1800 Congame
The “Contact Lens Rule,” implements the Fairness to Contact Lens Consumers Act, codified at 15 U.S.C. 7601–7610, which requires that rules be issued to address the release, verification, and sale of contact lens prescriptions. Here is one part that I have a huge issue with.
(c) Verification events. A prescription is verified under paragraph (a)(2) of this section only if one of the following occurs:
(1) The prescriber confirms the prescription is accurate by direct communication with the seller;
(2) The prescriber informs the seller through direct communication that the prescription is inaccurate and provides the accurate prescription; or
(3) The prescriber fails to communicate with the seller within eight (8) business hours after receiving from the seller the information described in paragraph (b) of this section. During these eight (8) business hours, the seller shall provide a reasonable opportunity for the prescriber to communicate with the seller concerning the verification request.
Just because nobody replied back, doesn’t mean the Rx is ok….certainly not ok to send the order! This bothers me tremendously. Patients can by pass health checks for years, simply by giving bogus doctors info. I had a patient publicly call me out on the crookedness of online contact lens vendors. The sad part, is that its perfectly legal for the vendors to sell contacts to without actually verifying if the Rx is actually correct through a time constraint loophole. Basically, if they do not get verification wihtin 8 hours, they fill the order. The work around is simply. All one does is submit a name of a random doctor and hope that doctor does not tell the vendor that they are not a patient there. There is a drop down list of doctors names. I just picked the first one and the order went trhough with out an issue. Let me make this very clear:
I was able to order contacts that are not even close to the right power, size, shape or material for my eye. Dangerous! I was able to choose a doctor whom I never heard of from a convenient drop down list.
I’m guessing the Dr. Edward Smith doesn’t exist, didn’t see the verification, or didn’t care enough to let 1800 know that I was not a patient of his. It is absolutely crazy to think that if the vendor hears nothing back from the doctor, they assume everything is fine and ship you the contacts!!!!!! That assumption is dangerous. A better solution is to have the patient email/fax a physical copy of the Rx that has the doctor’s name, signature, expiration date and contact info. A camera phone can easily take a pic and email it in. It would also free up the doctor’s office from having to do the verification process. The current system is a joke and easily gamed. Its a very dangerous game to play. You only have 1 set of eyes people, take care of them!
The Rub
It was really clever marketing to call it “No Rub”. Everyone and their mom thinks all you do is take your contacts out, put them in the empty case and fill it up with solution. That is not the way to do it!
Contacts have a bunch of crap on them from being on your eyes all day. If you hold them up to the light you can see it. You have to get this stuff off or it will be as if you are rubbing sandpaper on your eyes. You have 2 options.
The first is to high pressure wash them with the solution by blasting them for 10 seconds, making sure to get both sides. This means you will go through a bottle of solution in less than a month.
Nobody has ever told me they run through solution this frequently so NOBODY is cleaning their contacts correctly with the rinse only method. Is it effective? Well Dr. Peter Rozanec thinks “No-rub contact solution works as well as no-brush toothpaste.” Nice one doc. I agree! Another friend reminds me, “Its sort of like running your dishes under the faucet and then eating off them again. And a 20-second rinse is a ton of solution! Ineffective and expensive.”
The second thing you can do is take them out and add a few drops of solution then rub them for 5-10 seconds, flip it and rub it for 5-10 seconds. Finish with a quick squirt to wash it away. This will get most of the buildup off. Look at it. Its pretty clean now. The rubbing does the best job of getting it clean.
Whatever way you clean them, remember they are still germy and dry so they need to be soaked in multi-purpose solution overnight. This is where it is disinfected and re-hydrated. So it will come out clean, disinfected and hydrated. That will keep things clear and comfortable. It will also give your eyes the best chance at staying healthy.
As always, a fresh clean contact everyday is the best. If you can wear a daily disposables, wear them!
Don’t stretch it out.
Dont' strech your contact lenses!
Some contact lenses are to be changed daily. Others last for 2 weeks. Some last for a month. Why are they all different, and is it important to change them regularly?
Contacts sit on the eyes’ corneas. Light is able to pass through our corneas because they’re clear and don’t contain blood vessels. Consequently, oxygen, water, and other nutrients must be supplied to the cornea via the air, tears, and eyelids. When ANY contact lens is on the eye, the cornea receives dramatically lower amounts of these elements. As you can imagine, this opens the door to a lot of potential issues. Therefore it’s critical that patients and their eye doctors carefully manage the use of contact lenses.
Every type of contact lens differs in it’s physical and chemical properties. The amounts of water and oxygen that permeate through them hinge on the fit, material, prescription, and wearing schedule of the contact lens. The first three are largely concerns of one’s eye doctor. How the contacts should be worn is determined by the doctor, but the responsibility to follow said schedule is up to the patient.
