Amber Zaunbrecher, OD, of Eye to Eye Vision Center in Marietta, Georgia, recalls that she really didn’t have any good options left for a patient who came to see her in July 2018. The 35-year-old woman suffered from such severe headaches every day that she was practically unable to function by the end of an ibuprofen-fueled day. The refraction showed a low-plus requirement, but Dr. Zaunbrecher could not improve the near vision to much beyond 20/200 at near without any eyeglasses or contact lens correction. “We don’t have much in our arsenal for a same-day option for these patients,” she says.
Although she planned to order some low-plus eyeglasses and digital lenses for digital eye strain, Dr. Zaunbrecher had one last thought: the NaturalVue multifocal lens. “I have a contact lens that will help us get the maximum distance correction and the maximum accommodation in one shot,” she told the patient. However, she also told her she had never tried it with a patient with her profile before. She told the patient that the lens initially must settle for 10 minutes, and then asked, “Are you interested in exploring this with me?” She fit the patient and escorted her to the reception area to allow her to adapt to the lenses. When she came out 10 minutes later, the patient was reading on her cellphone. “I remember that she looked up at me and said, ‘My head doesn’t hurt.’ Her acuity was 20/20, and I thought that we may be onto something here.”
The Visioneering Technologies Inc. representative happened to be in the office and could tell that Dr. Zaunbrecher was excited about these results. The two began to talk about the implications for others with accommodative infacility and other accommodative disorders. “The representative put me in touch with Douglas P. Benoit, OD, FAAO, executive director for professional services at Visioneering Technologies, who was intrigued by the case, too.”
Dr. Zaunbrecher and Jennifer Dattolo, OD, FCOVD, who has a vision therapy practice in nearby Woodstock, Georgia, worked together to start seeing if they could identify patients for an “orphan study,” meaning that study participants could not be identified simply through a search of patient data with specific parameters. “These patients really have to be identified in the clinic. The accommodative disorders don’t become clear until we start doing the near testing,” she says. The two doctors met when Dr. Dattolo served as one of Dr. Zaunbrecher’s preceptors while she was still at University of Alabama Birmingham School of Optometry.
The pair presented a poster at Optometry’s Meeting in 2019, detailing their case study of six nonpresbyopic patients aged 7 to 35 who presented with initial complaints of blur at distance and/or near vision and headaches. These patients were wearing either no corrective eyewear or readers only. All patients experienced immediate improvement in subjective and objective blur when corrected with NaturalVue multifocal contact lenses. The patients also experienced one or more immediate findings of enhanced stabilization of their visual system, demonstrated by improvement in negative relative accommodation/positive relative accommodation, push up amplitudes, near vergences, near point of convergence or flipper bars.
Dr. Zaunbrecher and Dr. Dattolo say that the study provides sufficient evidence for further study. In the meantime, Dr. Zaunbrecher says that she continues to find patients for whom this technology is well-suited. “I had a 13-yearold boy just recently. He’s seeing 20/20 in the distance, but when I checked his reading, he is lagging way behind,” she says. His mother also noted that he complains about reading and his slow speed. The mom was a reading specialist, says Dr. Zaunbrecher, and the mother tested the boy again after being fit with NaturalVue multifocal contact lenses; his reading speed improved by 33 percent. “For these young students, there’s no motivation to sit down and read a book,” she says. This strategy can change the way these young people approach their education.
Dr. Zaunbrecher consults with Visioneering Technologies, Inc., and is a member of its Speaker’s Bureau.
This information may describe uses for multifocal contact lenses that have not been approved or cleared by the FDA for use in the United States.
NaturalVue® (etafilcon A) Multifocal Indications For Use—United States NaturalVue® (etafilcon A) Multifocal Daily Disposable Soft (Hydrophilic) Contact Lenses are indicated for daily wear for the correction of refractive ametropia (myopia and hyperopia) and/or presbyopia in aphakic and/or non-aphakic persons with non-diseased eyes in powers from -20.00 to +20.00 diopters and with non-diseased eyes who may require a reading addition of up to +3.00D. The lenses may be worn by persons who exhibit astigmatism of 2.00 diopters or less that does not interfere.