Download multifocal maximizing full spectrum

featuring
the
MULTIFOCAL
solution for
MAXIMIZING
correction & comfort
across the
FULL SPECTRUM
of vision needs
Indicated
Corneal Types:
• Spherical
• Regular Astigmatic
• Irregular Astigmatic
• Keratoconic
• Post-Surgical
• Trauma
Maximizing Correction & Comfort
Indications
The InSight® Scleral
can be used on
virtually anyone.
It works equally well on normal corneas as it does
on compromised corneas. It provides a stable and
comfortable fit while maximizing visual potential in cases
where soft lenses and intra-corneal rigid lenses cannot
provide acceptable vision and/or comfort. InSight
Scleral® can also deliver multifocal correction up to
3 diopters of add power. This innovative feature now
allows both normal and compromised cornea patients to
experience excellent distance and reading correction in a
remarkably comfortable lens.
Indicated Corneal Types:
• Spherical
• Regular Astigmatic
• Irregular Astigmatic
• Keratoconic
• Post-Surgical
• Trauma
Including optional Multifocal
The theory behind HHM Technology began with the
study of the human cornea, limbus and sclera to maximize
patients’ optimal visual performance while maintaining
best ocular health, vision, and comfort. HHM Technology
uses patient experiences, expectations, and physical
parameters to develop a theoretical and practical model
for contact lens success. Attention to the theoretical
model has brought about practical changes in design that
will exceed both patient and practitioner expectations.
HHM technology develops a physiologically safe contact
lens modality that will compensate visual impairment
for the near-sighted, far-sighted, astigmatic, presbyopic,
ocular surface diseased, and irregular cornea patient.
The innovation and technology behind HHM Technology
will continue to push boundaries on large diameter rigid
contact lens designs so that all refractive errors and
corneal conditions will be fit successfully with one lens
modality.
Available Parameters:
BASE CURVEUNLIMITED
SPHERE POWERUNLIMITED
CYLINDER POWER -0.25 to -8.00 in 0.25D STEPS
AXIS
0˚ to 180˚ in 5˚ STEPS
DIAMETER
STANDARD: 15.2mm or 15.6 mm
CUSTOM: 13.5mm to 20.0mm
PERIPHERYSTANDARD
FLAT1, FLAT2, FLAT3,
Description
STEEP1, STEEP2, STEEP3
The InSight Scleral Lens is a versatile design addressing
a virtually unlimited range of vision correction needs. It
also features a unique design approach we like to call
HHM Technology which
refers to the way this
lens was developed.
HHM Technology stands
for the collaboration of custom contact lens industry
professionals and clinical practitioners in the development
of optical devices that substantially improve the world
of sight for those in need of visual compensation. HHM
includes the expertise of over 80 years of work in the field
of contact lenses and optics. It blends characteristics of
optics, physiology, theory, and practicality to develop a
contact lens that is optimal to the wearer for both vision
and comfort; and reduces chair time for the clinical
practitioner.
TORIC
Fitting Approach
Empiric fitting is easily achieved on Spherical,
Regular Astigmatic and Corneal Surface Disease
cases having spherical or regular astigmatic corneas.
Empiric fitting is described in a separate fitting guide
accompanying this guide.
Diagnostic fitting is recommended on all irregular
cornea cases including Keratoconus, Trauma,
Post Surgery and other related
irregular corneas.
Lens Evaluation Examples
a. Central Clearance - An ideal fit will have 150-300 microns of clearance
Too Steep
Ideal
Too Flat
Diagnostic Fitting Approach
1. Base Curve Selection
Working from Keratometry or Corneal Topography readings:
FOR - Standard Cornea or Corneal Surface Disease
Corneal Cylinder
a. Less than 2.50 Diopters
Select Base Curve .40mm Steeper than Flat K
b. Greater than 2.50 Diopters
Select Base Curve .30mm Steeper than Steep K
Tear pool is greater than
300 microns. Thicker than
the lens.
Tear pool is between 100 &
300 microns. Equal to lens
thickness.
