DISPOSABLES
When the Solution is no
Solution
Single-use lenses could be the
answer for your patients suffering from dryness.
By Rhonda S. Robinson, O.D.
Indianapolis, Ind.
Dryness, that dreaded two-syllable
word. Sometimes it's as persistent as my neighbor's dog barking
in the middle of the night. My contact lens patients have never
complained as much about dryness as they have in the past few
years. Maybe it's my memory that has become selective, but it
seems like the old conventional heat-disinfected soft lenses
never evoked so many arid-like adjectives. Could the culprit be
the thinning ozone layer in the atmosphere? Is it cellular phone
radiation or genetically altered vegetables?
Will these work?
Ten different optometrists will
have 10 different theories for this seemingly sudden epidemic.
Increased computer use by everyone seems to be the only common
thread in any discussion about why disposable soft lenses feel
dry to our patients.
How to solve the problem of soft
lens dryness is even more varied in these discussions. Here are
some of the more popular problem-solvers:
- Use lubricant drops.
- Try an FDA Group I lens -- it
won't have the evaporative effect that a high water
content lens does.
- Increase the movement of the
lens by loosening the fit for better end-of-day comfort.
- Use a higher oxygen
transmissibility to increase comfort.
- Try to train your dry-eyed
patients to blink more fully and more often.
- Recommend that your patient
wear a pair of reading glasses over his contact lenses
while he's at the computer. This may increase his blink
rate.
- Suggest the patient use more
lubricant drops.
- Change the patient's lens
solution to one he hasn't tried yet.
- Check the lens for thinness.
It may be too thin, causing the lens to dry out faster.
- Insert punctal plugs.
I've tried all of the above re-
medies at one time or another, and they've shown some success for
my dry-eyed patients. However, I've found a solution that
produces even better results. The ultimate solution to cases of
dry eye is single-use contact lenses.
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Try Different Brands |
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Of course, one lens won't work
best for everyone, so you may want to try a different brand on
each eye and let the patient tell you if one or the other is
preferred for comfort.
I give the patient five single-use
lenses for each eye and instruct him to wear the last pair on the
day of his follow-up appointment so I can evaluate the lenses
after at least 4 hours of wear. More often than not, these
patients are as enthusiastic about the added comfort as they are
about the exceptional convenience. The approximate dollar-a-day
cost is a bargain considering the cost of a cup of coffee these
days.
Just remember, don't forget
about single-use contact lenses when problem-solving your soft
lens patients who have dry eyes. The solution to these patients'
dryness may just be no solution at all.
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No solution?
The solution to our problem is
sometimes no solution. I have to admit, I'd stumbled upon this
remarkable discovery purely by accident. I really didn't think
single-use lenses had a place in my office when they were first
introduced on the market. My first thought was they were "too
expensive."
Before, I used to only present
single-use lenses to patients who were considering part-time wear.
It seemed to me that convenience was really the only asset this
modality had to offer. After following-up with the patients whom
I'd fitted with single-use lenses, I started to discover that
more and more of them had fewer complaints of dryness compared to
my other patients who wore 2-week and monthly replacement lenses.
You might think the additional
comfort was from part-time wear, but on the contrary, these
patients began wearing their lenses more often because they were
more comfortable wearing single-use lenses.
Giving it a try
So I started fitting my more
problematic dry-eyed patients with single-use lenses. This, of
course, meant no more use of multi-purpose solutions. My results
were dramatic. Increased comfort, less dryness and overall
improvement in patient compliance skyrocketed. My office profit
margins were the highest I'd ever seen. Well, maybe I'm
exaggerating about the profit margins, but I really did see an
overall improvement in comfort.
Presently, we have three single-use
soft lenses to choose from. Bausch & Lomb's SofLens one day,
CIBA Vision's Focus Dailies and Vistakon's 1-Day Acuvue. See the
"Single-Use Soft Lenses" table below.
Dr. Robinson is in private
practice in Indianapolis, Ind. She's also an academic consultant
for Bausch & Lomb.
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Single-Use Soft Lenses |
| Manufacturer |
FDA Grp. |
Diam. |
Base Curves |
Powers |
| Bausch & Lomb |
II |
14.2mm |
8.6mm |
+6.5OD to -9.0OD |
| CIBA Vision |
II |
13.8mm |
8.6mm |
+0.5OD to -6.0OD |
| Vistakon |
IV |
14.2mm |
8.5mm, 9.0mm |
+6.0OD to -12.0OD |
Optometric Management, Issue: February 2001