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Thread: Contact Lens Education

  1. #176
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    Dk SmeeK

    My feelings on exteended wear. Except in those situations where there might be a compelling indication (i.e. combat, a romatic weekend where you want to see what your are enjoying), extended wear is foolish. My attitude might be different if I were so impared that I couldn't see who was on the other side of the bed. But as a rule I tell my patients: "Like your mother said: Any thing you sleep with is more likely to give you problems."
    Now as to the little known and oft forgotten facts.
    I once saw Fred Danker remove a PMMA lens that he had worn continuously for 27 years without damage. He had forgotten how to remove it and he didn't belive the posterior surface needed to be polished.
    I once read a report from a group of ophthalmolgist in Boston who as a an experiment built up to 24 hr a day wear in PMMA lenses, wore them for 90 days (without damage) and reported that that had discomfort after removal. Eventually had to use a removal (reverse wearing) schedule to wean themselves away from the lenses.
    Of course this is back when we felt the mechanics and skill of the fitter was more important than the material.

    Chip

  2. #177
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    Thumbs up

    Quote Originally Posted by chip anderson View Post
    My attitude might be different if I were so impared that I couldn't see who was on the other side of the bed. But as a rule I tell my patients: "Like your mother said: Any thing you sleep with is more likely to give you problems."

    Chip
    I really like this one!:bbg:
    But at least, you should be able to recognize what caused the problems......:D:D

  3. #178
    threadkiller? eromitlab's Avatar
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    Hey folks, I have another question:

    Does anyone know of a resource that has a listing of specific soft lens specs, like OZD, lens edge thicknesses and other technical data? I know that the TQ is probably the most complete general lens reference, but... I am wondering if there is a more detailed accounting of lens data out there.

    As always, thanks for any input!!

  4. #179
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    Pretty sure TQ gives Oz. as to rest of data, at least what is available (not not concidered propriatory) should either be in CLQ, or available from manufactures in thier data sheets (from either the mfg. or rep.)
    Jobson Review of Cornea and Contact Lenses (frames data) Annual Contact Lenses and Lens Care Guide gives most of the information you desire.

    Chip
    Last edited by chip anderson; 07-01-2008 at 09:41 AM. Reason: Jobson Review

  5. #180
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    Contact Lenses and Solutions Online?

    Contact Lens Forum used to post an online listing of Solutions and Contact Lenses online but have dropped it. Does anyone else do it now?

  6. #181
    ATO Member HarryChiling's Avatar
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    Quote Originally Posted by rdcoach5 View Post
    Contact Lens Forum used to post an online listing of Solutions and Contact Lenses online but have dropped it. Does anyone else do it now?
    http://contacts.onlineopticianry.com or through the http://optics.onlineopticianry.com search engine you can do a search haven't had the time to update it in a little while but a lot of info in there either way.

    Also the reference you talked about Dick is CLASS Contact Lenses and Solutions Summary which is a suplement provided by Vistakon found in CL Spectrum magazine once a year, you can print off the pages here, suprisingly a good resource even though it is put out by Vistakon it includes accurate and complete data from various CL manufacturers:

    http://www.clspectrum.com/supplement...8&tm=6/30/2008
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  7. #182
    threadkiller? eromitlab's Avatar
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    I can't seem to find a cheat sheet for RGP manufacturing tolerances anywhere. I know that the Efron text mentioned earlier in the thread has such a thing in the appendix, but that's at home and I'm here at work. Does anyone know where I might find one? Google turns a lot of hits, but I don't have the time to check through all of them.

    T I A!!

