A Different Application for a Sport Tint Contact Lens
Bausch & Lomb introduced its Nike Maxsight lens in late 2005 for eliminating image distortion and improving field of vision in athletes. According to Nike, the patented Light Architecture. Optics selectively filter blue light, thereby decreasing chromatic blur, and manipulate the remaining colors of the visible spectrum to visually enhance key elements in sporting environments. The lenses provide light transmission in peak areas of the visual spectrum to aid in object and contour recognition.
These monthly replacement lenses are designed for wear during sporting activities only. The amber tint is better for fast-moving ball sports in variable light conditions while the grey-green tint is good for sports played in bright sunlight. The amber tint allows longer wavelengths through and filters green out, while the grey-green tint allows green and red wavelengths through and filters the blue out.
Also, Nike Maxsight lenses filter out greater than 95 percent of UVA and UVB light from entering the eye, according to B&L.
The following case explains how this lens also benefited one patient following a corneal injury.
In 2004, the Birmingham Veterans Affairs Medical Center referred patient DC, a 50-year-old Caucasian male veteran, for contact lens fitting to the Cornea and Contact Lens Department at The UAB School of Optometry. He had a squamous cell carcinoma in his right upper lid that was removed in September 2001. According to DC, while the surgeon removed the carcinoma with the laser, the laser was too hot and consequently burned his right cornea, leaving an inferior nasal stromal scar. Since then he had experienced diplopia, more so at night than during the day. Figure 1 shows the scar in the right cornea, and Figure 2 shows DC's corneal topography. His manifest refraction at this visit was OD +0.75 -8.75 x180 (20/25-) and OS -1.00 -0.25 x105 (20/15).
After trying several GP lenses in late 2004, we successfully fit his right eye with a semi-scleral lens that had an 8.10mm base curve, 13.5mm overall diameter and -2.25D power (20/15) with no diplopia and his left eye with a Night & Day (CIBA Vision) contact lens with an 8.6mm base curve, 13.8mm diameter and -1.00D power (20/15).
Figure 2. DC's corneal topography before lens fitting.
Because of a constant change in refraction and vision, DC had consulted a local optometrist in Nashville, Tenn., who refit his right eye with a piggyback system consisting of a Night & Day lens with an 8.4mm base curve, 13.8mm diameter and +0.75D power and a GP lens made of Boston XO (B&L) with a 7.85mm base curve, 9.0mm overall diameter, 7.6mm optic zone diameter, 0.15mm center thickness and -2.75D power (20/15). He refit DC's left eye with a Night & Day lens with an 8.6mm base curve, 13.8mm diameter and -1.25D power (20/15). DC uses +1.50D readers over his contact lenses for near.
In June 2006, DC returned for a yearly eye exam and said his prescription OD had changed three times in nine months. Both the topography and manifest refraction showed a marked decrease in astigmatism. He arrived wearing Night & Day lenses, OD 8.6mm base curve, 13.8mm diameter, -1.75D power and OS 8.6mm base curve, 13.8mm diameter, -1.50D power. He had stopped wearing the GP lens OD in November 2005. Figure 3 shows his corneal topography. His manifest refraction at this visit was OD -1.25 -0.50 x175 (20/20) and OS -1.25 -0.50 x144 (20/20). He saw clearly with Night & Day lenses with an 8.6mm base curve, 13.8mm diameter and -1.25D in both eyes.
Not Just for Sports
At this visit, DC inquired about the new Nike Maxsight lenses because he was experiencing glare and halos day and night. He pilots a helicopter and was experiencing difficulties with stray light during the day. He had tried the amber lens during the day and the grey-green lens for night-time glare in his right eye only. He was interested in wearing the contact lenses in both eyes as needed for glare. The appearance of his eyes with these lenses didn't bother him.
We informed him that this would be an off-label use because these lenses are meant for sporting activities only. We also told him not to drive while wearing these lenses.
We fit DC with Nike Maxsight lenses with an 8.7mm base curve, 14.3mm diameter and -1.25D power OU (20/20) in both amber and grey-green. We advised him to try the lenses for a week and return for a progress check. When DC came back, he reported that he preferred the amber lens for day time glare and the grey-green lens for night time glare and haloes. He uses them on and off, and during work hours he wears his Night & Day lenses. We advised DC to return in one year for a regular annual exam.
We recently contacted DC and learned that he's happy with both tinted lenses for his daily activities. He also reported that he has started using them more often during the day because they decrease his ghost imaging and double vision. Even though the amber tint is marketed for variable light conditions and grey-green for bright light, DC found the grey-green lenses to help more during low light levels.
This case demonstrates that we don't need to limit Nike Maxsight lenses to patients interested in enhancing their sports performance. We can also consider them for patients who have glare problems secondary to corneal issues.
Based on DC's response and experience, other patients who've experienced corneal insult or injury secondary to surgery or post-refractive surgery (RK, PRK, LASIK or PK) might benefit from wearing Nike Maxsight contact lenses.
It's important to keep in mind that you should fit these lenses only after ensuring that the cornea is stable. Hence, you might fit Maxsight lenses in addition to a specialty contact lens. Make sure to inform patients that these are off-label uses of the contact lens. As long as you provide patients with the do's and don'ts for Maxsight contact lenses, such patients might find them extremely helpful and rewarding.
Dr. Chandrasekaran works as a clinical assistant professor at UAB School of Optometry and at two private practices in Montgomery, Alabama.