BYE-BYE DRY EYES

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Say hello to these contact lenses that help prevent dropouts.

For the last fifteen years, we’ve made very little progress in the contact lens dropout rate. In fact, the number has essentially stayed the same at about 20%. We’ve attempted to improve technology, but the fact is the improvements haven’t proven themselves. A two-prong approach that includes the treatment of the ocular surface along with the latest lenses is needed to help our patients stay in their contact lenses.

THE LATEST LENSES FOR DRY EYE
Ultra
This monthly silicone hydrogel lens with MoistureSeal Technology from Bausch + Lomb provides end-of-day comfort for digital device users. The lens maintains 95% of its moisture for up to 16 hours. Bausch + Lomb ULTRA for Presbyopia provides patients with presbyopia  comfortable, clear vision at near, intermediate and distance by combining the company’s MoistureSeal technology with its proven 3-Zone Progressive design.

Biotrue Oneday
This daily disposable lens, also from Bausch + Lomb, promises all-day comfort. Starting with a high water content of 78%, the same as the cornea, Biotrue ONEday utilizes Surface Active Technology to maintain over 98% of its moisture for up to 16 hours, providing comfortable vision throughout the day. They are also available for presbyopia.

Dailies Total1
Alcon Dailies Total1 represents a new category of silicone hydrogel lenses. This product’s water gradient technology means the water content becomes nearly 100% toward the outermost surface of the lens, reducing friction on the lens and ocular surface.

MyDay
CooperVision’s unique and innovative Smart Silicone chemistry provides optimal oxygen permeability, helping to create a naturally wettable lens that has the lowest modulus of any silicone hydrogel daily disposable.

Clariti 1 Day
One of the major benefits of this silicone hydrogel one-day lens from CooperVision is its availability in sphere, toric and multifocal designs. What’s also key is its affordability. Using the latest technology, CooperVision has developed a way to manufacture a silicone hydrogel one-day at the cost of a hydrogel lens, making it a viable upgrade for any hydrogel daily disposable wearer.

Acuvue Moist
The 1-DAY ACUVUE MOIST Brand family of contact lenses from Johnson and Johnson Vision Care, Inc. also has toric, sphere and multifocal fits. Their LACREON Technology embeds a hydrophilic wetting agent into the lens to create a cushion of moisture to combat dryness.

Acuvue Oasys 1-Day
Also from Johnson and Johnson Vision Care, Inc., ACUVUE OASYS 1-DAY Brand contact lenses incorporate HydraLuxe Technology to provide comfort in demanding conditions, whether it’s dry air or digital device use. The technology’s tear-like molecules mimic mucins to lubricate and moisturize the eyes.

Extreme H2O Daily Contact Lenses  
This lens from X-Cel Specialty Contacts is great for patients with corneal sizes outside the average range. The Extreme H2O Daily lens is available in three diameters””13.6, 14.2 and 14.8. Made from ultra-hydrating, non-ionic materials, the lens offers hydration and water-retention characteristics to provide relief from dry eye. The small diameter is ideal for patients with small apertures, such as pediatrics, allowing easier handling and insertion/removal. The large diameter is perfect for patients with active lifestyles or for any standard diameter wearer with comfort issues.

TREATING THE OCULAR SURFACE

WHAT’S THE DEAL WITH DAILY LENSES?
The benefits of single-use lenses far outweigh their cost. Their newer materials are effective, but a fresh lens every day eliminates the cycle of first-day wear feeling great to 14th day of wear feeling not so great. Encourage the patient to make the change to daily disposables, rather than going through the cycle of comfort, less comfort, comfort, less comfort and so on.
Regarding the pricing of daily disposables, it’s up to us to educate the patient. It’s really just a matter of whether the patient is spending money in our offices on the best contact lenses vs. spending money in our offices for older monthly or two-week technology and the supermarket for contact lens solution. Spell it out, if necessary. If a patient is compliant in lens care, they are spending a few hundred dollars a year on solution. Add about $200 for an annual supply of lenses. Now, compare that to $500 to $600 annually for daily disposables. Add the most important feature””comfort””and you may just have a convert in your chair.

As mentioned above, preventing dropout from dry eye requires more than switching lenses. The other part of the equation is that we need to know that the ocular surface is going to support contact lenses, and if necessary, intervene so that it can do so. We have to treat the eye in addition to addressing the lens choice. A study done in our practice found that patients with meibomian gland dysfunction (MGD) reported longer, improved wearing times for their lenses by several hours after receiving treatment for the condition. They didn’t even switch contact lenses.

For MGD, LipiFlow from TearScience applies heat and gentle pressure to safely remove gland obstructions. After the in-office procedure, the patient can use warm compresses and follow a lid hygiene routine at home for continued results.

Artificial tears, such as Refresh Optive Gel  Drops from Allergan, will help the patient feel more comfort and moisture. For patients with severe symptoms, topical steroids may be prescribed. Ocular surface inflammation can be detected using the InflammaDry Test from RPS Diagnostics.

Dry eye syndrome is a chronic condition but one we can confidently help our patients control, all while keeping them in their contact lenses.

David L. Kading, OD, is in private practice at Specialty Dry Eye and Contact Lens Center in Seattle, WA.

 

WHERE TO FIND IT:
Alcon Laboratories
800.451.3937 | alcon.com

Allergan
800.416.8780 | refreshbrand.com

Bausch + Lomb
800.828.9030 | Bausch.com/ecp

CooperVision, Inc.
800.341.2020 | coopervision.com

Johnson and Johnson Vision Care, Inc
800.843.2020 | acuvueprofessional.com
order@acuvue.com

RPS Diagnostics
877.921.0080 | RPSdetectors.com
info@inflammadry.com

TearScience, Inc.
919.467.4007 | tearscience.com

X-Cel Contacts
877.336.2482 | xcelspecialtycontacts.com
Cathy Smith, csmith@xcelspecialtycontacts.com

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