Article Date: 4/1/2004

contact lens management
Expanding the Candidate Pool

Silicone hydrogels have tremendous appeal, so don't niche them.

The most obvious candidates for a hyper-Dk/t lens are the patients who ask for "that 30-day lens" they saw advertised, or the ones who say they're already sleeping in their lenses. But if you're only moving the obvious candidates into CIBA Vision's Focus Night & Day lens, then you're limiting this incredible new technology to a narrow niche.

Broaden your horizons

I trial fit almost every extended or flexible wear patient with Night & Day. With six times greater oxygen transmissibility than ordinary low-Dk one-to-two week/monthly disposable lenses, and as the only lens available that exceeds the 125 Dk/t minimum threshold needed to avoid corneal acidosis, there's no better choice for patients who want to sleep in their lenses. I've seen studies showing that 70% of patients would like the convenience of overnight wear -- if they can do so with little risk.

Here's another plus

When upgrading patients from low-Dk one- to two-week/monthly disposable lenses into Night & Day, explain that their prescription may change as a result of the increased oxygen flow to the cornea. One of my patients had a 2.00D reduction in myopia, and a 1.00D shift isn't uncommon. Telling patients this same shift would have occurred if they stopped wearing lenses altogether reinforces why this lens is better for their eyes.

CIBA's Night & Days appeal to almost every hyperope, the author found.

Hyperopes rejoice

I now trial fit every hyperope, whether a daily wear or continuous wear lens wearer, with Night & Day. This was a category I'd initially overlooked, but I tried the lens with patients who complained of end-of-day discomfort or dryness. The results were so dramatic that I began telling more hyperopes, "My far-sighted patients are saying this lens is so much more comfortable at the end of the day and that their vision is so much better, I want you to try it too." About 95% upgrade to Night & Day.

Continuous wear hyperopes are nearly ecstatic with this lens. I particularly encourage continuous wear for monovision patients because they tend to be more satisfied than daily wear monovision patients. Daily wear patients who wear bifocals or glasses in the evenings have regular experiences with binocular vision. Continuous wear patients don't have their binocular vision to compare it to, making for a smoother transition.

Don't forget these candidates

While I recommend a trial fitting for every hyperopic patient, I don't necessarily do the same with myopic daily wear lens wearers. However -- and this is a big caveat -- if these wearers complain of blurred vision at the end of the day, dryness or other comfort problems, then I'll recommend Night & Day.

I've switched every post-refractive surgery patient in soft contact lenses to Night & Day lenses, and all piggyback keratoconic fits. I've also been fitting my recurrent corneal erosion patients with plano Night & Day bandage contact lenses.

Look for broadest range

As you can see, my candidate pool for silicone hydrogel patients goes far beyond the ones who come in asking for it specifically. Night & Day hyper-Dk/t lenses have tremendous advantages in terms of convenience, comfort and overall eye health. Determine which characteristic will most appeal to each group of patients and tailor your presentation accordingly. 



Optometric Management, Issue: April 2004