Prosthetic Soft

Today, more and more people are ordering prosthetic contact lenses. As patients and practitioners alike are learning, such lenses are now more readily available to them than ever before.

For a number of reasons, including eye injuries, one patient’s eye may appear differently than the other. The Orion Vision Group provides custom-tinted contact lenses to aesthetically match dissimilar appearing eyes, closely simulating the patterns and colors of the natural eye. This includes discolored or misshaped pupils and eyes that suffer from albinism, color vision deficiencies, amblyopia, or other ocular anomalies.

To know that you can expect your order to perform as well as you would like, we offer a diagnostic fitting set so that you can try various options with your patient on your own time.

You can now order our BioColors Fitting Set to aid in the matching of your patient’s eyes to the available lens designs. Visit our BioColors page for available colors and parameters. For more information about prosthetic lenses, call our office toll-free at (866) 300-6257.

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Lens selection

When fitting a prosthetic contact lens, it is always useful to use a diagnostic lens. The Orion Vision Group can provide diagnostic lenses upon request; however, if a prosthetic diagnostic lens is not available, an opaque contact lens such as FreshLook can be a valuable tool in color selection.

Prosthetic color application

 

Single color application

This color application will be comparable to conventional opaque contact lenses such as Freshlook, but the lens will be a conventional lathe cut lens designed for comfort and durability. These lenses are available with a clear pupil for seeing eyes and a black pupil for non-seeing eyes.

Double color application

This will be a more opaque color than the single color application. A double color application will block out about 70% of light transmission. On white corneas, this effect can be very intense and bright, which can be undesirable. To simulate a double print in the office, you can piggyback two FreshLook lenses on top of one another on the eye. Again, these lenses are available with a clear pupil for seeing eyes and a black pupil for non-seeing eyes.

Dark underprinting

This process can be done in black or brown, depending on the application. Dark underprinting can be useful for occluding light and for muting the cosmetic effect of lens colors on white corneas. To simulate a dark underprint, you can use an underprint diagnostic available from The Orion Vision Group, and then apply your prosthetic trial or a FreshLook lens piggybacked on top to determine the net result of the two lenses.

Light underprinting

Depending on the desired iris color, a light underprinting (available in brown or gray) may be effectively utilized in lighter colored eyes. Here again, an underprint diagnostic lens should be utilized with a prosthetic trial or a FreshLook piggybacked on top to determine the net result of the two lenses.

Clear pupil diameter

In selecting the clear pupil diameter, it is important to determine the relative importance of the cosmetic effect of the lens and how much light should be blocked by the occluding.  A diameter of 4.5 or 5.0 mm is usually recommended.

Black artificial pupil

If the eye in question has no vision, a black pupil is usually recommended. For the best cosmetic effect, matching the diameter of the pupil in the healthy eye is obviously best. Pupil diameter should be measured in the healthy eye in normal room light to bright room light.

New technology in custom colored contact lenses

Most eye care professionals are occasionally confronted with the task of prescribing a soft contact lens for a patient who needs color added for therapeutic or cosmetic purposes. With knowledge and expertise in fitting contact lenses, you can be successful in your next soft prosthetic lens case. New developments in color and cosmetic contact lenses have made a valuable resource for the patient in need and will help you build a specialty contact lens practice. Lens designs range from enhancer tints to new designs to specialty opaque colored lenses.

If you have shied away from fitting custom color contact lenses in the past, now is the time for you to reconsider what they can offer your patients.

New manufacturing technology

 

Micro-pigmentation

This process consists of applying up to six different colors onto a lens surface, and then hydrating the lens. This process is very reproducible and allows for customization such as black underprinting for light occlusion, limbal rings, and changes from brown to green (hazel) in a single lens design.

Other benefits

You can utilize a hydrogen peroxide care system with no effects on the lens colors. Gas permeability through the lens is barely affected after the lens is colored.

Finding the right color

Some practitioners hesitate to fit tinted lenses because they believe it takes too long for the patient to choose a color. Find someone in your office who enjoys working with colored lenses and has the time to help patients find the right match. The most flattering shades depend on skin and eye color.

Start by determining the patient needs, and use your experience to suggest one or two shades. After the initial fitting, the time requirement will dramatically decrease.

Taking the time to show patients new technology, like a tinted lens, can help you develop lasting patient relationships.

Understand the process

Practitioners who want to become more involved in offering color contact lenses need to stock some trial lenses. When offering color contact lenses, it also helps to have staff members knowledgeable enough to work with patients. Patients will want to know about the available colors and warranty policy. Remember that custom opaque colors are available from +20.00 to -20.00 with up to 6D of cylinder, so virtually anyone can change their eye color.

Ask the right questions

Find out what the patient does for a living and what their expectations are. If the color lenses will improve their lives in any way, recommend them.

Many practitioners offer the option of color lenses once a patient decides to option for contact lenses over eyeglasses.

Ask patients about their interest in colored lenses for complex prescriptions. Many of these patients assume it is not available because that is what they have always been told. Do not let the patient walk out of the front door only to ask themselves, “I wonder if I could have had colored lenses too?”

It can be difficult to predict what an opaque colored contact lens is going to do on an eye.

The use of any opaque trial lenses can be a valuable tool to get started.

  1. Note the patient’s history
  2. Determine what the patient wants to achieve
  3. Be aware of the patient’s emotional status
  4. Know your resources
  5. Explain the options
  6. Discuss the cost
    • Prosthetic lenses can be paid by insurance in some cases.
      • HCPCS Code V2623
      • ICD-9-CM Diagnosis Code 360.41
  7. Be aware of the delivery time
  8. Take measurements for prosthetic lenses
    • Pupil size
    • Iris diameter
    • Base curve

More on prosthetic lenses

Not all tinted lenses simply change eye color; they can also be used as a base for the piggyback system. Complex fits such as traumatic eye injuries and keratoconic patients may end up wearing a piggyback system. An occluder (to reduce glare) can be made in a soft cosmetic design and the complex astigmatism can be resolved with a rigid lens. Albino patients can appreciate the filter effect of an enhancer tint to reduce glare.

True prosthetic contact lenses can change a person’s life. Patients with scarred corneas, irregular irises, or complaints of monocular diplopia can benefit from a prosthetic soft lens. Prosthetic lenses can be stock designs or custom made.

Contraindications

There are no contraindications unique to opaque or translucent contact lens wear for cosmetic enhancement. As long as the lenses are prescribed and maintained properly and a healthy wear schedule is followed, any patient who can adapt to contact lens wear can adapt to colored lenses.

At one time, opaque and enhancing tinted lenses were not available in all the parameters of clear lenses. This is no longer the case.