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.

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.