Tear pool is less than 100
microns. Barely visible.
b. Limbal Clearance - An ideal fit will have slightly less clearance than
observed in the central portion
Too Steep
Ideal
Too Flat
FOR - Corneal Ectasia or Post-Surgery
Select Base Curve .30mm Steeper than Steep K
Note: If Keratometry readings are unobtainable select Base
Curve 7.20mm as a starting point.
2. Prepare lens and insert
a. Holding the lens base curve up, place on large suction cup
and over-fill the lens with saline
b. Add fluorescein
c. Apply the lens: Have the subject tilt their head down,
looking at a tabletop. Place the lens directly on the cornea
so that the solution stays in the lens. For more details, see
Insertion and Removal Tips on the back page.
3. Evaluate lens fit
Tear pool is greater than
100 microns. Greater than
1/4 of lens thickness.
Tear pool is between 50 &
80 microns. Approximately
1/4 of lens thickness.
Tear pool is less than 50
microns. Barely visible.
c. Edge alignment - An ideal fit will land squarely and evenly on the sclera
not having any stand off or blood vessel blanching in the full circumference
of the lens. An uneven fit may require a toric periphery which should be
designed with the assistance of a consultant.
Too Steep
Ideal
Too Flat
Clearance
Evaluation is done using a white light, slit-lamp optic section
technique. Using the lens thickness as a reference, central
clearance will generally be a 1 to 1 relationship. Limbal
clearance will generally be 1/2 of lens thickness.
Edge Landing
The lens edge should land squarely and evenly on the sclera
and must be evaluated 360 degrees. Be sure to lift upper
and lower lids to evaluate the edge hiding beneath. Note any
blanching or edge standoff. Depending on clock position and
severity, the lens edge may require adjustment. This should be
discussed with a consultant.
4. Determine lens power
Perform a sphere-cylinder over-refraction
5. Configure Add Power Option
For the needs of the presbyope, InSight Scleral can be
ordered with an add power of up to 3.00 diopters. Specify
the spectacle add requirement and pupil width measurement
taken in normal room illumination.
Edge is too steep and
is pinching into sclera.
Evidenced by blanching of
underlying blood vessels.
Edge is landing evenly and
squarely on the sclera and is
an ideal fit.
Edge is too flat and is
standing off sclera allowing
air to accumulate under lens
edge.
Insertion and Removal Tips
When handling the InSight Scleral lens, always wash your hands and follow the
lens care instructions provided by your eye care practitioner.
Insertion
Before INSERTION, it is best to rinse the lens and use a non-preserved or
sensitive-eye saline rinsing solution to apply the lens. Tear circulation is less with
a scleral lens than with a smaller corneal lens. Therefore, preservatives in the
soaking solution remain in contact with the cornea longer and this increases the
chance of a reaction to these solutions.
Step 1 Place the lens on suction cup and fill with non-preserved saline so that
the lens is over-filled like the Example photo.
Removal
Since the InSight Scleral® lens is large, the capillary forces which hold the lens
on the eye can be rather strong. Instilling several drops of contact lens rewetting
solution or non-preserved saline before lens removal is beneficial. A DMV
Contact Lens Remover is the recommended tool for lens removal.
Step 1 Instill several drops of contact lens rewetting solution or non-preserved
saline in the eye from which the lens is to be removed.
Step 2 Position the DMV Contact Lens Remover on the lower portion of the
lens as shown in the Example photo.
Step 3 Gently lift the lens away from the eye with the suction cup attached to the
lens. Example show best position of DMV on lens for removal.
Step 2 Using your fingers, pull both eye lids back to expose a large enough area
of the eye to allow easy insertion of the lens.
Step 3 Insert lens while facing downward over a table or counter top so that the
lens remains filled with saline.
Step 4 Observe lens on eye by looking into a mirror looking for bubbles that
may be trapped under the lens. If bubbles are present, remove the lens
and repeat insertion steps.
Proper position of DMV on lens being removed from eye.
Lens properly filled with saline. Note that the saline level extends above lens edge.
Apply DMV to lower portion of lens. Gently lift lens away using the remover.
Eye properly opened with head tilted downward for easiest lens insertion.
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