Poster 10 - The Use of Tinted Contact Lenses in the Management of Achromatopsia

Purpose: The objective of this study was to determine if con-tact lens dry eye subjects show-a preference between the Bausch & Lomb PureVision@/ReNum with MoistureLocm Multi-Purpose Solution and the CIBA Vision 020ptix'"/AQuify@5-Minute MPS lensllens care systems, after one hour of lens wear. Method: Nineteen subjects, all habitual soft contact lens wearers with an analog dryness score of 60 or less on a 100-point scale, were enrolled. Each subject wore a test Bausch & Lomb PureVisiong lens that had been pretreated with ReNu@with MoistureLocm Multi-Purpose Solution and a control CIBA Vision 020ptixTM lens that had been pre-treated with AQuify@5-Minute MPS on contralateral eyes for 1 hour. Subjects were masked to system identity. Baseline clinical testing was completed before lens insertion. Each subject was fitted with a pretreated lens pair, which was subsequently evaluated clinically. Testing was repeated after 1 hour of lens wear; subjects were requested to make a forced choice preference between the two lensllens care systems. Results: Fourteen of the 19 subjects (74%)preferred the Bausch & Lomb PureVision@/ReNu@ MoistureLoc@test system, while five subjects (26%)preferred the CIBA control system (chi-square Vision 020ptixTM/AQuif~ test, p < 0.04). There were no statistically significant differences noted between the test and control systems with respect to comfort, dryness, stinglburn, wettability, deposition, visual acuity, decentration, movement, and corneallconjunctival staining severity. Conclusions: The results indicate that dry eye contact lens wearers in this study preferred the Bausch & Lomb lensnens care system over the CIBA Vision lensllens care system, after one hour of lens wear. Future clinical work will address longer periods of lens wear.

POSTER 9 A Comparison of a Silicone-Hydrogel Toric Lens to the Bausch & Lomb SofLens66B Toric Soft Contact Lens Marc Robboy, O.D., Michael Paterno, O.D., Tim Green, M.Sc., and William Reindel, M.S., O.D. Bausch & Lomb, 38 Pioneer Drive, Fairport, New York 14450 Background: Consistent fitting performance over a range of contact lens powers is important in management of "chair time" associated with astigmatic patients. The design of the Bausch & Lomb Purevision@Toric (balafilcon A) soft contact lens, a silicone-hydrogel contact lens, was based on that of the SofLens66@Toric lens. Tho performance factors that are particularly important with respect to toric soft lens visual outcomes are lens orientation and rotational stability. Purpose: The purpose of this study was to compare the primary gaze orientation and rotational recovery of the Bausch & Lomb PureVisionmToric soft contact lens to the Bausch & Lomb SofLens66@Toric soft contact lens, across a range of sphere, cylinder, and axis combinations. Method: Thirty-six adapted subjects participated in this randomized, double-masked, repeated measures, single-eye study. Each subject wore a PureVisiong Toric lens and a p&ameter-matched SofLens66@Toric lens on a randomly selected eye, for approximately 10 minutes per

lens. Within each of the three lens powers that were assessed, there were two cylinder powers and three lens axes, yielding a total of 18 lens parameter combinations that were evaluated. Primary gaze orientation and rotational recovery were assessed. Results: There was no statistically significant difference in mean primary gaze orientation (ANOVA,p > 0.93) or in mean rotational recovery, with respect to the Lens effect (ANOVA,p > 0.28). Conclusions: These results suggest that insofar as orientation and rotational recovery are essential predictors of toric soft lens visual performance, the "chair time" required in the fitting of Purevision@Toric lenses should be similar to that with respect to the SofLens66@Toric lens.

POSTER 10 The Use of Tinted Contact Lenses in the Management of Achromatopsia Muriel Schornack, 0 .D. Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905 Background: Achromatopsia is a congenital, autosomal recessively inherited condition in which cones are either defective or absent. Clinical findings associated with achromatopsia include reduced visual acuity, nystagmus, high ametropia, and severe photophobia. Achromats frequently need to wear some type of light filter (either sunglasses or visors), even in normal indoor illumination. Tinted contact lenses can offer some advantages over sunglasses, and have been reported to reduce photophobia and improve visual function in these patients. Case Report: A 32-year-old man came to us with a diagnosis of achromatopsia. He requested information regarding any new developments in the treatment and management of his condition. He reported stable visual acuity, complete color blindness, and nystagmus, but his primary concern was debilitating photophobia. He felt the need to wear sunglasses constantly, but was reluctant to do so at work. We fit him with custom-tinted hydrogel contact lenses. The lenses did not improve his visual acuity, but the patient reported a dramatic reduction in photophobia with the lenses. Conclusion: Tinted spectacle or contact lenses have been used to relieve photophobia associated with a number of cone disorders, including achromatopsia. In addition to decreasing light sensitivity, tinted lenses have been reported to improve visual acuity, decrease the size of central scotomata, enlarge peripheral visual field, and enhance visibility of long wavelength stimuli in bright illumination. Tinted contact lenses may offer some benefits over spectacles. First, the pupil can be completely covered by the tinted contact lens. Contact lenses also eliminate reflections that can originate from the back surface of spectacle lenses. Finally, patients may prefer the relatively inconspicuous appearance of tinted contact lenses, as compared to darkly tinted sunglasses. (Investigators received grant support from Research to Prevent Blindness.)

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VOLUME 76lNUMBER 6lJUNE 2005

OPTOMETRY