contact lens management

Turn The Corner on Night Vision
Lens can make astigmatic patients more comfortable driving at night.

Although only 20% of driving is done after dark, traffic deaths occur three times more at night than during the day, according to the National Safety Council. This is due, at least in part, to limited vision at night.¹
Undercorrection of refractive error and physiological changes in the aging eye make many people — especially those with astigmatism — less comfortable driving at night. In the case of patients with astigmatism, this is because they lose depth-of-field and clarity-offocus at night as the pupil expands.
Uncorrected astigmatic error or misalignment of spectacles can worsen glare and halos around lights and cause starbursts from oncoming headlights. Further, some toric contact-lens (CL) patients suffer from temporary shifts in vision due to lens rotation, especially at the end of a long day of wear. Any one or several of these factors may result in headaches, blur at night and even avoidance of night driving altogether.
But, I have found Acuvue Advance for Astigmatism, from Vistakon, allows astigmatic patients to feel comfortable getting behind the wheel after dark.

Steering patients toward comfort and safety
In my practice, I discuss a toric CL correction with anyone who has -0.75D of cylinder — or even -0.50D — if the patient is symptomatic. I strongly encourage a toric lens for patients who have a correction higher than -0.75D. I recommend Acuvue Advance for Astigmatism because it’s a silicone hydrogel lens (galyfilcon A) that provides healthy oxygen transmission for the cornea. Also, since this lens brand has a two-week replacement schedule, patients always have a fresh lens on their eyes, which allows them to maintain ocular health, comfort and consistent vision regardless of time of day.
In addition, this lens uses an accelerated stabilization design that works with the natural blinking action to stabilize the lens quickly and then maintain that clear focus throughout the day. Finally, the Hydraclear technology ensures end-of-day comfort when CLs tend to dry out. This is particularly important for CL wearers who experience trouble with night driving. The dryness itself can cause fluctuating, blurry vision. My patients report minimal lens rotation and improved quality of vision at night with Acuvue Advance for Astigmatism.

You’re in the driver’s seat
In the past, I think many practitioners were reluctant to prescribe toric CLs due to the amount of chair time, and perceived difficulty in fitting these lenses and patient dissatisfaction with them. (Earlier toric lens designs often were uncomfortable and provided unstable or inconsistent vision.)
Although toric lenses are considered “specialty” CLs, the Acuvue Advance for Astigmatism lens is so easy to fit, that specialty experience really isn’t required. This is because this lens typically has minimal rotation and is so consistent that, in many cases, you can fit it empirically. Also, the Acuvue Advance for Astigmatism lens settles on the eye quickly, which has really improved chair time.
I tell all my patients, regardless of their prescription, to take some basic steps to make night driving safer. Specifically, I tell them to keep their windshield clean, so that a film of debris doesn’t cause incoming light to scatter; to clean their headlights to maximize illumination of the road; to use the night setting (if they have one) on their rearview mirror; and to redirect airconditioning vents away from their face to prevent drying out their eyes or lenses.
But, none of these tips will make much of a difference in the safety of my patients who have astigmatism unless I first correct their astigmatism. The Acuvue Advance for Astigmatism lens enables me to safely and effectively accomplish this.

1. National Safety Council Driving at Night Fact Sheet. www.nsc. org/library/facts/nightdr.htm (accessed April 12, 2007).

DR. RIEMER IS IN PRIVATE PRACTICE AT VISIONCARE ASSOCIATES IN EAST LANSING, MICH. E-MAIL HER AT CVIN CENTRIEMER@VISIONCAREPC.COM.