Extended wear contacts

[spilsburt]

Hi,
I have tried to find some extended wear contacts (30 days) for V.high myopia -15 diopters but can;t find them anywhere that go up to this power.
Can anybody help?
:)

[chip anderson]

Like you mommie said: Anything you sleep with is more likely to get you in trouble. 10 to 16 times more incidence (except in the minds of contact lens manufacturers marketing departments) of serious eye infections and ulcers.

The stronger a lens is the thicker (edge on minus, center on plus) and the less oxygen, fluid transmission through the lens, i.e. the greater risk of same. The stronger the power over about 5 diopters the more limited the market, hense less research and marketing in these ranges.

Now if you must sleep in you lenses there are some safer gas permeable lenses that can be any power and slept in.


Chip
Glad your love life is interesting enough to want to see what goes on at all hours of the night.;)

[ikon44]

the highest prescription available on continuous wear is -12.00, however on an earlier post of yours i did explain that if your spectacle prescription is -15.00 then you only need contacts of around -13.00 dioptres, i would go with chips advice GP would be better, i have fitted the Menicon Z Gp lens with great results, it has FDA approval for 30 days continuous wear.

[spilsburt]

Cool thank you - I am assuming as they are GPs the power is in the region -20?

out of interest do you know if the same range of power that GPs have (almost infinite) will eventually be repetaed for IOLs?

Hope I never have to go above -20 but you never know as my eyes don't seem to want to stop elongating

[ilanh]

Cool thank you - I am assuming as they are GPs the power is in the region -20?

out of interest do you know if the same range of power that GPs have (almost infinite) will eventually be repetaed for IOLs?

Hope I never have to go above -20 but you never know as my eyes don't seem to want to stop elongating

The higher minus your prescription the lower strength of IOL that you need. The average IOL power for an emmetrope is about +20.0 to +24.0. As the myopia increases the required IOL power decreases. Therefore, some very high myopes actually receive an IOL strength that is zero.

[chip anderson]

Ilani: Why does your doctor use an IOL at all if the strength is zero? High myopes did fine without IOL when the strength was zero before we had IOL's.

And if there is nothing put into the eye there is nothing to react to, nothing to slip or go wrong nothing to take a chance on the plastic deteriorating over time (and all plastics do deteriorate over time).

[ilanh]

Ilani: Why does your doctor use an IOL at all if the strength is zero? High myopes did fine without IOL when the strength was zero before we had IOL's.

And if there is nothing put into the eye there is nothing to react to, nothing to slip or go wrong nothing to take a chance on the plastic deteriorating over time (and all plastics do deteriorate over time).

Hi Chip,
There are many advantages to using an IOL, even when the strength is zero. It is always better not to leave the eye aphakic. Prior to the modern posterior chamber IOL's, eyes were often left aphakic or, at best, anterior chamber IOL's were used. These caused many complications including severe aphakic glaucoma, corneal edema and decompensation, vitreous prolapse into the anterior chamber etc. The posterior chamber IOL does not only correct refractive power it helps to prevent these types of complications. Furthermore, PMMA (polymethyl methacrylate) or modern acrylic lenses are totally inert in the eye and have not shown any reaction even in eyes that have had them for 50 years (this is the 50th anniversary of the PMMA lens).

Ilan Hartstein, M.D

[spilsburt]

Thank you, this is fantstic; science just needs to figure out a way of preveting retinal detachment and high myopes will benefit even more:cheers:

[chip anderson]

Dr. Hartstein:

I would probably agree with your statements if I knew more on the subject.
And I thank you fomr making me aware of thsi.

Incidentally I saw three patients last week that have been and are wearing PMMA lenses (contacts not implants) for 40+ years with no damage that I or thier ophthalmologist can detect. It's a shame thier corneas all rot after ten years isn't it? I doubt that I will ever see any patients who have worn soft or HGP lenses forty years without corneal damage.

I have seen patients fitted with sphere implants (ennucleation) that extruded when the muscles sliped behind the implant and this was called "a plastic allergy" to PMMA. Of course, we both know why the implants came out.

Chip

P.S. Any relation to Jack Hartstein, M.D. ?

[Myoptic33]

I had thought about 30 day continous lense and went to the optometrist for a lense fitting. He told me sleeping in your lenses is very bad and his patients come all the time with infections, uclears, hyperoxia, etc. I did my research online and hes right! Stick to daytime lenses, it takes 1 minute to insert and 1 to remove.

[ikon44]

I had thought about 30 day continous lense and went to the optometrist for a lense fitting. He told me sleeping in your lenses is very bad and his patients come all the time with infections, uclears, hyperoxia, etc. I did my research online and hes right! Stick to daytime lenses, it takes 1 minute to insert and 1 to remove.

your optometrist is obviously not screeing his patients properly. extended wear patients have to be checked carefully before fitting, and have frequent follow up checks. if people are buying them online without professional advice then they are asking for trouble.
may i also point out that many people wear extended wear for a variety of reasons it is just not so simple for a +6.00 hyperope to slip his/her lenses in, people on shift work may have to get up at 4 am, last thing you want to do is put lenses in at that time.

[Aarlan]

, it takes 1 minute to insert and 1 to remove.

Slow poke.. If it takes 60 seconds on and 60 seconds off, you need more coffee.

