We Specialise in Contact Lenses!
This what we do….
“We restore your eye’s focus with contact lenses so you can get back to focus on life”
Although we see many patients with irregular corneas with keratoconus, corneal grafts, ocular surface disease and other complex conditions we take just as much joy out of fitting non-complex eyes!
Sick of wearing glasses?
Our highly trained optometrists and teachers in this field at Mark Hinds Optometrists may have the answer. We use specialty contact lenses every day with complex problems solved with customised solutions.
It is common that we are doing clinical trials for contact lens manufacturers our patients are seeing through new lenses before the rest of the world does! Our latest lens is due for release Q1 2019 but we have been playing with this technology since mid 2017.
Failed before? Was it comfort, vision or convenience – let’s explore that. Is it simply that you have got at early 40’s and now find yourself reaching for reading specs? Daily disposable multifocal contact lenses are now available and have come a long way in optics and we have great success in this modality of lens. A fantastic opportunity not to wear the reading specs for those over 40’s.
Our contact lenses include:
- 2 weekly
- Toric for astigmatism
- Extended / flexible wear
- Kerataconic / post graft / RK / post LASIK / extreme dry eye / corneal hyperalgesia
- Rigid gas permeable
- Corneo-scleral contact lenses
- Mini / scleral contact lenses
- Multifocal or bifocal
- Cosmetic / Prosthetic
There are two main types of contact lenses – soft lenses and rigid lenses. Soft lenses are made of a soft gas-permeable water-absorbing material, as silicone hydrogel material or a water gradient silicone hydrogel material that conforms closely to the eye shape. Rigid lenses are usually made of a rigid gas-permeable material and cover only part of the cornea . Mark Hinds Optometrists are one of the few specialty fitters in Australia for the SynergEyes Hybrid contact lenses which use a silicone hydrogel skirt around a high oxygen RGP centre. We have many different designs of this particular lens.
In Australia, over 97% of the contact lenses prescribed are soft lenses, with the use of rigid lenses generally being reserved for the more specialized forms of contact lens fitting such as high refractive errors, keratoconus, corneal ectasia, corneal hyperalgesia, corneal dystrophies, ocular surface disease, orthokeratology and paediatric aphakia. Nearly all the soft lenses prescribed are ‘disposable’ or ‘frequent replacement’ contact lenses and these are designed to be discarded after a short period of time. This time interval can range from one day to three months depending on the particular type of disposable lens. One of the great advantages of disposable lenses is that it is usually possible to undertake a lens-wearing trial on a prospective contact lens patient using a diagnostic lens from a disposable lens inventory.
Contact lenses can be fitted to people of all ages, with our youngest contact lens patient being a few-week old baby and our oldest contact lens patient a sprightly and one of our favourite patients at 100 years old!
Soft Contact Lenses
These are the most popular mode of lens as they comprise different amounts of water and silicone component, which allows more oxygen to enter the eye i.e., breathe more. There has been a paradigm shift with the latest release daily disposable contact lenses in more parameters and designs than there was in all soft contact lenses 10 years ago. We are early adopters of new technology and often are getting the new lenses up 6-12 months before market release with our in practice clinical trials.
- Easy to wear and get used to.
- Comfortable over longer periods.
- Flexible wearing times.
- Wearer can alter eye colour – from cosmetic to prosthetic.
Hard Contact Lenses
Hard Contact Lenses are more inflexible, but sometimes are necessary because of the eye’s particular condition. That being the case we do many many many of these lenses and have the latest technology to custom design each lens to every eye. It is simply amazing how that little rigid gas permeable lens can be so comfortable. It just has to be the right fit for the right eye.
- Last longer (need less replacement).
- Be more stable for astigmatism.
- Correct vision for keratoconus, after corneal graft surgery, irregular corneas.
- Cost less over time.
- Be more dependent upon cleaning and conditioning solutions.
Soft Contacts are by far the most popular contact lens for wearers. They offer a wide range of fit with flexibility, comfort and less dependence on cleaning solutions. This type of lens, by frequently replacing the lens is designed to overcome the problems associated with long time exposure to harsh cleaning products. Your eye care needs will dictate which lens suits your eye the best.
Our Optometrists will discuss these needs with you, then custom fit you with the best available option.
The very latest in design means this material will breathe on the eye, even when you are asleep.
No more coming home late and fumbling around in the dark trying to get your lenses in a case!