I’ll illustrate by using CooperVision’s Biofinty contact lenses as an example. This lens is approved for 30 days of wear. To arrive at that number, CooperVision worked with many doctors, researchers, and the FDA to determine how long these lenses may be worn safely. Like all contacts, they permit less oxygen to reach the eye as compared to not wearing contacts at all. Experts have found that this is largely not a problem as long as the lenses are worn for 30 days or less and the patient regularly sees her optometrist. After 30 days of wear the story takes a turn for the worse. The amount of oxygen that reaches the eye is lower than professionally determined critical thresholds. This opens the floodgates for a lot of potential complications.
On the low end, wearing a contact lens for too long may cause the eyes to become slightly red. On some patients this can stay at a cosmetic level. However, frequently it’s the first warning sign of serious impending problems. With the eyes defenses reduced, bacterial and/or viral infections are much more likely to occur. It’s somewhat common for the cornea to respond to low oxygen levels by developing “subepithelial infiltrates.” These are inflammatory cells that arrive on the scene when the cornea is threatened. They interrupt a dense network of nerves in the front of the eye and are very painful. In some cases of contact lens overwear, the iris may become severely inflamed. This is a highly uncomfortable condition called iritis or anterior uveitis. The treatment for this condition is weeks of steroid drops and dilated eyes – not anyone’s idea of a good time. If left unchecked, a reduced oxygen level can even lead to ulceration of eye tissue.
The good news about all of these problems is that they are largely avoidable. By wearing your contacts lenses for the prescribed schedule, the risk of all these issues is quite low. Beyond simply wearing your contacts properly, it’s important to have them evaluated at least once a year by your optometrist. It’s his job to ensure that your eyes aren’t showing any signs of being “angry” with the lenses. It’s far better to stay on top of any complications than allowing them to run free.
Feel free to send an email if you have any questions or concerns.
Spencer Ritenour, O.D.
dr.ritenour@parkslopeeye.com
Spooky Eyes
Halloween is just around the corner. Now is the time to decorate the house, buy the candy (KitKats please), dial in your party plans, and figure out your costume. It’s very fun to visit a Halloween store to check out what they have. There are always the great masks, funky ‘staches, and goofy clothes. Many stores also carry a selection of spooky contact lenses. These are painted to make your eyes look reptilian, cat like, or just plain creepy. However, these lenses are not just spooky in their appearance. They are spooky deep down to their guts. Let me explain.
All contact lenses allow a certain amount of water and oxygen through to the eye. Engineers and chemists work aggressively to design lenses that are safe, comfortable, stable, free from bacteria, and allow for good vision. Then they go through a many year process of research and clinical trials to become approved by the FDA. Finally, the contact lens companies rely upon certified optometrists to skillfully fit the lenses on patients and then to regularly check the lenses and eyes for problems. This is how a contact lens goes from being a brilliant idea in a researcher’s head to performing beautifully on your eye. The problem with cosmetic Halloween contacts is that nearly all of them are not approved by the FDA. It’s also illegal to sell contacts without an explicit prescription from a licensed eye doctor. When a company wantonly ignores these regulations, it’s pretty easy to guess how interested they are in the health of your eye.
What happens when a contact doesn’t perform safely on the eye? At the low end of the spectrum, the eyes may become red and irritated. They can also become painfully inflamed and sensitive to light – a condition called uveitis. Sometimes they can develop a bacterial infection or activate a latent herpes virus. In some very severe cases, the cornea may develop an ulcer and leave a serious scar. Nearly all of these conditions can potentially lead to permanent vision loss or other complications. It’s not worth having “spooky” eyes one night and have “SPOOKY!” eyes for a long time afterwards.
Have a happy Halloween that’s full of candy and not eye infections!
Spencer Ritenour, O.D.
dr.ritenour@parkslopeeye.com
Acuvue TruEye contacts
Recently there has been a press release announcing a recall of the popular 1-Day Acuvue TruEye contact lenses. It’s very important to note that this recall solely affects lenses manufactured in Japan and a few other European and Asian countries. The TruEye lenses manufactured and distributed in the US are completely unaffected. The problem occurred on one manufacturing line that produces contacts for Asian distribution. It was remedied immediately.
At Park Slope Eye we have had remarkably high patient satisfaction rates with all of the Acuvue contacts that we fit – especially the TruEye lens. In addition to having an amazing safety profile and being extremely comfortable, the TruEye lens was recently certified as being in the highest class of UV blocking contacts. I have personally visited Acuvue’s world headquarters, their North American R&D division, and their North American manufacturing plant. Their industrial processes at every stage of contact lens development are state of the art.
If you are interested in trying TruEyes, I would be more than happy to fit you with a pair. Of course if another lens is more appropriate for your needs and eye health, we can try those instead.
Don’t have a bad romance!
Do you love your contacts? Most people do, but Americans are increasingly going gaga over a new cosmetic variety known as circle contact lenses. These are special colored contact lenses that give the illusion of having large “doe eyes.” Despite their innocent appearance, this type of lens can be highly unsafe for one’s eyes. They cause a dangerously low amount of oxygen to reach the surface of the eye which can lead to painful infections, ulcers, or worse. In some cases they can even lead to a permanent reduction in vision. In fact, they are illegal in the United States, but their popularity is increasing.
