toric fitting question

**Zeli** · 06-09-2003, 08:26 AM

I have tried many toric contacts: Ciba Focus, Biomedic Toric, Acuvue Toric, Dispo Toric. The problem I am having is with one eye: Every time I blink the contact moves. After a while, this irritates my eyelid. Any suggestions?

**Jimbob** · 06-10-2003, 03:45 AM

i am not the person most qualified..... but perhaps trying a custom lens.... the toric contact lenses will spin, but some will spin less, such as those with a lower base curve, aand those with a larger diameter, but, these need to be within normal guidelines, for your prescription...

**chip anderson** · 06-10-2003, 06:15 AM

Go to the Contact Lens Society of America's Web page, see the members directory and if there is one in your area see him/her. Most of them know what they are doing. Contact lenses should be fit on an individual basis by somenone who knows what he/she is doing. Not by mail or electronics.

Chip

**Zeli** · 06-11-2003, 03:20 AM

Thanks for the tip. In the last three weeks, I have been at two different eye doctors over a total of 12 visits.

**chip anderson** · 06-11-2003, 07:02 AM

Zedi:

I didn't note on your origional post that that you were not in the USA, there are not too many (a couple though) CLSA members in the Middle East.

Toric contact lenses usually spin if they are too flat (too much touch in the center, not enough on the edge). If a soft contact lens is uncomfortable (at least early in the wearing time) it is usually: wrong side out, has damage such as a finger nail cut, or has foriegn matter under it. However if it is way too flat, the edges will stand-away and rub the lid [same as being wrong side out] and be uncomfortable. Too flat also can some instances mean too small, strangely a small lens with a short radius can in some circumstances fit the same as a large lens with a somewhat longer radius.

Hope this helps a little.

Chip

**Stopper** · 06-11-2003, 10:57 PM

An excellent lense for stability is the Sunsoft Multiples Toric. It is a large diameter (15mm) lense so it usually has good stability and excellent optics. It is a three month replacement lense. Comes in two base curves, 8.5 and 8.9. you may also want to consider the Preference Toric (3 month) or Frequency 55 toric (1 month) 14.5 diameter and 8.4 and 8.7 base curves. Both made by CopperVision.
Keep trying.

**Zeli** · 06-12-2003, 12:37 AM

Chip and Stopper, thanks for the tips. In my country, trial lenses are not readily available. That means either the end consumer or the optometrist takes the hit for an incorrect fit. Some of the options here are to either buy the trial lenses (for approx $40 including exam) or buy two boxes of lenses (for approx $230.) When the lenses don't fit then you either have to argue with the optometrist (the first one I went to claimed that 20/40 vision in one eye was acceptable so I shouldn't get an exchange or refund) or, best case, get a free exchange of the same company's lens (just a different axis.) Additionally, optometrists don't carry many brands (usually 3 or 4, so they are not apt to recommend a lens that they can't sell you.) So, I come to a forum like this for advice before putting money down on another brand's trial lenses. My main options here are to choose between Ciba Freshlook, Coopervision Frequency 55, Bausch Softlens 66 or just to give up and stick to glasses.

**Stopper** · 06-12-2003, 08:56 PM

Zeli,
Soflens 66 toric is an excellent lens also, If no success, try the Frequency 55 toric. I haven't been that impressed with the fresh look toric but it does work on some patients and is also available in a few colors. I'm assuming the lens you are having trouble with is the one with the oblique axis. Good luck.

**chip anderson** · 06-12-2003, 09:54 PM

Zeli: Softlens 66 is an excellent toric if: Mean K must be 43.50 or steeper, it does not work on flat corneas (at least not without tight lens symptoms.) Fresh-look and the other former W/J lenses work well when they work and are easy to spot and evaluate axis. The big lenses work on big cornes, the small ones one small corneas. With thin lenses you can get by with a little larger lenses on small corneas but you can't defy physics too much, thick lenses will not "bend back in at the limbus" on small or steep corneas.

Chip

Zeli: Why don't you give us some particulars, like your K readings, corneal diameter and Rx? We could give you a lot better advise with this information.

**Zeli** · 06-15-2003, 03:19 AM

The only thing I can offer is my prescription. As you can imagine, the eye doctor who argued with me over 20/40 vision is probably not so interested in forwarding the other info. Nevertheless my contact lens prescription is:

0 power, -1.75 cylinder, +110 Axis, Right eye (20/15 with Focus Toric)

0 power, -1.75 cylinder, +70 Axis, Left eye (still searching)

My new doctor says that he prefers the following prescription for the left eye:

+.25 power, -1.25 cylinder, +70 Axis

He is the one who says that the first prescription only brings me to a little better than 20/20 and that his prescription should bring me to 20/15. I still feel a bit uncomfortable about adding power to lenses (I am not sure why?)

