Is there REALLY anything new for Contact Lens patients…?

Herb Caen, the noted columnist for the “San Francisco Chronicle”, was a strong believer in “3 dot journalism”. I used to read his columns while riding the BART train to San Francisco State, getting all those credits in Organic Chemistry so I could become an optometrist. His pithy comments (along with the bending of the Trans America Tower to accommodate his byline) were certainly more fun than differentiating between alkanes and alkenes. Chemist for Exxon I was not destined to be.

I was there for the semi-early days of soft contact lenses. Bausch & Lomb pretty much owned the marketplace back then, and heat disinfection units (AKA “cookers”) were slightly smaller than a can of Folger’s coffee and were the order of the day. These gave way to cold chemical disinfection with thimersol laden chemicals that caused more than their shares of red eyes. Followed by home-brewed saline solutions that led to acanthamoeba outbreaks and the disappearance of extended wear lenses…you know, the 30 day lens that became a 60 day lens that became a 90 day lens that became a…wait a minute doc, you mean I’m supposed to remove the lens to clean it? I thought I could wear it a year…I swear you told me that when I got them.

Au contraire my friend…that’s why you have that ulcer on your eye and are in excruciating pain.

So back to daily wear.

Then along comes the newcomer… Johnson & Johnson’s Acuvue 7 day extended wear lenses in ’88 and the race for new and better lenses changed the landscape.

Un huh…so what’s new, and I mean NEW, really REALLY NEW?

Two products come to mind. Game changers, IMHO. (In my humble opinion, as my staff would would tell me to say). Alcon’s Dailies Total 1, a single use, 1 day lens. It’s claim to fame is it’s a dual core lens…think, water gradient, with a lower water content center, and higher water content the closer you get to the surface. Highly wettable, for a silicone based lens (which, BTW, is generally repellant to water). [Quick aside…I remember in the mid 80’s when Dow Corning got into the contact lens business with a rigid (think “hard”) contact lens made of silicon. VERY VERY breathable, but oh so water repellant that we just could never get good results fitting it within the general population]. Modern day chemistry has solved a lot of problem with this great material, albeit with a lot of changes. But I’m getting off topic here….]

One Day single use contacts are definitely workable for those who want the ultimate in comfort and convenience…or those with allergies that have to give them up during the allergy season. My sister wears a competing product and would never, never go back to conventional lenses…period. She enjoys not dragging the pharmacy along with her when she travels, and I’ve worn this lens in a monovision configuration (1 lens for distance, 1 lens for near) since this is a way to see both distance when you’re over 40, and I’ve been in that category for quite some time.

The other lens is from Bausch and Lomb and named “Ultra”.  At the present time, this is a limited release lens with only 4 doctors in the Portland/Vancouver metro area having fitting sets.  I attended the product launch to gain as much insight to the logic and chemistry behind this lens to see if it’s just another overhyped product or something approaching the “real deal” of something different.  So I put it on, and yes, indeed, it is very very comfortable.  Approaching that, “I feel like I got nothing my eyes Dr. J” feeling.  Okay…let’s check your vision.  Oh, 20/20…20/15 with both lenses?  Time to take it out for a test drive and see how you like it tomorrow, or next week or so.  It’s a 30 day contact and you just toss it on a monthly basis.  Combine 3 silicone’s, develop “thin edge technology”, make it highly breathable but with a low degree of stiffness and I think this IS really a different product worthy of serious consideration.  We’ve fit 5 patients so far, and not one compliant about anything…comfort, wear time, redness.  Seems like a degree come true, in terms of contact lenses.

Patients and doctors look at 2 things when it come to contact lenses.  Patients want comfort.  And oh yes, good vision too.  But COMFORT is by far the patient’s biggest demand.  As doctors, we tend to look at vision and health, and oh yeah, is it comfortable?  The healthiest, most sharp vision, well centering and BAMM, highest Dk/t lens is irrelevant to the patient if “it just feels like a rock in my eye”.  “And doc, what’s Dk/t and do I need to know about it…isn’t that your job?”

I getcha.  Think comfort.

Well yes, we have this lens, and I think it’s a gamechanger.  Right now, it’s only available in spherical single vision, so for those with astigmatism to a significant degree, or if you’re wearing multifocal (think bifocal) contact lens, the wait is gonna be longer.

So if you’re having problems with your lenses, tell us.  We’re here to fix the problem or introduce you to what new out there.  Too often people have been told they can’t wear contacts, and by the yardstick of 1978, they couldn’t.  Lots of water under the bridge, and things change.  Who would have thunk it that you could surgically alter your eyes to see without glasses, or have surgery to IMPLANT a contact lens?  Been a long time since I heard the optician say…”Ok kid, you can have the black frame or brown frame.  Which one you want…?”

I think the Model T Ford was a fine car (one of my patients drives one here for his exam) which had a bumper sticker on it that says “Don’t blame me, I voted for Coolidge”.  But the point is, while that car has 4 tires and a steering wheel, much the same as most cars today, things DO change.  And we endeavor to stay right on the cusp of what’s to come.

If you have questions, please feel free to shoot me back a comment.  Hope you enjoy the post.

Dr. J

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