Up to 30 days continuous wear is possible with these lenses. Although not suitable for some, they are now proving very popular with the over 40’s who want a break from their glasses.
Contact Lenses can even alter the way your eyes look to others, by changing your eye colour.
This can be achieved by any of 3 means:
1. Handling Tints
These are simply a light tint to enable the wearer to see them when they drop the lens. This is purely for handling and does not alter the eye colour.
2. Enhancing Tints
Tints are transparent, but add colour to the underlying iris to make the eye more blue, brown, green or whatever.
3. Cosmetic Tints
These tints enable the wearer to have virtually any colour eye they desire. The colour of the underlying iris is completely blocked out, with the contact superimposing the desired colour on top. Various shapes, colours and logos can all be used (these are like the ones used in the movies for dramatic effect).
Hybrid Contact Lenses
A combination silicone hydrogel skirt and a rigid gas permeable contact lens in the centre – the perfect marriage for crisp vision for those with challenging topography and refractions. With corneal cross linking now very clinically sound and we have 100’s of successful patients with this procedure, keratoconus is often treated early. This being the case, this is where Duette Ultrahealth contact lenses come into their own. We do many of these contact lenses every week and have great success with them.
Keratoconus represents a progressive, non-inflammatory thinning and protrusion of the central cornea usually manifesting itself in youth or adolescence, although the age of onset can be anywhere between 7 and 50. It is nearly always bilateral and asymmetrical. Considerable visual impairment can result due to the development of a high degree of irregularity associated with this front surface (“window”) of the eye. Due to this marked distortion and irregularity the improvement in vision obtained with spectacles may be minimal. There is usually a marked improvement in vision if rigid contact lenses (or similar) are fitted and they are often the only adequate means of correction for patients suffering this condition. Keratoconus does not cause blindness! We often bring visual acuity up from counting fingers to close to 20/20 vision we our specialty contact lenses.
Keratoconus may also be a genetic condition that occurs in about 1 in 1,000 to 1 in 4000 people (depending on ethnicity), occurring with equal frequency in males and females. The hereditary nature of the condition is actually quite weak, so only about 10% of people with keratoconus will have an affected relative. Keratoconus is sometimes associated with other conditions such as allergies, asthma, eczema and double jointedness (Marfan Syndrome). Excessive eye rubbing has also been strongly implicated as a possible causative factor. Take home message is “DON’T RUB YOUR EYES
Signs and symptoms of keratoconus include a blurring and distortion of vision that cannot be totally alleviated by spectacle correction; frequent changes in the spectacle prescription over a relatively short period of time; reduced night vision with ghosting and haloes noticed around lights; multiple images observed with the one eye; and eye strain and headaches.
Progression with keratoconus is quite variable, however the condition does tend to progress more rapidly the earlier the age of onset. As stated earlier, keratoconus is basically a bilateral condition, however the degree of progression for the two eyes is often unequal and it is quite common for the keratoconus to be far more advanced in one eye. In about 85% of cases of keratoconus, the condition usually stabilizes anytime between 5 to 15 years after onset. For the remaining 15%, the keratoconus progresses to the point where contact lens fitting is no longer possible and so the only treatment option is then a corneal transplant. Thankfully corneal collagen cross-linking treatment (CXL) is a great intervention and we have the leading anterior segment ophthalmologists in the world here is Brisbane.
Corneal collagen cross-linking treatment (CXL) of keratoconus is a non-invasive procedure that is aimed at halting the progression of the keratoconus. The procedure works by increasing collagen cross-linking, which helps to prevent the cornea from becoming more conical and irregular, as it would normally with progression of the keratoconic condition. This technique was first developed in Germany about circa 2000. During the treatment, riboflavin eye drops are applied to the cornea and then activated by UVA radiation. This process has been shown in laboratory and clinical studies to increase the amount of collagen cross-linking in the cornea, thereby resulting in a stronger cornea. We now have 100’s of patients post CXL and it is a very successful procedure and refined since 2008 to be more accurate and quicker than the initial process. We now see treatments with epithelium on and epithelium off depending on corneal thickness and nature of the disease. The latest generation can even give just refractive changes to normal corneas – refractive CXL.
