contact lens management
The Dawn of a New Day
Focus Night & Day contact lenses can boost your practice.

BY JAMES KERR, O.D.

Contact lens practitioners have greeted new silicone hydrogel contact lenses lukewarmly because of the many previous failures. However, we're in the dawn of a new era. Even the most conservative practitioners would be well advised to add these lenses to their contact lens arsenal. Here's why.

Lending a hand in clinical trials

Focus Night & Day have a low water content.

Three years ago, my practice participated in the Canadian clinical trial of CIBA Vision's Focus Night & Day contact lens. Since then, we've fitted more than 600 patients with this lens. Most wear it continuously for 30 days and nights without difficulty. Those who can't, often wear it on a daily basis. The lens doesn't dry out as much as other lenses and patients enjoy the increased comfort and decreased limbal injection. The few problems with the lenses mostly relate to dry eyes, environmental factors and meibomian gland dysfunction.

Proving the benefits

• We present Focus Night & Day lenses as an option for all successful daily disposable contact lens wearers. We offer a free 30-day trial period and fit the lens out of inventory. Our patients are often apprehensive that they may have problems like those they had when they "napped" in their current HEMA lenses. They're pleasantly surprised to hear that:

• The lenses don't stick to the cornea (the low water-content lens retains its shape and hydration).
• The eye doesn't "fog up" with overnight wear (there's no corneal edema with Dk/t 175).
• The lens feels less dry during daily wear (because of low water content and surface characteristics that reduce tear film deposits).
• Eyes stay white (because of improved biocompatibility).

Evaluating the trial period

We let patients who show good comfort, vision and a proper fit wear the lenses continuously for 1 week. They remove the lenses only as needed and come for follow-up early in the morning after the first week of wear. If all is well, they wear the lenses until the end of the first month, when we re-check them and dispense lenses if the lenses are comfortable and clean.

If we note signs of corneal staining, epithelial splits or other corneal compromise, we discontinue lens wear. Few such problems have occurred. The lens appears to fit well in 70% to 80% of patients initially, and about 80% of those who wear it successfully in the first week continue overnight wear.

Our patients are happy and refer their friends. Because we price the lenses as a premium product and because patient adherence is improved, our profits have risen.

Take the good with the bad

The lenses aren't totally problem free. Here's what we've noticed:

• mucin balls under the lens
• lenses are occasionally too tight or loose and uncomfortable
• occasional coating even during daily wear (environmental considerations and tear chemistry)
• three patients required treatment for acute red eyes. But each patient was able to resume continuous wear without recurrence.

No patient has suffered microbial keratitis or vision loss secondary to lens wear.

Revitalizing practice

CIBA Vision's Night & Day lens has revitalized our contact lens practice and given patients a new option. Forget your previous experience with extended wear contact lenses. The future is here.

DR. KERR PRACTICES AT THE ATRIUM OPTOMETRIC GROUP IN SASKATOON, SASKATCHEWAN, CANADA.