Peter D’Arcy Optometrist member Contact lens Society of Australia in Bega can fit, assess and monitor all types of contact lenses for suitable patients to supplement spectacles used in the standard eye correction.
SCL wearers-daily disposable contact lenses,monthly disposables and extended wear lenses are often trialled instead of or before refractive surgery options are undertaken.
RGP (rigid gas permeable) lenses for kerataconus and ortho K myopia control.
Post graft CL fitting and advice on laser surgery/refractive surgery options.
Latest materials and designs including silicone hydrogel lenses are now available,and are more oxygen-permeable and wettable including daily and monthly types.
Wearing contact lenses even daily disposable wear lenses means eye care becomes more important.Studies have shown that wearers who do not follow recommended replacement schedules have more complications and self-reported discomfort than contact lens wearers who follow the replacement recommendations and after care visits. The risk of inflammation and infection increases with the frequency of overnight wear,especially in non peroxide disinfecting regimes.
An eye care professional often encounters eye health issues from unsuitable contact lens solutions or regimes being employed.
Lens specifications can vary widely including water content and contact lens intolerance can include giant papillary conjunctivitis (GPC).
Latest materials consist of a silicone layer in between thin layers of soft hydrated polymers allowing for greater oxygen transmission and greater wearing time,especially important for extended wear contacts.
BIOFINITY lenses may be prescribed for daily wear and extended wear for up to 6 nights/ 7 days of continuous day and night wear USFDA but it is subject to patient suitability.
Not all patients can achieve the maximum wear time. It is recommended that the contact lens wearer be evaluated on a daily wear schedule. If successful, then a gradual introduction of extended wear can be followed as determined by your personal responses and your eye doctor.
Once removed, it is recommended that the lens remain out of the eye for a period of rest overnight or longer and discarded in accordance with the prescribed wearing schedule. We can advise the appropriate wearing time for your specific circumstances.
All lenses have their purpose and different modality. Dailies are supplied than monthlies.
A fresh pair of daily contacts for daily wear are known as daily disposable contacts. Monthly disposable contacts are discarded after 30 days of wear and require more contact lens care eg surfactant cleaning with your index finger.
Recent studies demonstrated that daily disposable lenses decrease the risk of CIEs (corneal infiltrative events ) more than 12‐fold compared to reusable lenses or extended wear (EW) types.
The risk of developing a CIE may be higher with silicone hydrogel materials as they may bind more micro‐organisms than hydrogel lenses, but the events that occur are less severe
CLARE (contact lens induced acute red eye) has been reported with EW RGP lenses, silicone elastomer lenses, and with the over wear of daily soft lenses, a history of extended wear with hydrogel lenses is most typical, as is a uniocular presentation.
EW research studies report yearly incidence rate between 4% to 30 % depending on lens type, lens care regimen, and lens replacement frequency.
Bausch and Lomb Popularity
Coopervision Proclear has the FDA approval for dry eye.
Proview Elite and the Proview Perform are considered the best for handing. The Proveiw Elite has a blue tint and the Proview Perform has not.
all equally popular but differ in water content
Johnson & Johnson Vision Acuvue Popularity
Dailies Total 1 Smart Tears technology allows further release of phosphatidylcholine (PC) which exists in our tears naturally. Its role is to bind the lipid layer to the aqueous layer which allow for a smooth protective lipid layer.
The corneal health and regularity needs to be determined in assessing the optical correction possible.
Keratoconus lens wearers be they be in Bega ,Tathra, Tura, Bombala, Narooma, Merimbula or Eden need to ensure their lens fitting and tolerance is safe and comfortable.
Kerataconus (usually bilateral) is a progressive thinning of the cornea and is the most common corneal dystrophy. It can cause double or blurred vision, nearsightedness, astigmatism, and increased sensitivity to light.