It’s important to remember that all contact lenses are medical devices and must be prescribed by your eye doctor. Always be sure to follow the proper cleaning and replacement instructions and have your doctor check them annually. If you’re interested in trying contacts for the first time stop by the office, and I’d be happy to fit some on your eyes!
What do donuts and contacts have in common?
Patient said “Doc, I’ve worn my contacts like this for years and never had a problem!”
Eye Doc said “The guy who eats donuts for breakfast every day without a problem eventually has his FIRST heart attack. Just because you’ve never had a problem does not remotely mean that you never will, or that it is the right or smart thing to do.”
Courtesy of Dr. Anthony Clark
Even if one ignored the clinical research data, common sense would lead you to believe the longer your do something that is unhealthy, the riskier it gets. Wearing dirty contacts for long periods of times over the course of many years, just leaves your eyes open to such great risks. The patients who come in with a contact lens related red eye, almost are always contact lens abusers. They often are the ones who do not adequately clean them. They are often the ones who habitually fall asleep in them. They are often the ones who chronically stretch them out beyond their indicated replacement schedule. Its just not worth it!
Ciba Focus Dailies Toric
I’m really excited about providing so many more of you with an opportunity to try a daily disposable. Ciba has expanded its Dailies Toric parameters!
New – Now available in 6 axes (20°, 70°, 90°, 110°,160,180°) Focus® DAILIES® Toric lenses cover the majority of astigmatic patients. Available in -.75 and -1.50 cyl.
Recycle Your Contact Lens Foil!
PSEye already collects and recycles the plastic containers as seen here: http://justinbazan.wordpress.com/2009/02/20/contact-lens-recycling-program/
I’m happy to report that I have confirmed that NYC Dept. Of Sanitation will recycle the foil along with your normal metal recyclables!!! We will collect the foil here, but I encourage you to just recycle it with your metals at home. Double check with your department of sanitation to make sure this applies to your area of the country.
Park Slope Eye is located in Brooklyn, NY. For more info contact Justin Bazan, OD, the optometrist of Park Slope Eye, at Dr.Bazan@ParkSlopeEye.com or visit www.ParkSlopeEye.com Also, check us out on Yelp!, Twitter and FaceBook.
Contact Lens Recycling Program
Park Slope Eye is proud to announce that we will now be recycling used contact lens blister packs (see above). Blister packs are made of polypropylene as denoted by the #5 recycle symbol. Unfortunately, you can not currently place these with your other plastic recyclables because there is no NYC Dept. of Sanitation program to recycle them.
Save them up, and bring them by. I will ensure their delivery to the proper recycling facility. Just please remember to remove the foil from the plastic. Don’t forget the foil can go with your regular metal recyclables!
Park Slope Eye is located in Brooklyn, NY. For more info contact Justin Bazan, OD, the optometrist of Park Slope Eye, at Dr.Bazan@ParkSlopeEye.com or visit www.ParkSlopeEye.com Also, check us out on Yelp!, Twitter and FaceBook.
Halloween Contacts
I have not had a single request for this kind of contact this year. Historically these contacts get abused, and I see a lot of eye infections as a result. Many of them can be avoided by following 2 simple rules.
1. If you are re-using a contact, make sure its clean and disinfected. This means, the night before you use it, RUB/RINSE/SOAK it. BUY some CL solution! Do not keep sticking it back into the vial it came in (I can’t believe I actually had to write that!)
2. Take them out, before you pass out. A lot of times, people are out partying and get lazy about taking care of their contacts. If you are unable to properly take care of them, instead of sleeping in them, just throw them out. Its not worth the $, time and pain that’s involved with a CL related eye problem.
AOA warns consumers about risks of decorative contact lenses.
Medical News Today(10/21) reports, “With Halloween approaching, the American Optometric Association (AOA) is warning consumers about the risks of wearing decorative contact lenses without a prescription from an eye doctor.” While the Food and Drug Administration regulates “decorative lenses as a medical device, similar to corrective lenses,” some “decorative lenses continue to be illegally marketed and distributed directly to consumers through a variety of sources, including flea markets, the Internet, beauty salons, and convenience stores.” Paul Klein, O.D., chair of the AOA’s Contact Lens and Cornea Section, emphasized that “purchasing contact lenses without a prescription can result in serious eye health and vision damage since consumers are not properly educated on cleaning and disinfecting, nor in proper removal and application of the contact lens.” He explained that “consumers who wear these contact lenses put themselves at risk of serious bacterial infection, or even significant damage to the eye’s ability to function, with the potential for irreversible sight loss.” Additional “risks associated with the use of decorative contact lenses include conjunctivitis, swelling, allergic reaction, and corneal abrasion due to poor lens fit.”
Park Slope Eye is located in Brooklyn, NY. For more info contact Justin Bazan, OD, the optometrist of Park Slope Eye, at Dr.Bazan@ParkSlopeEye.com or visit www.ParkSlopeEye.com Also, check us out on Yelp!, Twitter and FaceBook.
