Myopia Profile

Clinical

NaturalVue Multifocal contact lens - Q&A With Dr Carolyn Lederman

 Posted on December 13th 2022 by Dr Carol Lederman

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Our new Q&A format is designed to explore a particular clinical topic, intervention, product or research paper with an expert. In this interview we chat with Dr Carolyn Lederman, a pediatric ophthalmologist from the USA, about how she prescribes and manages myopia patients with the NaturalVue Multifocal 1 Day contact lens in her practice.

Q&A with David Kern (1920 × 1500 px) (1).png How do you approach contact lens prescribing in childhood myopia management?Q&A with DR Carolyn.png I find multifocal contact lenses to be quite effective in reducing myopia and I offer them to all patients whose myopia has worsened over time, as long as the patient and their family feel they are ready. In my practice, girls tend to be ready at ages 9-12 and boys are ready typically between 10-13, but I do not have strict age criteria. If they are not mature enough for contact lenses, are not yet interested in contact lenses, or if their cylinder is greater than 1.25D, I will offer atropine 0.01-0.05%. I often transition from atropine to multifocal contact lenses after two years.

Dr Lederman mentions not having a strict age criteria for fitting children with contact lenses - this is in line with evidence stating that children aged 8-12 years get as much quality-of-life benefit from contact lens wear as teenagers.1

Children and teenagers can also be very successful contact lens wearers over the long-term, with one study reporting that children who started daily disposable contact lens wear between ages 8 and 12 years exhibited minimal impact on ocular health appearance after six years of wear.2

Dr Lederman also mentions using astigmatism level as a criteria for treatment selection. Read more on this topic in this Case Study entitled NaturalVue Multifocal contact lens fitting and astigmatism.

Kate-profile-thumbnail.png How does the NaturalVue Multifocal fit into your toolkit?Q&A with DR Carolyn.png I use NaturalVue Multifocal for myopia. I will offer NaturalVue Multifocal contact lenses to all appropriate patients with K readings 42 or greater. The lenses are comfortable and well-tolerated by most patients, and families appreciate that the lenses have UV protection. Children typically acclimate quickly to the lenses with no visual complaints after wearing them for a short time. I always start them reading for the first 15-20 minutes.

Read more detail in this clinical article entitled Understanding the NaturalVue Multifocal contact lens.

Kate-profile-thumbnail.png Is there a particular way that you find most useful in explaining the NaturalVue Multifocal?Q&A with DR Carolyn.png First, I teach patients and families about myopia. Families need to realize that myopia cannot be reversed, only corrected, and stabilized. I explain that the cause of myopia is multifactorial and that the incidence of myopia (and particularly high myopia) is increasing worldwide. I discuss the association of myopia and especially high myopia with other serious ocular conditions including glaucoma, retinal tears, and detachments. Then, I provide a recommendation on how we will address myopia. If I recommend NaturalVue, I explain the design of the lens: the center of the lens is for distance vision; the rapid increase of plus power to the periphery brings the light rays in front of the peripheral retina. Lastly, I talk about how focusing images in front of the peripheral retina decreases the factors encouraging the eye to continue to elongate. I assure the families that NaturalVue Multifocal will not only correct the child’s myopia but may also reduce peripheral hyperopic defocus, one of the risk factors for continued excessive ocular growth.

To explore more about what makes the NaturalVue Multifocal unique, have a look at our new article entitled What does extended depth of focus mean in contact lens designs?

Kate-profile-thumbnail.png What have been your clinical findings in terms of vision and visual function?Q&A with DR Carolyn.png It starts with fitting the lens on patients using the fitting guidelines. For kids, one fits for distance vision primarily. Adaption is minimal and kids report that everyday vision is good.Q&A with David Kern (1920 × 1500 px) (1).png How do you determine a successful outcome with NaturalVue in myopia?Q&A with DR Carolyn.png I have been using NaturalVue Multifocal contact lenses for over three years and have fit over 100 patients in them. In my experience, most patients have significant decreases in myopia worsening when wearing lenses as instructed (10-12 hours per day, 6-7 days per week). The patient must be happy with their vision, both distance and near, and the majority are. I have not seen any adverse events in my patients wearing NaturalVue Multifocal (including keratitis, corneal ulcers, or pannus). It is too soon to know the long-term effect of slowing myopic progression, and I look forward to future studies that measure the change in axial length. but we should be proactive in our approach to myopia.

In a published paper describing retrospective clinical cohort data from wearers for up to 6 years, the average annual refractive myopia progression of the wearer group at each time point was less than 0.25D.3 Read more about this data in our Myopia Profile Science Summary.

Learn more about the NaturalVue Multifocal 1 Day

Disclaimer

Indications for Use - United States: NaturalVue® (etafilcon A) Multifocal Daily Disposable Soft Contact Lenses are indicated for daily wear for the correction of refractive ametropia (myopia and hyperopia), and/or presbyopia in normal eyes.

Indications for Use - Global (OUS) NaturalVue® (etafilcon A) Multifocal Daily Disposable Soft Contact Lenses are indicated for daily wear for the correction of refractive ametropia (myopia and hyperopia), and/or presbyopia, and myopia progression control.

Meet the Authors:

About Dr Carol Lederman

Dr. Carolyn Lederman is a Pediatric Ophthalmologist practicing in White Plains and Purchase, New York for 25 years. She graduated from the University of Virginia medical school, completed her Ophthalmology residency at Manhattan Eye, Ear and Throat Hospital, and her fellowship in Pediatric Ophthalmology and Strabismus at Children's National Medical Center. In addition to her medical and surgical practice, Dr. Lederman has served as President of the Greater New York Society of Pediatric Ophthalmology and Strabismus and Vice President of the Westchester Ophthalmology Society. She is currently the Division Chief of Ophthalmology at White Plains Hospital, and in private practice at Lederman & Lederman in Stamford, CT.

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