Johnson & Johnson Vision and Transitions Optical recently introduced the Acuvue Oasys with Transitions Light Intelligent Technology lens, a first-of-its-kind photochromic contact lens that combines the proven Acuvue Oasys material with Transitions Light Intelligent Technology, according to Johnson & Johnson Vision (JJV). JJV says that the result is a lens that seamlessly adapts to changing light, providing all-day, soothing vision. Acuvue Oasys with Transitions balances the amount of indoor and outdoor light entering the eye, including filtering blue light and blocking harmful UV rays; it offers superior optical precision with exceptional color contrast enhancement; it helps patients’ vision recover from bright light up to five seconds faster; and it brings out the best in everything that patients see by providing enhanced color contrast, according to JJV. The company further states that the lens delivers more effortless sight with lens squinting from dawn to dusk and that it reduces the stressful impact that light can have on patients’ eyes.

Acuvue Oasys with Transitions is manufactured in senofilcon A (38% water) silicone hydrogel material. It has a reported Dk/t of 121 and a Class 1 UV blocker. The intended replacement schedule is two weeks. JJV says that the lens activates in less than a minute and quickly fades from dark to clear when going from outdoors to indoors.

I recently talked with two practitioners who are actively fitting the Acuvue Oasys with Transitions lens in their practices. Here we share their clinical experiences.

Please tell us about your general experience with Acuvue Oasys with Transitions lenses in your practice.

Shane Kannarr, OD, from Pittsburg, KS, says that his overall experience has been very positive. “When this lens first rolled out, we looked at it as a ‘sunglass lens’ that was going to help patients see better on bright, sunny days,” he notes. But, he continues that while there’s definitely merit to that, practitioners will lose a lot if they make that the focus for this lens. “The experiences that we’ve had are that this lens really helps people who have any kind of light sensitivity. Not just bright, sunny days, but fluorescent lighting, glare from computers, and even night driving,” he explains.

Dr. Kannarr says that Acuvue Oasys with Transitions has been an upgrade for all of his patients wearing other two-week, monthly, and planned replacement lenses. “It’s an active lens; it’s engaged with patients’ lifestyles and with the changes in lighting conditions and the different light exposures that we have today. This lens is actively engaged with that and improves visual acuity and quality for patients,” he says.

Keith Smithson, OD, who practices in Alexandria and Reston, VA, says that his general experience with Acuvue Oasys with Transitions has been very exciting. “This is a thrilling new technology that did not exist in the world before, so I think people have been eager to hear and to learn more about it,” he says. Dr. Smithson discusses this technology every time that he has a contact lens fitting, even with patients who are not necessarily good candidates for the lens. “It’s just that exciting of a technology,” he says. “Even if a patient wears multifocal or toric lenses or has parameters outside of the range, I talk about this lens because I want my patients to know that the technology is available. If they’re excited about it and learn more about it, then when they do become candidates they will ask for it.”

Who are the best candidates for this lens and why?

Both practitioners agree that what defines a “good candidate” for the Acuvue Oasys with Transitions lens has evolved for them over time. “This has changed a bit since I started using the lens in February,” says Dr. Smithson. He is the director of Visual Performance for the Washington Nationals baseball team, and he fitted some players in the lens during spring training. “I felt like it was going to make a lot of sense for outdoor athletes because of the sunglass aspect of the Transitions technology. But the more that we learned about the lens and its ability to block high-energy visible (HEV) light from digital devices and glare from headlights when driving at night, we’ve reached the point that it’s hard to find someone who is not a candidate,” he says.

Dr. Smithson says that at his practice, they no longer see it as a sunglass lens, but as a lens that manages light in all conditions, all day long. “One of my fitting pearls is that we fit a number of plano lenses in this technology to help people who don’t need vision correction but are simply bothered by light,” he says.

Dr. Kannarr agrees. “This has really evolved for us. We first focused on people who have outside jobs, hobbies, and activities. But now, we’re recommending and fitting this contact lens in a high percentage of patients who spend a lot of time under fluorescent lights, who drive at night, or who experience compensating behaviors such as squinting,” he says.

He actively asks patients whether they are having trouble with light, and when patients say that they do, he proceeds with a trial. “Some patients notice the benefit of the lens but decide not to switch. Then, when they return to their original lenses, they really appreciate what they had with the Acuvue Oasys with Transitions. It’s subtle in some ways, so it’s important for us to point out to our patients where the benefits of the technology lie,” he says.

Tell us about the fitting process for the Acuvue Oasys with Transitions lens and what has worked best for you.

Both Dr. Kannarr and Dr. Smithson agree that the physical fitting of this lens is straightforward and very similar to the standard Acuvue Oasys lens. Dr. Smithson adds that the 8.8mm base curve works well for post-refractive surgery and other patients who have flat Ks.

In addition, Dr. Kannarr noted that for patients who do spend a great deal of time outside, they will still need sunglasses. “With this lens, patients might reach for their sunglasses less than they did before, but it doesn’t mean that they won’t need their sunglasses,” he says.

They also both recommend that practitioners discuss the appearance of the changing tint with patients up front. “I don’t think that cosmesis is a big issue if you make patients aware of it. There is a little bit of shading and color distortion, but they won’t get a black eyeball. We’re not seeing the dramatic presentation or the change in appearance that we thought we might,” says Dr. Kannarr.

Dr. Smithson says that he gets in front of this and tells patients that if the lens didn’t darken, it wouldn’t provide the benefits. “We use a demo unit in the exam room to show patients how the technology works. We let them know that their eyes are going to look darker when the tint darkens, and we show them that it changes within a minute from clear to dark and from dark to clear depending on the light exposure. Once patients see this a few times, many think that the way it looks is cool rather than strange,” he says.

How has Acuvue Oasys with Transitions helped with troubleshooting for particular patients? Tell us about any success stories in that regard.

Dr. Kannarr shared the story of a 9-year-old softball player who struggled with glare coming off of the infield. With this lens, she felt like her entire softball season was a better experience and her performance was improved. “We can’t attribute all of that to the lens, I’m not trying to do that, but I think that the lens certainly played a part,” he says.

Dr. Kannarr further notes that he is seeing as much if not more success with patients who are in and out a lot or who spend a great deal of time in bright indoor conditions. “I’ve had many office workers tell me that their end-of-day comfort is better and that they’re not leaving work so fatigued that they can’t keep their eyes open,” he says.

Dr. Smithson has found that this lens can be a game changer for anyone who is really bothered by any type of light. “In some cases, this lens has been life-changing for people who have a history of conditions such as migraines or residual light sensitivity post-traumatic brain injury. This is an off-label use of the technology, but it can really benefit this type of patient,” he says.

Dr. Smithson also says that Acuvue Oasys with Transitions is great to use with youth athletes and with youth in general. They are exposed to bright lights at school and to computers and digital devices, then they go outside and they’re active and play sports after school. “After wearing the lenses, kids come back and say that their eyes feel so much better at the end of the school day and after practices and games,” he says.

Finally, he notes that for patients who experience light sensitivity and are developing early cataracts or other vision problems, these lenses can can make a huge difference in their feeling of safety when they’re driving at night. CLS