In the earliest stages of keratoconus, a spectacle correction may be used to correct the myopia and astigmatism associated with this condition. Soft contact lenses can often also be prescribed during this time for general, recreational or sporting use. As keratoconus progresses, the additional corneal thinning results in the shape of the cornea becoming more irregular to the point that it is not possible to obtain adequate vision with spectacles. At this stage, rigid contact lenses are then required to provide optimal vision. The contact lenses essentially provide a new, regular front surface for the eye, eliminating the distortions caused by the keratoconus. It should be emphasized that, while contact lenses will generally provide a significant improvement in vision, wearing them is not a cure for keratoconus.
The majority of individuals with keratoconus comfortably wear rigid contact lenses throughout the day, enjoying significant visual improvement. About 10% of keratoconic patients are unable to tolerate wearing rigid contact lenses due to extreme ocular sensitivity. For this group there are other contact lens options available, most notably a hybrid (piggyback) lens design that consists of a rigid central portion attached to a peripheral soft skirt. This hybrid lens design is also a good option for keratoconics who play contact sports such as football, as rigid lenses may be easily dislodged during these types of activities.
Keratoconus is a progressive condition, hence it is important that people with keratoconus have regular examinations to monitor the status of their condition and ensure that their contact lenses are still an optimal fit. Poorly-fitting contact lenses will generally have a radius of curvature much flatter (greater) than that of the cornea and this situation can arise either from a practitioner prescribing an inappropriate contact lens curvature or the patient continuing to wear an older contact lens prescription when their has been a significant progression in their keratoconus. Flat-fitting lenses can lead to corneal abrasions and subsequent corneal scarring; the corneal scarring may then result in a significant reduction in vision.
Only in about 15% of cases of keratoconus does a corneal transplant (graft) become necessary. A corneal graft (or keratoplasty) is an operation in which the affected (thinned) area of the cornea is removed and replaced by normal tissue transplanted from a donor cornea. Corneal grafting is required when either a satisfactory fit or normal visual acuity cannot be achieved with contact lenses, or the patient has extreme ocular sensitivity and so is unable to tolerate wearing any form of contact lens (this type of scenario is quite uncommon in clinical practice). The success rate for corneal grafts for keratoconus is very high (between 95-100%), although about 60% of people will be required to wear spectacles after a graft and approximately 30% of people will need to wear contact lenses to achieve normal vision subsequent to having a graft. Keratoconus does not generally reoccur after a corneal graft. There have been a few isolated examples in the past 30 years where this has happened, however it is generally thought in these cases that this was due to the inadvertent use of a donor cornea from a descendant who had keratoconus.
Orthokeratology also known as Corneal Reshaping Therapy or Ortho-K is the programmed use of contact lenses to remold the shape of the cornea to reduce or eliminate myopic (short-sighted) and astigmatic (irregular surface) errors in the eye. At Mark Hinds Optometrists we have been performing Ortho-K since 2003 and have many patients now living life with clear vision during the day.
Why have Ortho-K done?
The main purpose of Ortho-K is to be free of both contact lenses and spectacles for the majority of, or possibly all, waking hours. However, most of the patients in Ortho-K are doing it for the purpose of myopia control.
Is everyone suitable for Ortho-K?
No. At present the procedure is only suitable for shortsighted errors of up to 4.00 dioptres and up to 1.50 dioptres of astigmatism. We have patients with -7.00D of myopia correction but these patients are the exception not the rule. It is important to note that the Ortho-K procedure is reversible and we are very conservative treatment wise.
What does Ortho-K involve?
A series of Ortho-K contact lenses made from a highly oxygen permeable rigid material are fitted in progressive stages to gently reshape the cornea towards less curvature and a more spherical shape. This reduces near sightedness (myopia) and astigmatism whilst dramatically improving unaided eyesight. These lenses are generally worn overnight. The full program is often flexible and higher prescriptions may require up to ten visits over a six month period. That being said generally 4 or 5 visits are expected.
As the cornea is highly elastic and always returns to its original shape, retainer lenses will need to be worn four to six nights per week to stabilise the new corneal shape when maximum results have been achieved. It is just the little cells (epithelium) on the basement (Bowmans) membrane that are remodeled to induce the refractive power change.
Fees for Ortho-K
The total fee is $1650. This fee is not rebateable from Medicare. Your private health fund where applicable will allocate funds for the contact lenses involved in this procedure and a lifestyle bonus may also be applied if available. A full fee disclosure is available at time of consultation and we ALWAYS perform an initial evaluation and consultation for determination of suitability. We are happy to accept a referral from your optometrist or ophthalmologist and will give them a comprehensive report when required.
