avoid developing GPC. If you’re susceptible to getting GPC, make sure to schedule follow-up visits with Dr. Moshe Roth and Dr. Steffani Tiomno.

Can GPC Develop in Scleral Lens Wearers?

Although the chances are much lower than in conventional contact lenses, giant papillary conjunctivitis may at times develop with scleral lenses due to potential lens surface debris buildup. For those with allergies, it is ideal to use a peroxide cleaning solution as it provides in-depth disinfection.

Make sure to regularly visit Dr. Moshe Roth and Dr. Steffani Tiomno to have your cornea monitored in order to prevent GPC from worsening or recurring.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
Book An Appointment
Call Us 844-450-6850

Learn More About Scleral Lenses

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Scleral Lenses for Astigmatism

Scleral lenses are a great nonsurgical solution that provides exceptional vision correction in patients with astigmatism, whether by birth, due to post-refractive surgery, or other corneal procedures. Astigmatism is a refractive error caused by irregular corneal curvature, resulting in blurred and distorted vision. Scleral lenses allow astigmatic patients to experience improved visual acuity and comfort while keeping eyes hydrated all day.

If you have been told that your astigmatism is too severe to wear contacts, ask Dr. Moshe Roth and Dr. Steffani Tiomno about scleral contact lenses. At the Family Eye Care in Old Bridge, we work hard to give each patient a superior contact lens fit and know that these lenses can truly make a difference in our patients’ lives.

What is Astigmatism

Histoplasmosis Retinopathy ThumbnailAstigmatism is a common type of refractive error caused by an irregularly shaped cornea. The abnormal cornea causes light to enter unequally onto the retina, which results in blurred or distorted vision, eye strain, headaches, squinting and eye irritation. People are either born with this condition or can develop it later in life.

This condition typically occurs with myopia (nearsightedness) or hyperopia (farsightedness) and can be easily diagnosed using a simple eye exam.

Astigmatism falls into three categories:

  • Myopic (nearsighted) astigmatism: For the myopic, light rays focus in front of the retina, leading objects in the distance to appear blurred. Myopic people who have astigmatism experience further blurring and vision distortion due to the refractive error caused by mismatched curvatures of the cornea or lens.
  • Hyperopic (farsighted) astigmatism: For the farsighted, light focuses beyond the retina. Individuals with hyperopia and astigmatism experience blurred and distorted vision and have difficulty focusing on objects that are up close.
  • Mixed astigmatism: In people with mixed astigmatism, one curvature of the cornea or lens focuses light to the front of the retina while the other focuses light to the back of the retina.

Astigmatism falls into the regular or irregular camp:

Most cases of astigmatism are regular, meaning that the front surface of the eye is oval-shaped. Irregular astigmatism is often caused by scarring of the cornea, keratoconus or from certain types of eye surgeries.

Can People With Astigmatism Wear Contact Lenses?

In cases of moderate to severe astigmatism, sometimes the distortion is too severe to be compensated for properly by soft contact lenses, which simply conform to the irregular shape of the cornea. Scleral lenses, on the other hand, sit on the sclera – not the cornea. They are rigid and maintain their shape regardless of the corneal dimensions. This allows the eye to properly focus light and thus ensures the sharp vision and exceptional comfort. The liquid reservoir that gets trapped underneath the scleral lens masks corneal astigmatism and ensures a stable fit.

What are Scleral Lenses?

Scleral lenses get their name from the way they fit on the eye. The sclera is the white part of the eye, and these lenses rest on the sclera while the lens itself vaults over the cornea.

Scleral lenses have become an important therapeutic strategy in the visual rehabilitation of patients with irregular corneas, such as astigmatism. The liquid reservoir between the lens and the cornea neutralizes astigmatism and provides a continuous moist environment that protects the cornea from exposure to air and friction from blinking.

Scleral lenses offer better comfort, breathability and improved visual acuity due to their rigid optical surface and a shape designed specifically for each patient’s eye. We have found that for our patients with astigmatism, scleral lenses have proven to be the best solution in providing sharp and comfortable vision all day long.

eye doctor, scleral lens on the finger

Are Scleral Lenses for Astigmatism Expensive?

Scleral lenses are custom-fit to each eye, and though the fees for fitting scleral and the cost of the lenses are higher than traditional lenses, their life span and benefits offset the costs.

Coverage rates and restrictions vary among providers, and if considered a medical necessity, many insurance companies will cover the cost of scleral lenses. That said, every country and state has its own restrictions and regulations. Consult with our eye care team at the Family Eye Care to discuss your specific payment options and cost of scleral lenses.

Specialized optometrists, such as Dr. Moshe Roth and Dr. Steffani Tiomno, are trained in fitting scleral lenses for excellent, effective vision correction, and help patients with astigmatism and other corneal irregularities enjoy great vision and comfort with specialty lenses.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.