As to an extended wear, DONT BOTHER. WHy risk an increase in corneal infection? The small increase in convenience you may realize is far outweighed by danger of long term damage and/or the pain in the @$$ of going to the doctor for treatment of an ulcer (and you can't wear the contact lenses for a few weeks anyway).

AA

[eromitlab]

what is there to see in your sleep? the backs of your eyelids?

if it's an issue of getting them in and out... practice. I used to work with an OD who wears +6.00D RGPs, I watched him take his lenses out and clean them one day... he popped them out, cleaned them and had them back in under 5 minutes. I asked him if he actually got them clean that fast, he said "sure, it just comes from practice, that's all."

This is the same doc that fitted me with Night & Day lenses with the admonition that you really shouldn't leave them in for 30 days, although a few people can do that with no real ill effects... no big deal to me, I can't stand having them in more than 8 or 9 hours.

[HarryChiling]

I love the extended wear lenses that are on the market today higher Dk/t and better designs, but I wear them as a daily wear when I wear them at all. Most of the time issues like corneal ulcers are rare and you only see in the most non comliant patients, but their is neovascularization which is very common and hypoxia and GPC. These are more common to the extended wear patients that abuse the lenses. I heard someone post once that you can buy as many contacts as you want but you only get 2 eyes and last I checked no ones selling theirs.

[Myoptic33]

"people on shift work may have to get up at 4 am, last thing you want to do is put lenses in at that time."


It takes one minute to insert them or just wear glasses sometimes.


"Slow poke.. If it takes 60 seconds on and 60 seconds off, you need more coffee."


im not in a hurry and besides I can do it faster than my sister and shes been wearing them daily for many months now, I wear them a few hours like once a week because I cant tolerate them well but at least it gives me a taste of good vision without glasses


"As to an extended wear, DONT BOTHER. WHy risk an increase in corneal infection? The small increase in convenience you may realize is far outweighed by danger of long term damage and/or the pain in the @$$ of going to the doctor for treatment of an ulcer (and you can't wear the contact lenses for a few weeks anyway)."


My own optometrist strongly discouraged me and im surely gonna listen to the doctor. He told me he gets patients all the time with infections, neovasculation, uclears, pain, irritation, etc. I have two friends, both very low myopes and one moderate myope who wear day and night contacts and sleep in them. The moderate myope guy told me he wants to wake up to a clear world and not "blind" plus it takes him forever to insert and remove the contacts. The other two lack maturity and just dont care, sad I know.


"This is the same doc that fitted me with Night & Day lenses with the admonition that you really shouldn't leave them in for 30 days, although a few people can do that with no real ill effects... no big deal to me, I can't stand having them in more than 8 or 9 hours."


mine isnt even a fan of contacts and really against sleeping in them. He will fit people already wearing contacts with a different brand or pescription but those who dont really wear contacts, he says just stick to glasses. Not having any ill effects doesnt mean youll get them down the road or have it eventrually happen. My own ophthamologist told me how risky contacts are and he treats complications including two cases of amberoia(sp?) a parasitic infection thats extremely serious and requires drastic action or you may go blind and even need the eyeball removed(!) if caught early, it can be scraped out or you may need a corneal transplant. He also reported many incidences of corneal uclears and loss of vision. I asked him if he personally thinks one would be better of getting lasek(hes a surgeon too) than sleep in your contacts nightly for years.

[Happylady]

I sleep in my Night and Days with no problems. I rarely see a problem with extended wear lenses now that there are silcon hydegel lenses available.

We do see problems with patients sleeping in other kinds of lenses. We see problems with overwear of contacts even when they aren't slept in. I hate it that so many contact lens wears don't have a decent pair of glasses.

The doctors I work for recommend removing extended wear lenses every week.

[chip anderson]

An then I once saw Fred Danker remove a pair of PMMA lenses in LasVegas at a CLSA convention that had not been out for 27 years. Convention full of ophthalmologists who could find nothing wrong with Fred's eyes. Of course Fred had forgotten how to remove them after this time.


Chip

[QDO1]

An then I once saw Fred Danker remove a pair of PMMA lenses in LasVegas at a CLSA convention that had not been out for 27 years. Convention full of ophthalmologists who could find nothing wrong with Fred's eyes. Of course Fred had forgotten how to remove them after this time.


Chip

well many years ago I had a patient come in complaining of sudden vision loss. turned out the lady had been wearing a trial set of hard lenses, in an opticians in Germany, from 30 years previously, she thought they were OK and never returned to the trial, the lenses had stayed in place from that date onwards. One lens had fallen out.. Lady was CO unfomfrotable eye and poor vision. cells had grown over the edge of the lens and formed something that looked like a crater ring under the microscope. she was quite anoyed we wouldnt fit another lens immediatally

[chip anderson]

Fred's fit.


I have seen patient's from the Orient and Germany that complained thier lenses fit fine until they ran out of the solution they got when they bought them. Turned out to be anesthetic drops bottled as wetting solution.

[Myoptic33]

wow thats scary! I dont know if its true or not. However I heard one case where he wore contacts day and night and day for months without taking them out. Oneday he tried to take em out but they were stuck. The doctors said they had fused to the eye and are now a permaent part. They would need to surgically be removed so he just said ill leave em in as long as my eyes feel fine. I know another case where one guy wore them continiously for 6 months then he got a major infection which damaged his vision. Some people just lack responsability. Even sleeping in your lenses increases the risks more than tenfold.

[eyepro]

that is a wild story......