Contact Lenses Care

In general extended-wear patients follow similar instructions concerning adaptation and wear as outlined on conventional soft contact lenses. The slight discomfort some experience at first usually disappears in a very short time; vision may fluctuate until the eye adjusts and the lens “settles in.

Other than that there’s almost no adaptation time to speak of. Patients usually go on an extended-wear regimen after one week of daily wear.

Minor symptoms to be on the lookout for are excessive tearing, redness, stinging, burning, itching, blurry vision, halos around lights, and light sensitivity. If any of these occur, remove the lens for at least three hours. If the problem ceases, your lens may be the source of the problem and you should check to see if cracks or chipped or ripped edges are present. Do not reinsert the lens if it is damaged. Put it back in its case and return it to the doctor, who will order a replacement. If you see dirt or an eyelash (or any other foreign matter) use the enzyme solution, clean, and disinfect the lens. Then you may reinsert it. If any of these problems persist, consult your doctor.

Follow-up Visits

It’s very important that you return to your eye practitioner for follow-up eye examinations. It is recommended that these occur:

• After the first twenty-four hours of extended wear.
• After the first three days of extended wear.
• After the first week of extended wear.
• After each month of the first six months of extended wear.
• After each six months of extended wear.

Care and Handling of Extended-Wear Contact Lenses

The procedures used in extended-wear lens care and handling are essentially the same as for conventional soft contact lenses. The main modification is the frequency with which these are done. There are also a few additional amendments of which the extended-lens wearer should be aware that will make these lenses more comfortable and safer.

Lens deposits are the most frequent cause for discomfort and replacement. That these lenses are worn longer and are very high in water content encourages deposits to form even more readily than on conventional soft contact lenses. Proper care and hygiene are therefore even more important, and the diligent cleansing of extended-wear lenses adds appreciably to their useful life.

For cosmetic wear the lenses may be worn up to fourteen days. On the fourteenth night the lenses should be removed, cleaned with a surfactant and / or saline and enzyme solution, disinfected, and then reinserted the next morning. However, some patients find they must remove and clean their lenses more frequently. The patient can perform these procedures himself, except when he goes for checkup exams. At that time the lenses are removed, cleaned, and reinserted in the office by the doctor or his technicians.

Aphakes wear their lenses longer in general: from one month up to six months, with an average of three months of extended wear. These patients usually leave the cleaning procedures to the doctor, who performs them whenever the patient goes for a checkup. Sometimes a neighbor or relative can be instructed to clean, remove, and insert the lenses for the patient between office visits if the wearer is unable to do this for himself.

Extended-wear lenses may be disinfected either thermally or chemically. If the heat method is employed, a “low-heat” unit should be used to avoid shortening the life of the lenses.

Lubricating the Lenses while in place

Whenever the lenses feel dry, scratchy, or don’t move freely on the eyes, relief may be obtained by instilling a few drops of saline solution or lubricating solution formulated for use with soft lenses. These eye drops may be used as often as you like.

They are especially helpful in the morning upon awakening when the eye and lens are their driest, and as a way to lubricate the lens before removal, since even a partially dehydrated lens can tear when it is removed.

For some, more involved measures are indicated in order to increase the comfort, slow down the progress of deposits, and reduce the incidence of “red eye.” In between scheduled removals and cleanings you can give your eyes a saline bath while the lenses are in place. Dr. H. Johnson Kersley, the London ophthalmologist who devised this method, recommends that you use the unpreserved premixed saline solution, which comes in single-unit packets. Use one quarter of the packet in an eyecup for each eye, each morning and each night. (Thus one entire packet is used each day.) Apply the eyewash in the eyecup, keeping the lids partially closed, so that the eye, lids, and lashes are rinsed.

Alternatively, you could shower the eye and the lens by carefully and gently pouring a stream of saline into the open eye, head tossed back, blotting up the excess with a clean tissue.

These measures may help extend the length of time that the lenses can be worn without removal for cleaning. Even so, many extended-wear patients will have to remove and clean their lenses more often than every two weeks. A large number are on a once-a-week schedule, but even those who need to remove them every other day or every three days welcome the freedom from the inconvenience of daily care and the opportunity to lead fuller, more normal lives.

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