Avaira
If you have to wear a reusable contact, you may find your doctor prescribing a new contact called Avaira. For my patients in which a daily disposable is not the best option, the Avaira often is. Check out the infomercial about this exciting new product. http://www.coopervision.tv/avaira.shtml
Park Slope Eye is located in Brooklyn, NY. For more info contact Justin Bazan, OD, the optometrist of Park Slope Eye, at Dr.Bazan@ParkSlopeEye.com or visit www.ParkSlopeEye.com Also, check us out on Yelp!, Twitter and FaceBook.
Why I love my daily disposable contacts.::::Doctor Bazan of Park Slope Eye
Why I love my daily disposable contacts (DD cls).::::Dr. Bazan of Park Slope Eye
DD cls give me piece of mind: I feel they have the lowest chance of allowing anything bad happening to my eye. Harmful bacteria are thrown away each night. Eliminates risk of serious vision threatening conditions resulting from contact lens ineffective cleaning routines. The use of dirty contact lens cases and contaminated solutions are a thing of the past.
DD cls are comfortable: Irritating build up and debris are thrown away. A fresh and clean feeling every day. Essential to keeping me comfortable especially during allergy season.
DD cls are convenient: No fuss. No muss. You will find the 5 strips easy to pack and can be kept anywhere.
DD cls are affordable: A buck a day. Seriously what can you get for a dollar these days? Surely healthy and comfortable contacts are better meeting your needs than a 4 pc chicken nugget from McDonald’s.
DD cls are easy. I’m lazy. It really was a pain for me to take the time and effort to properly take care of my reusable contacts. It is so nice not having to go through the whole cleaning routine.
Park Slope Eye is located in Brooklyn, NY. For more info contact Justin Bazan, OD, the optometrist of Park Slope Eye, at Dr.Bazan@ParkSlopeEye.com or visit www.ParkSlopeEye.com Also, check us out on Yelp!, Twitter and FaceBook.
Can I swim in my contacts?
Can I swim in my contacts? With summer upon us, everyone is thinking about fun in the sun. Although it is ideal not to swim in contacts, I know that it is impractical not to do so. The risk of bad things happening are real. Listen to the facts and decide for yourself if the risk is worth taking. Water, even chlorinated water contains harmful bugs. If you are wearing your contacts, swim goggles would be a step in the right direction. A step in a better direction would be daily disposables, which are thrown out after a day of swimming.
A very common parasite know as Acanthamoeba has been linked to numerous contact lens related eye infections. Get a little bit of water in your eye, and you are at risk for this “little nasty” taking residence in your contact lens. Your contact lens is a great place for that bug to thrive and replicate to enourmous quantities. Not a big deal if it was content with just being on the contact. However, Acanthamoeba also recognizes that your eye is a great spot to live as well. This bug is devastating, and will burrow deep into your cornea, destroying tissue as it goes. Many people suffer blindness that is only remedied with a corneal transplant. That means you lose your own cornea and have to rely on a “donor” cornea. Sounds fun? This infection is on the rise. Read more here http://tinyurl.com/3matvl or watch the video here http://video.nbc10.com/player/?id=262700 .
What makes things worse is that this bug can make it past the disinfection process. Bad news for us. The disinfection solutions that many of us use, may not be eliminating this harmful pathogen from our contacts and our contact lens cases. Pretty scary info to hear. The good news is that you can minimize this risk by tossing out your contacts everyday. Personally, I feel the risk of an infection occurring from a contaminated daily disposable that is thrown out at the end of the day is acceptable. I wear my contacts to the beach and throw them out at the end of the day. I have yet to read or hear about an infection occurring in similar situations. Nearly everyone can wear a daily disposable, there are very few of you that could not, so it would be a great contact to use on days involving water. Even if you have to sacrifice some vision temporarily by not having the perfect prescription, it still beats sacrificing your vision permanently! Go get fit for some daily disposables and worry about a sunburn instead of a serious eye infection!
Park Slope Eye is located in Brooklyn, NY. For more info contact Justin Bazan, OD, the optometrist of Park Slope Eye, at Dr.Bazan@ParkSlopeEye.com or visit www.ParkSlopeEye.com Also, check us out on Yelp!, Twitter and FaceBook.
Cost Comparison of a Daily Disposable vs. a 2 week Silicone Hydrogel
Cost Comparison
Daily Disposable vs. 2 week Silicone Hydrogel
| Ciba Focus Dailies | Acuvue Oasys | |
| Annual Supply (number of boxes) | 8 | 8 |
| Cost of Solutions | $0 | $80 |
| Lens Retail Price Per Box | $50 | $30 |
| Annual Lens Supply Cost | $400 | $240 |
| Total Lens and Solution Cost | $400 | $320 |
| Rebate | $70 | $60 |
| After Rebate Cost | $330 | $260 |
Difference = $0.20 a day.