TESTIMONIAL:

“ I went to the Family Eye Care for my astigmatism, and I’m so grateful to the staff and doctors for their thorough care! They meticulously fitted me for scleral lenses, and now I can not only see well, but I tend to forget I’m wearing lenses. They’re so very comfortable! “

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.
Book An Appointment
Call Us 844-450-6850

Learn More About Scleral Lenses

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Scleral Lenses for Keratoconus

Keratoconus (keh-rah-toe-cone-us) is a non-inflammatory eye disorder in which the round dome-shaped cornea progressively thins causing a cone-like bulge to develop.

Hence the name keratoconus, from the Greek word ‘kerato’ (cornea) and ‘conus’ (cone-shaped).

Because those with keratoconus have irregular, cone-shaped corneas, glasses cannot conform to the shape of the eyes and thus cannot adequately correct the patients’ vision. The best solution, therefore, is scleral contact lenses, since they sit on the sclera without touching the cornea and deliver maximal clarity while being perfectly comfortable in most cases.

What are Scleral Lenses?

what are scleral lensesCustom designed scleral lenses help patients with corneal irregularities achieve dramatic improvements in visual acuity and comfort. Scleral lenses vault over the cornea and rest on the sclera while avoiding the diseased cornea. This creates a new optical surface instead of the damaged cornea and prevents discomfort by resting on the sclera of the eye. Moreover, the reservoir of pure saline solution between the back surface of the lens and the front of the cornea ensures that the eye is always in a liquid environment – making it optimal for healing.

Both rigid gas permeable (GP) lenses and scleral lenses provide the eyes with sufficient oxygen. However, scleral lenses provide more comfort and stable vision than traditional GP lenses. In most cases, scleral contact lenses are the optimal choice of treatment for patients with keratoconus and irregularly-shaped corneas.

If you have Keratoconus and are interested in scleral lenses, Dr. Moshe Roth and Dr. Steffani Tiomno at Family Eye Care can help. We serve patients from all over Old Bridge, East Brunswick, Woodbridge and Edison, New Jersey and provides the highest level of care.

Two Major Benefits of Scleral Lenses for Keratoconus

1) Scleral Lenses Provide More Comfort

Our patients report comfort as the most prominent feature of the scleral lens. Throughout the fitting process, we survey our patients on how the lenses feel, and not surprisingly, the usual response we get is “fine” or “I can’t feel them at all”.

The size of a scleral lens is one of the reasons it is more comfortable than a traditional gas permeable contact lens. A traditional contact lens is much smaller, typically 9 -10 mm in diameter. With each blink, this contact lens moves a bit over the cornea and the lid tends to roll over the edge of the lens as well. Many patients report being unable to wear them for more than a few hours at a time due to discomfort.

The scleral lens, on the other hand, is larger in diameter and spreads its weight over a much greater, less sensitive area so that when you blink, the eyelid doesn’t catch the edge of the lens. Moreover, because the lens vaults over the bulging cornea, it protects the cornea from any abrasion caused by blinking or external irritants. Furthermore, the scleral lens is made up of highly oxygen permeable materials and provides a soothing bath of artificial tears that refresh the ocular surface.

2) Scleral Lenses Offer Improved Vision

Patients with keratoconus have a clearer vision with scleral lenses than with glasses. With glasses, patients usually see 20/200, whereas with scleral lenses their vision typically improves to 20/30 or even 20/20. Furthermore, because the lenses sit firmly on the eye, they offer more stable vision than traditional lenses. The scleral lens not only offers comfort but also improves vision acuity.

What Changes Will I Notice with Scleral Lenses?

Once you have been properly fitted for scleral lenses, you can expect to gradually see improvements in clarity, color and detailed contrast between multiple images and objects within your visual field. The comfort you’ll experience will enable you to wear your custom-made scleral lenses all day long so that you can keep doing all the things you enjoy – but with better vision.

Should I See An Eye Doctor Experienced in Fitting Keratoconus Patients with Scleral Lenses?

improved vision with scleral lensesIf you are interested in seeing whether scleral lenses are right for you, make sure that the eye doctor you visit has the knowledge and experience required to correctly fit the lenses on patients with keratoconus. Scleral lenses require precise customization, and every patient’s case of keratoconus varies in degrees of severity and corneal measurements.

To check if you are a good candidate for scleral lenses, contact us at The Family Eye Care. Our staff has the expertise in fitting specialty contact lenses. Call or book online and regain your quality of life.

Our practice serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, New Jersey and surrounding communities.

“I loved my visit from start to finish. The Family Eye Care staff is friendly, caring and knowledgeable. The eye exam that I had for keratoconus was incredibly thorough and Dr. Moshe Roth and Dr. Steffani Tiomno explained all the results very clearly. He fitted me for scleral lenses, and now my eyes feel so comfortable that I frequently forget that I’m wearing contact lenses.“

REFERENCES:

Ariela Gordon‐Shaag, Michel Millodot, Igor Kaiserman, Tzahi Sela, Guy Barnett Itzhaki, Yaffa Zerbib, Efrat Matityahu, Shira Shkedi, Svetlana Miroshnichenko and Einat Shneor, Risk factors for keratoconus in Israel: a case–control study, Ophthalmic and Physiological Optics, 35, 6, (673-681), (2015).

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