Kiwi optometrist Gina Partridge discusses instances when the new Abiliti 1-Day soft contact lens has made the difference in some worrisome cases of myopia.
New Zealand optometrist Ms Gina Partridge has been prescribing ACUVUE Abiliti 1-Day for more than 18 months – a head start, it would seem, over her Australian counterparts who have only recently gained access to the latest soft contact lens for myopia control.
But in many ways, Australian optometrists are in a unique position to hit the ground running, drawing on insights from their Kiwi colleagues who’ve been diligently figuring how out how to integrate the new lens into their management strategies.
In Partridge’s Auckland Myopia Clinic, soft contact lenses are a cornerstone of myopia management, used in 60% of cases. She often prescribes them for low myopes, typically under -1.50 D or -2.00 D or those not yet ready for orthokeratology. Soft lenses are also ideal for anisometropia when one eye has good vision and the child might resist glasses.
In the case of Abiliti 1-Day, she has observed several key advantages since becoming one of New Zealand’s early adopters of the Johnson & Johnson (J&J) Vision lens in late 2023.
Firstly, the smaller size and lens properties make it easier to fit, especially in very young children with smaller eyes. The high oxygen permeability provides significant peace of mind given their potentially long lifetime of contact lens wear, and the concentrated high plus in the centre is beneficial, especially in patients with smaller pupils and low or no astigmatism.
On average, Abiliti 1-Day has been shown to slow axial elongation by 0.25 mm over a two-year period,1 with almost 65% showing no clinically meaningful myopia progression (less than 0.25 D).
But Partridge has also seen the lens have remarkable effect in some more extreme and unique cases.
One of those patients is a four-year-old boy already -8.00 D and diagnosed with genetically-influenced high myopia. Previous attempts with atropine caused an eye turn, myopia control spectacles weren’t effective enough, and an earlier trial with soft contact lenses was also unsuccessful due to dry eye issues and lens dislodgement. Furthermore, his eyelid anatomy made insertion of larger lenses challenging. The smaller Abiliti 1-Day lens addressed these issues directly, while also providing a bandage effect against his inward turning eyelashes which were causing corneal staining and discomfort.
“With Abiliti, he could learn to put it on and take it off completely by himself,” Partridge explains.
“We fitted him with the lens in July-August 2024, and for the last year his spectacle and contact lens prescription hasn’t changed. His axial length is still progressing, but instead of being ~0.6-0.7 mm per year, it’s reduced to ~0.2-0.3 mm a year.”
With the patient having a smaller pupil, Partridge can’t say for sure but suspects the high treatment zone in the centre of the lens contributed to this success story, plus his better visual acuity promoted greater compliance.
In another instance, a child presented with a unique scenario where one eye was progressing at a much faster rate than the other (R 0.22 vs L 0.12mm) over 10 months.
Abiliti 1-Day was fitted to the progressing eye, creating a direct comparative study within a single patient.
“After 15 months, the right eye fitted with Abiliti progressed at a much slower rate (~0.07mm) while the other progressed at a rate similar to the year before (~0.15mm). So, the Abiliti lens did seem to have more of an effect in this child.”
Teenage patients present their own set of challenges, particularly concerning compliance with prolonged lens wear.
Another of Partridge’s patients is a 17-year-old high myope who dropped out of orthok wear due to poor vision and allergies. He was still experiencing significant discomfort and redness from his previous myopia control soft contact lenses due to extended wear hours – often from 7am to midnight due to educational demands. He resorted to changing his lenses twice a day, using lubricating and anti-allergy eye drops in order to remedy this.
While not endorsing excessive wear, Partridge had some comfort knowing he was in a silicone hydrogel lens when switching over to Abiliti 1-Day, which is made from senofilcon A, the same material as ACUVUE OASYS 1-Day, known for its comfort and breathability.
“This allowed him to wear a single lens for the majority of the day, significantly improving his comfort and proving more cost-effective for his family,” Partridge adds.
