The use of fluorescein in contact lens aftercare.

This short communication reports on the responses of a cohort of more than 2000 contact lens practitioners across five European countries, who were surveyed on the routine use of fluorescein in soft contact lens aftercare. Although corneal staining has received extensive interest amongst the academic community, most practitioners do not routinely use fluorescein at aftercare visits. The arguments for not using the agent seem to be somewhat flawed in modern contact lens practice and it is hoped by education and wider communications of the value of staining that more practitioners use it more often.

An evaluation of 1-day disposable contact lens wear in a population of allergy sufferers.

PURPOSE: This was a multi-site, 128-subject, bilateral crossover study to evaluate subjective comfort and slit-lamp findings with 1-day disposable contact lenses in a population of allergy sufferers during periods when allergen levels were elevated. METHODS: The study involved 1-month of single-use daily wear with a 1-day disposable test lens (1. DAY ACUVUE Brand Contact Lenses, Johnson & Johnson Vision Care) and 1-month of daily wear with subjects' habitual lenses replaced to their usual replacement schedule. Pollen and mould counts were obtained for each site 1 week prior to the study and twice weekly throughout the study period. Subjective comfort and slit-lamp findings were recorded at baseline and after 1-month's wear of each modality. RESULTS: Sixty-seven percent of subjects agreed that the 1-day disposable lenses provided improved comfort when compared to the lenses they wore prior to the study, compared with 18% agreeing that the new pair of habitual lenses provided improved comfort. The 1-day disposable lenses showed greater improvement in slit-lamp findings from baseline than new habitual lenses. CONCLUSION: The use of 1-day disposable lenses is an effective strategy for managing allergy-suffering contact lens wearers.

A multi-centre study of lapsed contact lens wearers.

PURPOSE: Discontinuation from contact lens wear has been identified as a contributing factor in the lack of growth of contact lens use in Europe. The purpose of this study was to determine the proportion of lapsed contact lens wearers that can be refitted successfully with contact lenses and to evaluate the reasons for discontinuation from contact lens wear. METHODS: This was a multi-site clinical study involving 15 UK investigators and 236 lapsed contact lens wearers who had previously tried contact lenses and discontinued. The reasons for discontinuation were assessed by subjects, who were then refitted with contact lenses. Investigators subsequently evaluated factors associated with their initial discontinuation. Short-term success was defined as the successful completion of 1 month of contact lens wear with absence of complications that would prevent further wear. Subjects were interviewed by telephone 6 months after being refitted to determine whether they were still wearing contact lenses. Those who were not wearing lenses were questioned about the reasons for discontinuation and their likelihood of resuming lens wear. RESULTS: A majority of subjects (51%) cited discomfort as the principal reason for having previously given up contact lens wear. Problems with vision were the second most common reason (13%), either with reading (6%) or general vision (7%). The most common type of discomfort was dryness (40%). In almost all cases (97%), the investigator's assessment of the reasons for discontinuation agreed with the subject's own assessment but investigators also cited product-related and practitioner-related factors as contributing to previous failure. The short-term success rate for refitting lapsed wearers was found to be 77% (Cl: 70-82%). The highest short-term success rates were for 2-weekly/monthly soft spherical lenses (91%) and daily disposable lenses (89%). Lower success rates were found for soft toric (69%) and soft bifocal (53%) lenses. At the 6-month stage, 73% of those who continued in lenses after the 1-month visit were still wearing contact lenses and a further 18% indicated that they were either 'very likely' or 'likely' to resume lens wear. CONCLUSIONS: A high proportion of lapsed contact lens wearers can be successfully refitted with contact lenses. The prime reason for previous discontinuation from contact lenses is discomfort and, in particular, dryness-related discomfort. In many cases, previous contact lens failure is product or practitioner-related rather than because of patient-specific problems. Once refitted with contact lenses, lapsed wearers cite vision problems rather than discomfort as the most common reason for discontinuing. This finding suggests that recent advances in contact lens material, design, replacement frequencies and care systems have improved the prospects for avoiding lens-related discomfort and for continuing contact lens wear.