During the Ortho-K program, each trial lens must be returned at the end of its intended period of use. Lenses not returned or lost or broken will be charged separately. Some lens costs may be claimable from your private health fund. Once the Ortho-K program is complete, you will need to purchase a pair of retainer lenses which is a part of the full fee above. The ongoing costs associated with these lenses are usually much less than for conventional contact lens wear. The lenses will last between 2 and 5 years depending on how they are looked after, if they maintain their shape, and the ocular prescription does not change.
So how does it work again?
Similar in appearance to standard contact lenses, Ortho-K therapeutic lenses gently reshape the corneal surface during sleep and provide clear, natural vision when the lenses are removed upon waking.
The result is temporary correction of myopia (short-sightedness) with or without moderate astigmatism (irregular surface of the cornea). For some people, Orthokeratology slows down or even halts the progression of shortsightedness altogether! This is one of our goals and is gaining popularity as “myopia control”.
What are the benefits of Orthokeratology?
Ortho-k offers freedom from glasses and the hassle of wearing contact lenses during the day, enhancing the lifestyle of those requiring vision correction.
Active individuals can freely participate in sports without the interference of glasses or bother of contact lenses. As these special lenses are worn whilst sleeping, eye irritation and dryness often associated with the combination of contact lens wear, extended computer use and outside dust and pollutants, is eliminated. These lenses are very popular with young sports people, people with mild dry eye, and those who struggle with contact lenses during the day. What a great alternative to refractive or LASIK surgery.
Orthokeratology is a safe and effective, surgery free method of managing myopia and low to moderate astigmatism.
Why have I not heard about Ortho-K before?
Orthokeratology has been around for decades, however the recent advances in contact lens technology has brought it to the forefront of myopia control.
The practice of Ortho-K requires a great deal of technical skill and specialized equipment. Mark Hinds Optometrists specialise in contact lens fittings and Orthokeratology and we have achieved excellent results in the management of myopia and low to moderate astigmatism. It is a brilliant result when we can see there is no change in the short sighted prescription over many years with kids who were destined to have coke bottled glasses!
To find out more about Orthokeratology treatment feel free to make an appointment with one of our qualified optometrists on 07-3358 6566 or send an enquiry to firstname.lastname@example.org
(For more information see www.oso.net.au)
Children and Contact Lenses
Yes! Children can wear contact lenses. The visual benefits that children with refractive errors derive from contact lenses are the same as those for adults. Children can be prescribed contact lenses for the correction of refractive errors such as myopia, hyperopia and astigmatism. Ortho-K can also be performed successfully on myopic children, although this does require a very high level of hygiene, care and compliance. Children who want to wear contact lenses for sport or for cosmetic reasons can usually be examined, counselled and fitted like an adult albeit with parental guidance at about 8 or 9 years of age. For those little people who have a hyperopic accommodative esotropia this is a God send as a contact lens can straighten up the eyes just the same as spectacles – without the massive positively powered lenses!
A recent study from the USA indicates that contact lenses significantly improve how children feel about their appearance and participation in activities compared to spectacles. 71.2 % of the children stated that they liked wearing contact lenses a little better or a lot better than glasses, while 95.9 % of the children said they loved or liked to wear contact lenses during sports. Almost 60% of the children felt their sporting performance was much better or better while wearing contact lenses. The study went on to conclude that children derive a number of benefits from contact lenses which leads to greater satisfaction with their vision correction.
Children under the age of 7 (including infants and babies) are generally only fitted with contact lenses if there is a specific indication. The most common reason for paediatric contact lens fitting is unilateral or bilateral aphakia. Surgical removal of the crystalline lens results in aphakia and the most common reason for performing this procedure is congenital cataract. Patients with aphakia will have an extremely high degree of hyperopia (long-sightedness). Contact lenses are definitely the preferred option for the management of aphakia, as aphakic spectacles are incredibly thick and so very difficult for a baby or young infant to wear. Infants born with congenital cataracts should have them surgically removed as soon as possible (preferably before 3 months of age) with contact lenses then being fitted about one week post-operatively. Rigid gas permeable contact lenses are usually the best option for the contact lens management of the paediatric aphake.
Other indications for paediatric contact lens fitting include high myopia and high hyperopia (the latter without aphakia), unilateral ametropia (where the baby or young infant has a significant refractive error only in one eye) and corneal irregularity (usually as a result of trauma).