The College of Optometrists

Sorry I seem to have posted this on the wrong forum before, doh.

Thanks for the reply Palfi she is late 50's. Will probably give the acuvues a bash hope it does the trick!

Here's the original post if anyone has any other ideas......

Need some suggestions please!

I have a lovely lady patient who was fitted with Night & Day 8.6 on a continuous wear basis 3 months ago. Absolutely adores her lenses and is desperate to carry on with them, they've changed her life etc.!

The problem is she's developed SEAL stains bilaterally. We previously tried purevision which weren't as comfortable and the movement on blink just wasn't adequate for me to be happy with it.

There never seems to be much info on the long-term effects of things likes SEALS - would I be woefully negligent in letting her continue? I would imagine such an epithelial breach is increasing her risk of serious corneal infection???

Or can anyone suggest a continuous wear lens that might be a good replacement (is the 8.4 likely to do the trick for example or will this worsen it?) - haven't really any experience yet of the acuvue CWs; have found Optix O2 brilliant but not really intended for regular overnight? I don't think the overnight element is the problem think it's just probably modulus-related.

Thanks would really appreciate your thoughts!

Hmmm... well there you have it - she is in her late fifties! At what age will you be taking her out of lenses, please?

At that age - her tear film possibly won't be the best -

I would suggest she reduce her wear to max two weekly (with N & D), and see if that fixes it. Fail that - get her down to weekly extended - see if that does it.

There is a bit of circumstantial evidence that extending two weekly - then 24 hrs out clean and re-insert minimises the risks.

If you want to make it easy for yourself and her - get her in to the Oasys lenses from J & J. It will solve the problem as said before. They are a weekly extended lens, but soft and ideal for a person like yr px. I do hope it works out fine for her - she sounds delightful.

You could back this up with comfort drops (every morning) to rinse debris out of the eyes. Lid care would also help - as would possibly omega 3 oils. All this helps the tears to maintain a good preocular film.

Palfi is quite correct in this =steven

Think I will give the Oasys a try, modulus being alot lower it's likely to chaffe a bit less. My only reservation is that in my limited experience with acuvue advance, they seem to have mucked up the vision, ie. distortions. Does the Oasys seem to behave itself better?

Tear film is actually pretty good so unfortunately I don't think it's going to make a huge difference trying to 'improve' it or going for the ocular lubricants, shame!