It’s these sorts of patients – those with “high or tricky scripts” – where Partridge’s Auckland Myopia Clinic does its most powerful work. Being able to offer Abiliti 1-Day in her myopia management repertoire is a privilege for Partridge, who – as a high myope herself with subsequent yet mild retinopathy – is personally motivated to ensure progressing myopes aren’t resigned to a similar fate.
She has worn contact lenses since the age of 11 and understands the practical and emotional journey many of her young patients embark on. This lived experience, coupled with her unexpected foray into paediatric optometry, serendipitously drew her into the world of myopia management.
Her practice, co-founded with two other colleagues, was originally a central CBD practice providing general optometry services, but it pivoted dramatically post-COVID lockdowns to become myopia-focused. This was driven by the volume of children who were presenting with progressive myopia.
“It was also a chance to make a difference in an area of optometry that we were so passionate about,” she adds.
That passion for myopia management continues to grow, driven not only by emerging research and clinical insights but also by innovations like Abiliti 1-Day.
For Partridge and her optometry colleagues, much of the fascination lies in its unique design that includes a smaller diameter and base curve suited to a child’s eye.
But at its core, Abiliti 1-Day has two critical elements: a +10D Central Boost zone and a +7 D RingBoost design.2
Dr Emma Gillies, J&J Vision’s professional education and development lead, says the +7 D RingBoost provides a substantially greater amount of plus to be incorporated into the treatment zones.
The ring is focused off the line of sight, creating a treatment effect that maintains visual quality, while the +10 D boost is designed to increase the overall efficacy of the design.
She references the BLINK study3 demonstrating the more plus power that can be incorporated into a design, the greater the efficacy in myopia management. But, there’ s a limit to the amount of plus that can be built into the design without significantly impacting the quality of vision through the lens.
“This has historically been a limitation in most soft contact lens designs used for myopia management,” Dr Gillies says. “The breakthrough technology of Abiliti 1-Day breaks that nexus.”
The principle of non co-axial optics – which doesn’t feature in competing designs – is the secret sauce in Abiliti 1-Day.
“The non co-axial design allows the light from the treatment zones to be focused in a ring around the line of sight. This is what allows us to introduce significantly more plus into the design without significantly impacting the visual quality for the patient,” Gillies says.
For other practitioners looking to prescribe Abiliti 1-Day, Partridge believes it stands out in first-time wearers with smaller apertures and higher corneal curvatures.
She encourages careful and precise fitting in the presence of astigmatism (the clinical study inclusion criteria limited astigmatism less than 1.00D cyl), or when the child has a dilated pupil from atropine. She encourages a longer trial period of approximately two to three weeks to allow for adaptation.
“I find teaching children much easier than adults with contact lens wear. They are so much more adaptable, more fearless and quick to learn,” Partridge says. “Soft contact lenses make a huge difference to a lot of children and families who want to avoid the stigma of wearing glasses or being short-sighted, plus it allows them to more confidently pursue the activities and hobbies they love.”
References
1.JJV Data on file, 2021. Efficacy of ACUVUE® Abiliti® 1-Day Soft Therapeutic Lenses for Myopia Management: Comparative Claims vs. Single Vision and Dual Focus Lenses.
2. JJV Data on File 2021. Development of Optical Design of ACUVUE® Abiliti® 1-Day Soft Therapeutic Lenses for Myopia Management.
3. Walline JJ, Walker MK, Mutti DO, Jones-Jordan LA, Sinnott LT, Giannoni AG, Bickle KM, Schulle KL, Nixon A, Pierce GE, Berntsen DA; BLINK Study Group. Effect of High Add Power, Medium Add Power, or Single-Vision Contact Lenses on Myopia Progression in Children: The BLINK Randomized Clinical Trial. JAMA. 2020 Aug 11;324(6):571-580. doi: 10.1001/jama.2020.10834. PMID: 32780139; PMCID: PMC7420158.
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