You may need specially fitted custom,soft,rgp, (rigid gas permeable) ,scleral or piggyyback forms to correct the distortion of the cornea and provide better vision rather than glasses if the disease progresses.
Corneal collagen cross linking ideally in the mid teens can be considered to strengthen the cornea.
Using an application of riboflavin (Vitamin B2) eye drops during exposure to ultraviolet (UVA) light, the exposed deeper layers of the cornea develops bonds between its fibres,followed by a bandage contact lens to aid repair.
The cause of keratoconus is unknown,likely to be an inherited condition. Some studies have connected keratoconus with allergies such as asthma ,eczema and excessive rubbing.
KBA design 10.2mm, Epicon 13.5mm or Katt 16.5mm can vault much of this irregularity.
We can advise on the material and design based on the optics,health and shape of your eyes and frequency of replacement.
In advanced cases corneal grafts can be done often ideally between 20 – 45 years of age which then are fitted sometimes with contact lenses.
Different materials vary in how much oxygen can pass through to the eye, and how moist your lenses stay throughout the day .
Corneal topography images and maps the surface curvature regularity as does anterior OCT scanning for a variety of eye conditions.
In most cases, the cornea stabilizes after a few years without causing severe vision problems.
A small number of people with keratoconus may develop severe corneal scarring or become unable to tolerate a contact lens. For these people, the corneal transplant may become necessary
Standardised grading scales are used for recording and monitoring clinical changes to ocular tissues.
The conditions under which lenses are purchased, stored and transported should be better regulated as should controls over on line sellers with risks of counterfeit lenses or repackaged.
Never change your lens-care system without oversight as preservative reactions are common and require examination.
How to use Hydrogen Peroxide correctly
Hydrogen peroxide placed directly into the eyes or on your contact lenses can cause stinging, burning, and temporary corneal damage. When using hydrogen peroxide you must follow the disinfecting process with a neutralizer. The neutralizer turns the peroxide into water and oxygen, making it safe to put your lenses back into your eyes.
Specific lubricating eyedrops or artificial tears that are preservative free can help wetting of specific lens materials and we can recommend the ideal wearing replacement schedule to avoid the potential contact lens blindness at worst or suboptimal performance and safety.
Bausch & Lomb regimes
In terms of the regimen for soft lenses, it’s a one step process for cleaning, disinfecting and conditioning.
B+L solutions for soft lenses :
One Step Cleaner – Boston Simplus – cleans, disinfects, conditions and cushions RGP contact lenses and removes protein daily.
Step one – Boston Advance Cleaner removes debris and deposits from RGP lenses, leaving lenses clean and clear. It is visibly tinted for improved rinsing.
Step two – Boston Advance Conditioner contains a dual disinfecting system that delivers excellent protection against harmful microorganisms.
For Additional Cleaning Boston One Step Liquid Enzymatic Cleaner removes protein deposits weekly from RGP lenses.
Lubricated contact lenses Boston Rewetting Drops, rewet, recondition and lubricate RGP lenses to relieve minor irritation and discomfort during contact lens wear.
Worst cases which can lead to a corneal graft
Vast majority are wearers of soft lenses who ignore the risks of rinsing their lenses in tap water or wear them in the shower.
In rare cases, the parasite has been known to enter the spinal cord (via the optical nerve) which can lead to death.
Scuba divers enjoying the beautiful nearby sapphire coast from Narooma to Merimbula and Eden ideally need to wear prescription dive masks.
The health of your eyes can be comprimised so supervision is advisable.
Often trials of a free contact lens in the form of a daily disposable can engender a false sense of security which is why follow up appointments can troubleshoot for potential problems.
Too many contact lens wearers are not opting for proper disposal so not being biodegradable can find their way into fish, birds or other animals.
Such recycling means after proper disposal , they can be shredded, washed and melted down into sustainable raw material that can be used as an alternative to newly manufactured materials.
All brands and blister packs can be sent to via us to TerraCycle an innovative recycling company for this purpose.