Only about 5 bucks more a month to have fresh, clean, clear, comfortable, convenient and healthy contacts everyday!
Park Slope Eye is located in Brooklyn, NY. For more info contact Justin Bazan, OD, the optometrist of Park Slope Eye, at Dr.Bazan@ParkSlopeEye.com or visit www.ParkSlopeEye.com Also, check us out on Yelp!, Twitter and FaceBook.
What Contact Lens Solution Should I use?
What Contact Lens Solution Should I use?
A few years ago, choosing a contact lens solutions was pretty much a non issue. Contacts were basically composed of plastic and water and the CL solutions were similarly formulated regardless of manufacturer. Most people would get the cheapest product on the shelf and do ok with it.
This is not true today. Certain contact lenses need to be used with certain solutions. Not all solutions are compatible with every type of contact. Using a contact lens with a non compatible solution can damage your eye, and unfortunately this damage may occur with out you feeling or seeing anything until a serious issue develops. Your eye doctor should prescribed the best CL solution for your particular contacts.
Generics solutions pose a problem for several issues. One is that its hard to know what exactly is in the bottle. Without knowing what really is in that bottle leaves it impossible to determine if it is the best to use with you particular type of contact. Furthermore, generic brands are know to use older, less beneficial formulations, and to switch the ingredients of the solutions frequently. Using a generic, makes it almost impossible to guarantee that your are utilizing the best solution for your particular contacts.
The buck you save on a generic is far outweighed by the piece of mind of allowing yourself to get the best contact lens solution your doctor prescribed specifically for you. Your eye doctor cares enough about you to make sure your eyes stay as healthy as possible. Stick to what he prescribes. If he forgot to prescribe a solution, call him and ask him. It really does matter!
Park Slope Eye is located in Brooklyn, NY. For more info contact Justin Bazan, OD, the optometrist of Park Slope Eye, at Dr.Bazan@ParkSlopeEye.com or visit www.ParkSlopeEye.com Also, check us out on Yelp!, Twitter and FaceBook.
But if it says "No Rub" why do I have to rub?
We all want fresh and clean contacts so our eyes stay comfortable and healthy right? Well, the no rub solutions where you are only rinsing off the contacts are not good at getting them clean. If you take a shower and don’t do any scrubbing do you get clean? Not really right? Well contacts need to be scrubbed clean as well. Simply rinsing them off does close to nothing, the cleaning comes from the scrubbing! What is worse, is many of you report, that all you do is just put them directly into the solution without a rinse or rub!
Scrubbing a contact clean is the only way to make the surface smooth. Having a nice smooth surface is important for your tears to keep the contact lens coated. If the tears hit a bump of buildup on the lens, and they break up and can’t coat the surface, the contact dries out and feels uncomfortable. Not to mention all that buildup irritates your eyelids and makes its impossible for your eye to breath. A contact must be fresh and clean to keep things healthy and comfortable, and scrubbing the lens is the only way to achieve this. I’m not saying scrub for hours, just a 5 second scrub on each side is all you really need, I know you can handle the extra 20 seconds.
The scrubbing is what is cleaning the lens, and after you scrubbed it, it has all that loose debris on the surface still. You have to rinse that loose debris off with a steady stream of solution, or it will end up just settling back onto the surface of the contact.
After the rub and the rinse, the clean contact needs to be disinfected to kill the germs. The overnight soak in fresh solution does that. It also rehydrates and moisturizes the lens making it much more comfortable. After soaking its also important to rinse each side of the lens off to get rid of any residual surface debris that could cause that contact to irritate your eyes.
So the best way to keep your eyes comfortable and healthy is to keep the contacts fresh and clean. A rub, rinse, soak, rinse routine will do just that. Trust me, it will make a huge difference. Or better yet, let’s forget about this whole process and just move into a daily disposable. In your eye, then in your trash! Simple, healthy, convenient! If you are interested and have a valid CL RX from me, I will really re-fit you at no charge….I really feel that strongly about it! To learn more about daily disposable contacts follow this link.
Email This To A FriendHalloween Contacts!!!!!
Halloween is just around the corner and many of you are out shopping for the perfect costume. Many of you are also considering going all out, with extreme hair and make up, intricate outfits, and even special effect contact lenses. Non-Prescription Halloween Contacts are still considered medical devices and should be treated as such. Take care of your precious eyes and use the proper channels for obtaing your special effect contacts. Your eye care provider would be happy to assist you in creating your perfect Halloween costume by fitting you with the perfect special effect contact lenses. Those of you who may already have special effects contacts have been OK’d by your eye care provider right? Please make sure they are the appropriate for your own unique eyes! Having a poorly fit contact can cause not only discomfort but could lead to potentially ser
ious vision threatening condition.