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    One general rule I have learned when you are cleanning contact lenses is not to use water even to soak the lenses because water contains amobes

    jeff

  9. #184
    ATO Member HarryChiling's Avatar
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    Z80.2 - 1989, is the RGP ANSI standard
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  10. #185
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    why not?
    When we have the forum?
    :cheers:

  11. #186
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    A most excellent cleaner/ Pre-Wetter

    Just the other day I had a patient in with RGP's so coated you couldn't even tell the color of the plastic. I sprayed one lens in flat pack with Perma-Brite (a cleaner mostly EDTA, formerly known as Obrite) sold by Danker/Utica labs. I was interupted for a few minites and returned, the sprayed lens had returned to it's origional color and shined like brand new.
    I took it back to the patient and showed him the cleaned and uncleaned lens in a white flat pack. He immeadiately became a believer in cleaning his lenses and coming in for his bi-annual check-ups.
    I have known since the '60's that PermaBrite was an excellent cleaner and often found that "new" lenses when they came from the lab would not "wet" properly. If I sprayed and rubbed, and rinsed these new lenses and then rubbed them as I should with proper "wetting" or "conditioning" solution the lens would wet excellently.
    I have for decades advised my rigid bifocal contact lens patients to clean with Perma-Brite prior to overnight storage.
    And no I don't have any financial (other than I owe them money at the end of each month) interest in Danker/Utica labs.

    Chip

  12. #187
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    Overwearing extended wear

    I thought Chip and some others would appreciate this over-wearing story. I had a pt , one of the few, who was a really successful extended wear person. Back in the 70's, we would insist all extended wear patients return after 1st day of sleeping in lenses and if all looked good, return for periodic checks.Only those who did not show deposits were allowed to go a full 2 weeks. Now, this one patient , after 30 days of wear, looked like she had just inserted them. She was instructed to continue monthly wear if everything remained the same. Two and 1/2 years leater she was in for an exam and admitted she had not removed the contacts at all because it took them a day to feel real comfortable again. Amazingly, the contacts were removed and examined for deposits to find that they were still free of deposits but had yellowed slighty. I explained to my patient the dangers of over-wear, she was an RN, after-all, and she agreed not to repeat the over-wear. Next time I saw this patient, she again admitted to wearing these conact lenses for a year and a half. She had corneas that looked like a non-contact lens wearer-no neovasc at all and the contact were free of deposits or protein. I believe the contacts were Hydrocurve torics.

  13. #188
    threadkiller? eromitlab's Avatar
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    WOW! That is unbelieveable. Even with non-compliancy, the lenses still looked ok?? No neo but how did her endothelial cells look?? how about K's or topo? any distortion? I find it hard to believe that someone wearing a lens continuously like that would not have some morphological changes or irregular topo/K readings.

  14. #189
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    For what it's worth I was in Las Vegas (Back when there was still money in contacts) for a CLSA Meeting. In fact It was when I took my FCLSA exam many, many decades ago.
    Fred Danker was there with a PMMA lens on that he had not removed for 27 years. He had even forgotten how to remove it. He did remove it as was examined by many experience fitters and OMD's and no one could find anything wrong with Mr. Fred's eye.


    Chip

    And no, I am not advocating exteended wear of PMMA or any other type of contact. Just relating what I was told, I was there but I did not examine Mr. Danker.

  15. #190
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    Lenses had yellowed

    Quote Originally Posted by eromitlab View Post
    WOW! That is unbelieveable. Even with non-compliancy, the lenses still looked ok?? No neo but how did her endothelial cells look?? how about K's or topo? any distortion? I find it hard to believe that someone wearing a lens continuously like that would not have some morphological changes or irregular topo/K readings.
    The only thing abnormal was the yellowing of the contact lenses. I'm not sure if this was from natural epinephrine in her tears or exposure to cigarette smoke. Visual acuity was 20/20 still and corneas crystal clear.

  16. #191
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    It's been almost 2 years since anyone has added to this long-running post started by Chip. Let's start a new one by asking what everyone thinks are the pros/cons of the silicone hydrogels that have taken over. Favorite brands?

  17. #192
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    Wow. It has been a long time. I've been busy with grad school and just working a busy practice so getting on OB hasn't really crossed my mind. I just got a notification on my phone this morning (hooray for smartphones) that someone had posted to this thread. Anyhow...