By the way, my experience with the left eye has been the following:

Focus Toric - lens would sit 30 degrees off center, lens that would sit well (i.e. with the 30 degree less axis) provided blurry vision

Acuvue Toric - lens moved in and out of focus for periods of time (i.e. one hour in focus, one hour out of focus)

Biomedics Toric - lens provided crisp vision and stayed in place, but sat off center (low and to the right) and thus irritated the eye lid.

Dispo Toric - lens provided crisp vision when I am stationary but moves when I move (i.e. I have blurry vision whenever I am walking or driving etc.)

**Shutterbug** · 06-17-2003, 04:47 PM

Zeli - Your new prescription has a substantial change in the cyl power, and this alone could account for some of the fitting problem you've experienced. Making the change as your new Dr. recommends might make all the difference.

shutterbug

**chip anderson** · 06-17-2003, 06:42 PM

Zeli: All of the brands of toric lenses you mention have more than one fit (base curve) available. Without knowing your corneal measurments (K reading/diameter) and the fit used in either brand, no one can tell you why it turned or you didn't see.

If too flat/small it will spin. If too steep it will cavitate at center an you still will not see even if it holds axis.

Of course, you could have one of those fitters that thinks one size fits all.

Chip

**Zeli** · 06-18-2003, 08:22 AM

I Just got a FreshLook Toric. It only cost me $10. Vision crisp and very stable even when blinking. But the most uncomfortable yet. Could it be that the diameter of all of the lenses is too big.

Here is what I have tried so far

Freshlook Toric: Diameter 14.5, Base Curve 8.6 (very uncomfortable)

Biomedics Toric: Diameter 14.5, Base Curve 8.7 (uncomfortable)

Dispo Toric: Diameter 14.4, Base Curve 8.7 (comfortable but not stable)

Focus Toric: Diameter 14.5, Base Curve 8.9 (blurry, uncomfortable)

Any ideas?

**chip anderson** · 06-18-2003, 06:43 PM

Yeah: Like I said: If a soft lens is too flat, it will spin and have some of the edge standing away from the eye, which is what makes it uncomfortable. Obviously, you need a base curve of 8.6 or less. If you had obtained your K readings we could have saved a lot of time and trouble.

Bet you have a steep (46.00 or steeper) cornea.

Chip

P.S. your are probably not going to find a toric softlens (without going to an expensive custom made lens under 14.0 mm in diameter). Finding one under 8.6 in curvature is difficult but possible without being custom made. If you got a toric lens for $10.00 it was probably pre-used, discontinued or stolen.

**Stopper** · 06-18-2003, 08:29 PM

Zeli,
I seems that you have not tried the soflens 66 toric yet. If your corneas are steep as most of us are suspecting, this is a good lense for a steep cornea. (8.5 base curve) I'm a big fan of this lens and use it very often. It performs very well and even if it is off axis slightly, it still provides good acuity. Also the frequency 55 toric comes in and 8.4 base curve. As you can see fitting toric lenses can consume alittle more time. keep at it.

As far as the comfort of the fresh look toric, the diameter is usually not the issue for comfort. The lens edge design and the fit of the lens are usually the main factors.

**Zeli** · 06-19-2003, 11:17 AM

Thanks for the tips. BTW, The fresh look toric lens was sealed in original packaging with an exp. date in 2006 and sent to me by an American eye doctor I know. The money was to cover the shipping costs and was volunteered, not asked for.

Nevertheless an interesting experience. I went to my eye doctor at 6:00 pm for an evaulation of the fit. She informed me that:

Vision was excellent even immediately after blinking (20/18)
Stability was ok
but, "Your eye hates this lens!"

She noticed a scratch on my cornea directly under the large T marking on the inner part of the lens. Her impression based on examination is that the area with the marking is ever so slightly raised and rubbed against my cornea.

I contacted Ciba who explained that the marking is laser engraved and in no way protudes above the surface.
Nevertheless, they want to see the lens.

I can't wait for my Softlens 66 trial lens to arrive next week (Free gift from Bausch management in the UK)

**Zeli** · 07-07-2003, 04:54 AM

Stopper - excellent advice!

I just tried the Bausch Softlens 66 Toric. It is comfortable and provides a "95% perfect fit" and 20/18 vision according to my eye doctor.

BTW, Bausch customer service get a big thumbs up. When I explained to them (Bausch Europe) all the problems with obtaining a trial lens, they apologized for the inconvenience and sent me a box of 6 lenses free of charge.

So the end result of my search for Torics is

Right Eye:
Ciba Focus

Left Eye:
Bausch Softlens.