Ok, moving on. If you are going to utilize an approved pair of special effects contacts please keep the following in mind. If the contacts are fresh and brand new right out of the pack/vial great. If they have been sitting around for more than a few days (like last Halloween!) it is imperative that they be inspected, cleaned and disinfected the night before you plan to wear them. Remember the old contact lens adage for wearing contacts; while wearing contacts, your eyes should always Look Good, Feel Good and See Good! If one of those requirements is off, discontinue wear and if necessary seek out an eye care provider. You want your eyes to look scary from the contact, not because of it.
Daily Disposable Contacts
I am a proactive doctor. I would rather prevent problems than treat them, just as I hope you would as well. Your current contact lens regime may be good so far, however we will determine if it truly is the best for your long term ocular health. In most cases daily disposable contacts are the ultimate in providing you with the highest chance of maintaining healthy and comfortable eyes. If a daily disposable lens is an option for you, you will be well educated about them and given a free trial of them. I am a firm believer that daily disposable contacts are the most successful way to preserv
e your ocular health. Here is what makes sense to me.
Contacts by design are porous. They are designed to act like a sponge, allowing them to hold water so they stay comfortable. This design also helps vital elements of our tears, such as oxygen, to pass through. Unfortunately, this design also makes them the perfect place for harmful bacteria to grow and for irritating debris to deposit.
No matter how well you may think you get them clean, there is no substitute for a new contact. There is nothing in this world that will be as good as new after it has been used. Why do people think contacts are the exception? If you were only allowed to take a bath and not allowed to use a washcloth (or perform an equivalent scrub), how clean would you be at the end of a few weeks? Contacts are no exception. There will always be some potentially irritating deposits and harmful bacteria left in and on the lens, no matter how thorough your cleaning routine is. What even makes things worse is that many of you barely, if at all, thoroughly rub and rinse the lens before storing it in solution (hopefully not reused solution either). Factor in a dirty old unsanitary case and you have a great formula for unhealthy, if not uncomfortable eyes.
It’s easy to give your eyes the best chance of remaining healthy and comfortable, switch to a daily disposable. Please don’t be that patient who refuses to change, still uses a standard plastic lens that they wear and keep till it starts to bother them, sleeps in on occasion if not frequently, and just kind of put them into a dirty case in some generic solution overnight. That is the formula for a disaster. These are you eyes, you have only two. Please take some time to think about that next time you’re paying your $100 a month cable bill, buying a $200 handbag or feeding your $4 dollar a day Starbucks habit. The cost of wearing a basic daily disposable; about a buck a day. The cost of preserving your eyes; Priceless. Gain some perspective, you will be rewarded. I would like you to think of your contacts as disposable, not your eyes. Both myself and your eyes thank you in advance.
Good Enough Contacts!
So you really feel those old out dated contacts are good enough? Yearly contacts are so great right? Really love those Acuvue 2? Why not? You have been in them for years, maybe even decades, with no problems, the comfort is decent and for sure the price is right. Your eyes are fine and you don’t want to try a new, probably more expensive, kind of lens. Not too concerned about those contacts causing eye problems? I can assure you that the most problematic contacts are the standard plastic contacts that are worn for a period of weeks to months. That is just basic logic. The longer you keep a lens, the higher the probability of it to cause a problem. 
I’d rather prevent problems then treat them. And trust me, you’d rather have them prevented than treated. Your family doctor wouldn’t prescribe the same blood pressure medicine year after year if he knew there was a newer, safer, more effective drug for you. I also subscribe to that basic Hippocratic philosophy. Don’t forget I am caring enough to give you a great education on how to use contacts in a safe, healthy and comfortable way. Did I also mention that there is no fee involved to try it? Yes I provide you with a FREE trial of the new contacts!
I can assure you that if you are in my chair, the priority I have for you is a contact that gives you the best chance of keeping your eyes healthy, comfortable and your vision clear. I can assure you its not an standard plastic lens that you wear and keep till it starts to bother you, sleep in on occasion if not frequently, and just kind of put it into a dirty case in some generic solution overnight. 
We are talking less than a buck a day difference in cost! Why not choose health, comfort, convenience, and clarity over cost? I want you to feel compelled to allow yourself to select the best, not cheapest lens for you. More information
about daily disposable contacts can be found here. Some compromises will be necessary, I view each patient as a unique case. You can rest assured that my interests, lie with your best interests.
Extended Wear Contacts – Gambling With Your Eyes
Extended Wear is defined as overnight use. Typical extended wear
ranges from a few nights a week to up to 30 days of continuous wear. No one can argue that the longer you keep a contact on your eye, the greater the chance for problems to occur. Sleeping in your contacts puts you in the HIGHEST RISK group amongst contact lens wearers. Sleeping in contacts is gambling with your eyes. Two minor problems that frequently occur are red, irritated eyes and blurry vision. Two major problems with serious complications are corneal inflammatory events and ulcerative keratitis (see picture below). The articles found at the end of this post may be used to help prove the reality of the situation.
But first, here is what makes sense to me.
Contacts by design are porous. They are designed to act like a sponge, allowing them to hold water so they stay comfortable. This design also helps vital elements of our tears, such as oxygen, to pass through. Unfortunately, this design also makes them the perfect place for harmful bacteria to grow and for irritating debris to deposit. Fortunately our eye is designed to withstand these assaults.
