What every optometrist shouldknow about prescribing the right solution for each contact lens patient
In recent times, we have seen the emergence of serious ocular infections and
In recent times, we have seen the emergence of serious ocular infections and resultant contact lens solution recalls.
Fall2005 (CIBA VISION discontinues all lenscare products) Summer 2006 ( B&L recalls ReNu MoistureLoc) Fall 2006 ( AMO recalls Complete MoisturePlus) Winter 2006 ( B&L recall of ReNu MultiPlus)
ReNu recallBausch + Lomb company acknowledged that polymers in this particular lens solution formulation easily formed microbial films under certain conditions that resulted from poor patient compliance.
These conditions included: Topping off contact lenssolution not replacing the lens case regularly not closing the bottle top between uses
When fitting patients with contact lenses, optometrists utilize their expertise to choose lenses with attributes that willbest meet each patient’s vision and eye health needs.
Once the lens has been chosen, should practitioners go one step further and prescribe a contact lens solution?
A patient who: is not prescribed a contact lens solution receives no explanation as to why a certain solution is best
A patient who: is not prescribed a contact lens solution receives no explanation as to why a certain solution is bestmay resort to picking aproduct based solely on thesale price or availablecoupons.
Shortcuts and ways to “save” solution or extend contact lens wear are common, even among our best patients.
To underscore the importance of theirrecommendation, optometrist should write solution recommendations on a prescription pad
There are two types of contact lens care systems:
There are two types of contact lens care systems: multipurpose contact lens solutions (MPS) hydrogenperoxide-based care systems(HPB)
Multipurpose solutions also are called "no- rub" solutions:because they are designed to adequately clean and disinfect lenses with a simple rinse-and-store method, eliminating the need to mechanically rub the lenses to remove lens deposits.
many eye care professionals recommendadding a short, 10-second period ofmechanical rubbing as part of thecleaning regimen with multipurposesolutions.
less expensive easier to use than hydrogen peroxide- based solutions, therefore contact lens wearers are more likely to use multipurpose solutions properly
recent years there has been a global recallof at least one brand of a multipurposecontact lens solution because of anoutbreak of fungal eye infections associatedwith the product
thepreservatives(varying molecular weights) Wettingagents(harbor opportunistic microbes) challengeof cleaning and disinfecting the newest contact lens material: silicone hydrogel.
provide effective lens disinfection noproduct recalls have occurred due to outbreaks of eye infections. low amounts of corneal staining
one-step two-step process
Both one-step and two-step HPB lens care systems after lens disinfection and prior to wearing the lensesrequire neutralization of the hydrogen peroxide solution.
because hydrogen peroxide is an effective disinfecting agent,
because hydrogen peroxide is an effective disinfecting agent,but it is toxic to the cornea and must be converted to saline with a neutralizing agent to avoid eye injury.
the lenses are placed in a holder within a cylindrical contact lens case. the case is filled with a 3 percent solution of hydrogen peroxide. The bottom of the case contains a solid disk of a material that immediately begins neutralizing the hydrogen peroxide.
the contact lens are placed in a lens case filled with only the hydrogen peroxide for a specified period of timeA neutralizer is then added to the case to convert the disinfectant to harmless saline
Hydrogen peroxide care systems arepreservative-free and therefore are often recommended for contact lens wearers who :
Hydrogen peroxide care systems are preservative-free and therefore are often recommended for contact lens wearers who :may be sensitive to preservatives found in multipurpose contact lens solutions
one-stepHPB:may not expose contacts to full-strength hydrogen peroxide for an adequate period of time
one-stepHPB:may not expose contacts to full-strength hydrogen peroxide for an adequate period of time two-step HPB :users will forget the neutralizing step and incur a painful eye injury
Opti-Free RepleniSH (Alcon) and Clear Care (CIBA Vision)Clear Care could provide longer wear times than the other MPS system
Biotrue inspired by the biology of the eye to make wearing contact lenses easie. pH in the range of healthy tears keep lenses moist for up to 20 hours can be used with all soft and silicone hydrogel lenses. Keeps beneficial tear proteins alive
renu® fresh renu sensitive(will soon be available in a convenient clear bottle, and both the carton and bottle are 100% recyclable)
AQuify® 2004 PRO-GUARD™ lens case.(reduce lens case contamination when used with Aquify) ideal for patients that wear their lenses for extended periods during the day.
Clear Care 2001 one bottle 3% hydrogen peroxide solution kills bacteria and germs The bottle is marked with a red tip( caution patients from directly putting in their eyes.)
OPTI-FREE® RepleniSH 2006: provide a high level of moisture for patients wearing all types of contact lenses Wettingagent -TearGlyde® formulation( provides the lenses with a layer of moisture all day)
OPTI-FREE PureMoist Wetting agent -HydraGlyde® Moisture Matrix( surrounds lenses in a cushion of moisture to keep contacts hydrated) dual disinfectants POLYQUAD® and ALDOX can also be used for sensitive eyes reduceslipid deposition and removes protein deposits.
RevitaLens OcuTec - 2010 combines the disinfection of a peroxide system with the convenience of a multi-purpose solution OcuTec- antimicrobial activity even under non-compliant conditions -a high effectiveness against Acanthamoeba (single- celled living organism)
- low rates of corneal staining and adverse effects- - effective protein removal leading to tolerability less redness less end of day dryness
Oxysept hydrogen peroxide disinfection solution/neutralizer Neutralized Oxysept is also nearly identical to natural tears (viscosity and surface tension) the neutralizing tablet eliminates the risk of residual peroxide a natural B12 color has been added ideal for sensitive eyes
Thank you for your attention We welcome your questions ,suggestions, comments!