    I am a big fan of SiHy lenses... the off-the-shelf products that are available work incredibly well for my soft lens patients 95% of the time. I absolutely am in love with Biofinity lenses right now and enjoy (knock on wood) almost 100% first fit success with them. I haven't really been an ardent Cooper fan in the past but the Biofinity products have really given me cause to look at their product portfolio more and more as of late. I usually dispense with Bio True and Blink Contacts for solutions and have had incredibly positive feedback. This is coming from established patients of my practice as well as newer patients that come to us with complaints regarding their lenses or the ECP that was fitting them... I see a lot of what other guys would call 'problem patients' where I work and many times all it takes is switching to SiHy. While SiHy isn't a magic bullet lens that solves all the world's contact lens problems... it has certainly helped a lot of patients that I see.

    To open a can of worms, so to speak... I think that some of the issues I see patients coming in with are due to a lack of initiative to learn about new products on the part of the ECPs. A good number of patients that are coming new to the practice I work for are still being fit with older hydrogels and not even being educated about the newer technologies that are available or about proper care and replacement. I can think of one patient this week who was fit with SofLens MF last year and has been unable to wear them comfortably since being fit. When she went to the OD that fit her, he told her that there was nothing better available and that this was it for her in terms of soft lenses. What are some impressions about the ECP community maybe not taking a stake in raising the standard by engaging actively in learning about new products and technologies and just sticking with what has worked for years past? Does anyone think it's okay to just stay 'in their box'?

  18. #193
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    I agree with the positive feedback on Biofinity but we have had success also with Acuvue Oasys including both of their new Multifocals. We have also switched to Bio True with positive results

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    Fantastic thread...I would agree that a separate CL section on the forum would be nice! I love some of the new lens materials that are out, but improvements need to be made in edge design with some. They are like rocks for some people who are used to more invisible/thinner lens. I wish there were more base curves, too.

    Eromitlab, you mentioned initiative to learn about new products on the part of the ECPs. I find it difficult to find enough readily available information about lenses beyond the simplistic glossy brochures and postcards the manufacturers send out. The reps tend to not know much beyond the glossy brochure. If you have a chance to shadowgraph some of the lenses, you will find the base curves stated are not the true curvature, in some brands. I think that a veteran contact lens fitter becomes skeptical and chair time defensive because of all the epic fails the industry has heaped upon them. A successful contact lens fitting does not exist until several years has transpired.

  20. #195
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    We have switched our soft lens starter kit to Bio-True . So far, so good. Anyone else have any results on this solution?

  21. #196
    OptiBoard Professional OptiBoard Silver Supporter jrumbaug's Avatar
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    not scientific but....
    my wife likes Bio-True (better than Renu )

  22. #197
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    Quote Originally Posted by rdcoach5 View Post
    We have switched our soft lens starter kit to Bio-True . So far, so good. Anyone else have any results on this solution?
    For educational purposes.....Post with more info re:Bio-True, chemistry, technique for use, maker, drawbacks..... for example.

  23. #198
    OptiGeek Wes's Avatar
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    I fitted my ex-gf, who was a CPOT, with Air Optix N&D 8.6, purevision 8.6 and Oasys 8.8, and she raved about the oasys. Didnt care for the others. She did have big dry eyes...

  24. #199
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    Quote Originally Posted by wss2020 View Post
    I fitted my ex-gf, who was a CPOT, with Air Optix N&D 8.6, purevision 8.6 and Oasys 8.8, and she raved about the oasys. Didnt care for the others. She did have big dry eyes...
    Could it have been that 8.80 base curve that gave her the rave-ability?

  25. #200
    Master OptiBoarder OptiBoard Silver Supporter rdcoach5's Avatar
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    Quote Originally Posted by uncut View Post
    For educational purposes.....Post with more info re:Bio-True, chemistry, technique for use, maker, drawbacks..... for example.
    Bausch & Lomb makes Bio True. It's their new all in one solution for soft lenses. I have not seen any negative reactions, yet. It's supposed to mimic the natural tear chemistry using hyaluranon to keep contacts lubricated and helps remove denatured protein. The wettable coatings on the new contacts like Oasys and Biofinity also help keep denatured proteins from binding to lenses.

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