Our eyes have many protective features, but one critical feature is our ability to blink. However this blink is only effective while ours eyes are open. A blink will gather then remove potentially irritating and/or harmful debris from the corneas surface. Think of the blink as how a win
dow washer’s squeegee removes dirt from a window. When we are sleeping, we do not blink. Our eye losses one of its defensive mechanisms and thusly is left in a slightly compromised state. Now picture that dirty, never been cleaned, up to 30 day old contact just sitting on an eye incapable of removing the debris and bacteria from its surface. Its a veritable cesspool. You have the perfect situation for something bad to occur. Overnight wears means a compromised eye subjected to prolonged exposure to debris and bacteria. Now multiply that risk factor by frequency and duration. Are you willing to keep putting your eyes at risk night after night, year after year? Do you really still feel like gambling with the only two eyes you will ever be given? Do you still feel like extended wear conditions will keep your eyes the healthiest? Try a more convenient lens, something that you can take out of you eye and just throw on the floor no matter how tired you are. I would love to save you from a trip to the bathroom to “take out your contacts”(what are the chances you do the best job rubbing, rinsing and soaking them when your in that mood?). Please let me tell you about daily disposables or other healthier ways to wear contacts. Stop sleeping in the lenses. Now.
RELATED SCIENTIFIC ARTICLES:
Incidence of keratitis of varying severity among contact lens wearers
Aim: To determine the incidence of non-severe keratitis (NSK) and severe keratitis (SK) among wearers of current generation contact lenses.
Methods: A 12 month, prospective, hospital based epidemiological study was conducted by examining all contact lens wearers presenting with a corneal infiltrate/ulcer to a hospital centre in Manchester. A clinical severity matrix was used to differentiate between NSK and SK, based on the severity of signs and symptoms. The size of the hospital catchment population and the wearing modalities (daily wear (DW) or extended wear (EW)) and lens types being used were estimated from relevant demographic and market data.
Conclusions: A clinical severity matrix has considerable utility in assessing contact lens related keratitis. There is a significantly higher incidence of SK in wearers who sleep in contact lenses compared with those who only use lenses during the waking hours.
SOURCE: (2005) Incidence of keratitis of varying severity among contact lens wearers. British Journal of Ophthalmology 89(4):pp. 430-436.
Corneal Inflammatory Events with Extended Contact Lens Wear
High-Dk silicone hydrogel (SH) lenses have been shown to significantly decrease the risk of hypoxic complications compared to traditional low-Dk hydrogels. However, the risks of inflammatory complications with SH compared to that of low-Dk lenses are not as clear. A meta-analysis was performed to combine the relevant literature to evaluate the risks of corneal inflammatory events in users of SH and low-Dk hydrogel extended wear lenses. A systematic search was conducted using online databases, unpublished meeting abstracts and retrieval of other cited references presented or published between 1990 and February 2006. Each study was evaluated for quality in terms of the research question, and these quality assessments were used to determine which studies should be used in subgroup analyses.
Twenty-three studies published or presented on either or both arms by February 2006 were selected for analysis. A total of 9,336 subjects and 18,537 eyes comprised the entire sample. Seven studies were published in the 1990s. Eighteen studies (78 percent) were prospective and 11 (48 percent) used randomization. The follow-up ranged from 4 to 36 months, with a median of 12 months. The rates of infiltrates for low-Dk hydrogels and SH lenses were 7.7 and 14.4 per 100 eye-years, respectively. In the subset of five best quality studies, the unadjusted risk ratio for corneal inflammatory events for SH lenses compared to low-Dk lenses was 2.18. Across studies, adjusted risk ratios ranged from 2.18 to 2.23, with strong confounding between material and length of wear.
Based on published or presented studies between 1991 and 2006, there is approximately a twofold higher risk for corneal inflammatory events in users of SH lenses when typically worn for up to 30 days extended wear when compared with low-Dk extended wear lenses when typically worn for seven days extended wear. The increased risk cannot be definitively linked to SH lens materials because the effect of material on outcome is confounded by length of wear.
SOURCE: Szczotka-Flynn L, Diaz M. Risk of corneal inflammatory events with silicone hydrogel and low dk hydrogel extended contact lens wear: a meta-analysis. Optom Vis Sci 2007;84(4):247-56.
