Contact Lens Research

[stephanie]

I was curious that if contact lenses have been in a house fire, but without any apparent damage except the singed box can they still safely be worn? I already know the answers to my questions here I just want some seasoned professional's opinions here. Wouldn't just the heat alone be able to change the chemical composition of a cl??? Please share your opinions on this subject with me. BTW this isn't just something I came up with this was an actual incident that I witnessed. I am very curious to hear what you all will say.

Thanks!
Steph

[chip anderson]

Unless melted probably no contact would be damaged. Soft lenses would be sterilized if hot. Rigid lenses should be inspected warpage, especially HGP lenses. I once had a doctor's daughter (these seem to be especially stupid and spoiled patients) come in with a hard lens that had been in the ash tray, was distorted from the heat and stained brown. She was wearing it without complaint.

Soft lenses in the case, and if the saline is still in the case and case has not exploded, probably didn't get over 212 degrees. So at best they would be sterile.

Chip

[Shwing]

Along the same lines is freezing of lenses.

I had a patient many years ago who was moving in the dead of winter (as in -25C) and teh box with their contacts was left in the truck for a couple of days, and the lenses froze in the packages.

I suggested that they throw them out, and when the lenses froze and then were thawed out, the expansion and contraction would have altered the lenses from their pristine parameters...

[mullo]

Chip gets my vote. Ditto.......................Mullo ;)


If they are the least bit worried, sell them a new box. What do contact lenses cost down there? Something like $15 a box?? That's $1000 Canadian I think? :drop:

[stephanie]

Ok so what you guys are saying is it would indeed be safe for them to wear? Even if the lenses were not in a case they were still in the plastic containers they come packaged in(soft disposable.) Hmmm....interesting not at all what I thought. I figured they would essentially be melted and the high heat from the fire would or could change the compound of the lenses between the lens material and the saline.

Steph

[mullo]

Keep in mind Steph, you did say singed. If you had said burnt or worse, I would say the lenses are more likely to be damaged. I would still tell them that a replacement is cheaper than going to a doctor if anything goes wrong.....Mullo ;)

[chip anderson]

Remember:

1: You can sterilize these things by boiling and 212 is as hot as water gets unless pressurized and a little less for saline.

2: You can sometimes purge contaminates out by putting them in very salty solution alternating with distilled water, so the salt content will not change anything but the water content of the lenses, and that only temporaily untill they are returned to a proper environment.

3: Some individuals used to try to re-machine soft contacts while in a frozen state, so cold probably doesn't hurt them either except for a temporary freeze drying effect.

4: If these were disposable soft lenses, they are so damn cheap who cares, throw them away and start over.

Chip

[Shwing]

To the heart of the matter though:

1) House catches on fire

2) stuff burns

3) one has insurance (see where I am going now?)

4) buy new and very expensive custom contact lenses to replace the 'damaged' ones...

[stephanie]

Ok let me give you the full story now...Pt had a house fire, the pt WANTED replacement CLs, OD was in that day (pt was actually a pt of OD btw)pt was told by the "opticians" NO, we can't do anything for you and that she couldn't have a cl exam for a few months(???) Pt showed "opticians" her boxes of cls and they told her it was fine to wear them. I personally felt that these "opticians" had an obligation to send this pt to the doctor. Bear in mind I witnessed this entire situation and heard every word so it is not embellished or altered in any way. Ultimately I went and got the OD and made her come and get the pt. Maybe I should have posted the story entirely so you would fully understand what I was saying. Any thoughts??? I have spent may sleepless nights sickened by my experience that day.

Steph "still sick over it" D

[chip anderson]

Steph:

Why in the ? did you get the O.D. for her? At best she needed replacement contacts or a statement of how much they cost for the insurance company. Why get cost of new eye exam, take the doctor's time, or do anything but give her a set of replacement lenses?

Chip

[stephanie]

Chip, I got the OD because her rx was expired and the opticians were giving her a terrible time about helping her. I figured I would just get the pt out of the situation. What I didn't understand was why the "opticians" refused to help this pt. I am still trying to figure it out. Sorry if I am not making sense...the entire day didn't make sense.

Steph

[Cindy Hamlin]

Stephanie,
At the very least they lost the concept of patient care. We had a customer at the store who was traveling and lost a contact (of course, very high minus toric specialty lenses) and of course had no glasses either.

He had been to 6 different optical shops as they stopped at various cities before he got to my location. He told us that nobody offered to call his doctor to even try to get his prescription. My employee called the OD and when they found that it was a toric specialty lens, the OD told us a "close" spherical trial we could give him to get him by. If he hadn't been traveling we would have had a patient for life.

It amazed me that nobody was willing to even make the phone call! He sent a letter to our company in essence complimenting us on doing what any optician should have automatically done!

Good job Steph! You certainly took care of the customer. Without mentioning your former employer, I guess you did at least learn good customer service! :D

Cindy

[chip anderson]

Steph:

You did right if you view "valid dated Rx" as a patient safety law, if you view it as a political ploy, maybe, maybe not.

[stephanie]

Oh no Chip safety safety!! That was what I was concerned about that day as well as treating the pt with respect. It was a really disgusting day. You should have been there it was really something that should have been witnessed by all about how NOT to treat people. Customer service!! YEA right. See here is my second point...I did not know they were ok to wear til I came on here yesterday and asked I would assume that the "opticians" didn't either. With that said they weren't really sure whether or not she was going to be caused harm or not. I am not politically motivated...just ethical, honest and know how to treat people.

Steph

[chip anderson]

Steph:

My point is that I think the "one year Rx" is more of a political move to get the patient's money back into the doctor's office than real concern for the patient. You can bet that if a patient calls his doctor who sells is own contact lenses or glasses, says he is out of town and wants lenses or glasses mailed to him, gets them wihout waiting to come in for a new Rx. I do agree that patient's should have a exam 1-3 years depending on age, health, condition and the doctor's preference. I agree that we should advise them to do so. I also don't think this should be legislated as manditory.

Now what would I have done in this case:

If the patient was not one that I had seen and fitted but had say an old box, I would have given him 1 trial lens per eye, no charge, no receipt and no record of his ever being in my office and advised him to see his doctor before the disposal period ran out. If patient had been in a non~disposable and the specifications were known, I would have given him a disposable with nearest available specifications and the same advise.

Remember no one is going to have the eye rot out because they wore contacts a few weeks longer than Rx was dated til they could get into see the doctor. This may not be legal, and to some it may not be ethical but to my way of thinking, it's Christian.

Chip

[stephanie]

Chip, OD did give her some trials that day. No I am not the type looking to get in the pt's wallet that is for sure. I just wanted to get her some help and knew legally (by employer's standards and state standards anyway) that I couldn't be the one to approve trials. I also knew if I didn't do something I wouldn't be able to live with myself. I felt OD was the only hope for this situation.


Steph

[mullo]

Chip, When you do the ghost dispensing without records, do you take K's/slit lamp evaluation? Or do you assume that what they have now is correct enough due to the fact that their eye hasn't "rotted out" yet? ;) Just curious.....Mullo

[chip anderson]

Mullo:

What Ghost dispensing:

It's only dispensing, or practiceing medicine if: "You represent yourself to be a doctor and you charge a fee for your services." If you do it for free it's a "good samaritan (you'll need a bible for this) act.

Chip

[mullo]

Chip, I've have done this also. Only when someone is in an emergency. I don't have a bible though...........Mullo ;)

[chip anderson]

Mullo:

I am very sorry to hear that you don't. Was afraid that this might be the case.

Hope some day you learn that the laws of me or only contrivances designed to further thier own ends.

Chip