CLSA Eye Witness Spring 2011 - (Page 5)

and maximizes the quality of the lens by the fact that it is replaced every day. This has allowed practitioners to treat patients with pathology related to contact lens degradation. One such condition is giant papillary conjunctivitis (GPC) and by prescribing daily disposable contact lenses you eliminate the causal agent and allow these patients to continue wearing contact lenses. The increased frequency of replacement has also been shown to decrease other biofilms on the lens such as allergens, making this a great modality for allergy sufferers. Preservatives from cleaning systems are also minimized reducing their toxic effects on ocular tissues. Any bacterial biofilms are disposed of every night and this, in theory should greatly reduce the risk of any microbial consequences of contact lens wear. Fahmy, et al. as well as others have shown clinically that the implementation of a daily disposable modality can improve comfort and other symptoms common to contact lens wearers including tired eyes, blurred vision, redness, irritated eyes, dryness, and discomfort as well as an improvement in biomicroscopy signs. Many of our contact lens patients are part-time patients. By this I mean they don’t wear their lenses every day. Many myopic presbyopes choose not to wear any correction at their desk or in the office and glasses afford them the ability to switch back and forth from near to far tasks quickly and easily. Some patients just prefer glasses and wear contact lenses only for certain activities such as sports or exercising. Others enjoy the option of wearing glasses for a different look, style or simply for convenience. Daily disposable contacts fill the niche better than other modalities for these part time patients. Daily disposables allow these patients the benefits of contact lenses for the times they need them (sports for example) while eliminating the possibility of contamination or poor care habits that can occur from leaving the lenses in the case until the next game, event or occasion. These patients may also have a financial benefit to wear daily disposables. As they use fewer lenses in between eye exams it may actually be less expensive for them to buy or restock their shelves with dailies as opposed to getting little use out of a supply of less frequently replaced lenses. With the ever-changing world of air travel as well as other lifestyle needs contact lens solutions continue to be a hindrance to many contact lens patients. By eliminating the need for these solutions, daily disposable contacts allow frequent flyers, travelers and even college students on a road trip a more convenient way to travel. The Bad Daily disposable contacts cost more than other modality lenses. This has been the biggest sticking point of these lenses for years. However, as I stated earlier, if patients EyEWitnEss spring 2011 | don’t wear their lenses every day it may actually be to the patient’s financial advantage to wear dailies. According to Efron, et al. “The point at which the cost-per-wear is virtually the same for all lens replacement frequencies is five days of lens wear per week. A similar but upwardly displaced (higher cost) pattern is observed for toric lenses, with the cross-over point occurring between three and four days of wear per week.” As you can see the difference in cost is minimal and as prescribing trends have shown us patients don’t seem to be bothered by the increased cost incurred with these lenses. Yes, there may be slightly larger cost up front, and yes, this may be a significant factor for some patients, but I would argue that this is the exception, not the rule. Especially if the improved ease of care and other benefits of a daily disposable modality are included into the equation. Some might say that oxygen permeability is the most important factor in soft contact lens fitting. They might also feel that because most daily disposables have less oxygen permeability than some other lenses that daily disposables are an unhealthy option for patients. I believe oxygen is an obvious component to corneal health, and now with daily disposable silicone hydrogels hitting the market this argument may be over. However, I also feel standard hydrogels have a proven track record as a safe and effective option for vision correction. As we move forward with the ever expanding knowledge base and understanding of corneal physiology I expect oxygen permeability and other factors to continue to be incorporated into all forms of contact lenses including daily disposables. Whether daily disposables improve patient compliance is debatable. People are interesting creatures and because of this I believe there will always be the occasional patient that sleeps in their lenses for three months straight or the patient that comes back after not keeping several followups in a year’s time still wearing the trial lenses given to them a year earlier. Moral of the story, and I know this may take you by surprise, but patients don’t always do what we ask them to do! A study by Dart et al. found that 30% of daily disposable patients used their lenses for occasional or regular overnight wear. This obviously puts these patients at higher risk for complications. I do believe, however that | w w w. c l s a . i n f o c o n ta c t l e n s s o c i e t y o f a m e r i c a 5 http://www.clsa.info http://WWW.CLSA.INFO

Table of Contents for the Digital Edition of CLSA Eye Witness Spring 2011

CLSA Eye Witness Spring 2011

CLSA Eye Witness Spring 2011 - (Page Cover1)
CLSA Eye Witness Spring 2011 - (Page Cover2)
CLSA Eye Witness Spring 2011 - (Page 1)
CLSA Eye Witness Spring 2011 - (Page 2)
CLSA Eye Witness Spring 2011 - (Page 3)
CLSA Eye Witness Spring 2011 - (Page 4)
CLSA Eye Witness Spring 2011 - (Page 5)
CLSA Eye Witness Spring 2011 - (Page 6)
CLSA Eye Witness Spring 2011 - (Page 7)
CLSA Eye Witness Spring 2011 - (Page 8)
CLSA Eye Witness Spring 2011 - (Page 9)
CLSA Eye Witness Spring 2011 - (Page 10)
CLSA Eye Witness Spring 2011 - (Page 11)
CLSA Eye Witness Spring 2011 - (Page 12)
CLSA Eye Witness Spring 2011 - (Page 13)
CLSA Eye Witness Spring 2011 - (Page 14)
CLSA Eye Witness Spring 2011 - (Page 15)
CLSA Eye Witness Spring 2011 - (Page 16)
CLSA Eye Witness Spring 2011 - (Page 17)
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CLSA Eye Witness Spring 2011 - (Page 19)
CLSA Eye Witness Spring 2011 - (Page 20)
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CLSA Eye Witness Spring 2011 - (Page 22)
CLSA Eye Witness Spring 2011 - (Page 23)
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CLSA Eye Witness Spring 2011 - (Page 26)
CLSA Eye Witness Spring 2011 - (Page 27)
CLSA Eye Witness Spring 2011 - (Page 28)
CLSA Eye Witness Spring 2011 - (Page 29)
CLSA Eye Witness Spring 2011 - (Page 30)
CLSA Eye Witness Spring 2011 - (Page 31)
CLSA Eye Witness Spring 2011 - (Page 32)
CLSA Eye Witness Spring 2011 - (Page 33)
CLSA Eye Witness Spring 2011 - (Page 34)
CLSA Eye Witness Spring 2011 - (Page 35)
CLSA Eye Witness Spring 2011 - (Page 36)
CLSA Eye Witness Spring 2011 - (Page Cover3)
CLSA Eye Witness Spring 2011 - (Page Cover4)
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