Incidence of Ulcerative Keratitis in Soft Contact Lens Wearers – Extended vs Daily Wear
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A case-control study of ulcerative keratitis in soft contact lens (CL) users compared three groups of daily wear or extended wear patients: (a) 86 patients with ulcerative keratitis, (b) 61 hospital-based controls, and (c) 410 population-based controls. Overnight lens use, whether regularly with extended wear lenses or occasionally with daily wear lenses, emerged as the preeminent risk factor for ulcerative keratitis. It increased risk by 10 to 15 times in users of extended wear lenses and by 9 times in users of daily wear lenses when these groups were compared with subjects engaged in strict daily wear of daily wear lenses. Even when actual overnight wear was not taken into account, the relative risk was four times greater in users of extended wear lenses than in users of daily wear lenses. The study found a marginal association (p = 0.056) between lens care frequency in general and ulcerative keratitis in comparing ulcerative keratitis cases with population controls. Of the individual hygiene-related measures, evidence of a protective effect was strongest for cleaning the lens case. Smokers showed a threefold greater risk than nonsmokers, regardless of the type of lens worn. An incidence study found the rate of ulcerative keratitis to be approximately 1 in 2,500 daily wear lens users and 1 in 500 extended wear lens users per year. This finding was statistically consistent with the risk ratio noted in the case-control study. Extrapolations suggest that 4,000 of the 9 million U.S. users of daily wear soft lenses develop ulcerative keratitis annually. Among the 4 million U.S. extended wear soft lens users, 8,000 may do so per year.
SOURCE: ScheinOD, Poggio EC Ulcerative keratitis in contact lens wearers. Incidence and risk factors. Cornea. 1990;9 Suppl 1:S55-8; Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston 02114.
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GPC Giant Papillary Conjunctivitis
Giant Papillary Conjunctivitis
Giant Papillary Conjunctivitis (GPC) is an immune-mediated, inflammatory disorder that is a response to the presence of an irritant. That irritant can be an allergen, a contact lens, an ocular prosthesis, an exposed postoperative suture (stitch), a contact lens solution or even the dirty deposits of bacteria and buildup that accumulates in and on a contact lens. Basically something interacts with the inside of your eyelid to the point where it becomes irritated and bumpy, leaving your eye very uncomfortable.It is most commonly associated with soft contact lens use, especially contacts that aren’t being thoroughly rubbed cleaned, thrown out frequently and/or are worn for long hours (especially overnight). Although GPC can be extremely uncomfortable and annoying to deal with, it is NOT a dangerous condition and it will not cause permanent vision loss or cause permanent damage to your eyes. It is also ok to go to work, as it is NOT contagious.
Many eye doctor’s call GPC in contact lens wearers Contact Lens Induced Papillary Conjunctivitis (CLPC). CLPC can cause your eyes to feel horrible. Many people will have symptoms that include tearing, significant mucus production, and itching. The eyes will most commonly present as red, irritated and uncomfortable. Sometimes the eyes will even feel worse after the contact lens is removed, because the contact was acting as a protective layer between the sensitive cornea and the bumpy lid that is rubbing against it. The presence of the irritant (ex, prolonged exposure to a dirty contact) leads to the production of giant papillae (bumps) on the under surface of the upper eyelid. One may think of it as a rash in response to touching something irritating, like poison ivy.
Here is what makes sense to me. The longer you wear a contact lens the more irritating it is to your eye. The dirtier the contact lens the more irritating it is to your eye. Therefore the ideal formula for irritating your eye, is wearing a d
irty contact for as long as possible.That would also explain why people who sleep in there lenses are 3 times more likely to experience GPC than a normal daily use contact lens wearer. Furthermore, I have personally never seen CLPC exhibited in a patient who uses a brand new lens everyday, ie a daily disposable contact lens wearer. Therefore, I am attributing CLPC in the majority of my contact lens patients to wearing a not so clean contact for too long of a period. The good news is that I can help provide the ways and means to return you to healthy and comfortable contact lens wear.
GPC is a fully reversible condition in the great majority of cases simply discontinuing contact lens wear. I recognize that I would be hard pressed to find a patient who would be 100% compliant with the idea of suspending contact lens wear indefinitely. There for I have adopted the following care package which will get you back into contact lenses as quick as possible. However, I will state that contact lens wearers with significant signs and symptoms of GPC, should ideally discontinue use of contact lenses until a noted improvement of the signs and especially the symptoms of the disorder have resolved. The giant papillae themselves may not fully disappear for many months or years even after removal of the contact lenses although the symptoms will have surely been long resolved. Most likely you will be out of contacts for a few days to about a week.
My treatment plan is highly effective, geared towards the fastest resolution, and the minimization of the chance of recurrence. It most certainly will involve a change into a daily disposable contact if possible. If a daily disposable is not an option, we would implement a strict contact lens hygiene regime consisting of a rub-rinse-soak routine (Opti-Free Replenish or Clear Care) and the most frequently replaced lens available. Finally, cold compress and artificial tears/rewetting drops may be implemented several times 
daily which may afford additional relief by providing a moisture rich barrier between the lid and the lens. It will also include the use of medication to help return the eyelid to a normal condition and to alleviate the symptoms. Typically Pataday, an antihistamine/mast-cell stabilizer will be utilized. For patients with particularly severe GPC, a short course of corticosteroid eye drops (ie. FML, Alrex, Lotemax) may be prescribed alternatively or in conjunction with the Pataday. Both agents will help to control and suppress certain aspects of the inflammation associated with the GPC, leaving you eye feeling a lot better.
