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Medical Forum / General / Vision / June 2005Any dry eyes with Acuvue Advance?
My wife recently switched from Frequency 55 lenses to Acuvue Advance. The trial Advance lenses she used were very clear and lasted over two weeks. Upon ordering a batch of lenses she is now finding that after a couple of days the lenses feel coated with something and are scratchy and uncomfortable. She has been a contact lens wearer for over 20 years and this is the first time that lenses seem to get contaminated very very quickly. Just wondering if others are having similar "dry eye" scratching feeling with the Acuvue Advance lenses? Thanks... -Jim > Just wondering if others are having similar "dry eye" scratching feeling > with the Acuvue Advance lenses? AV Advance has been remarkably _comfortable_ but there are always exceptions. Advance comes in two different shapes, one of which might be uncomfortable, dry, scratchy, especially late in the day. That's how lenses feel when they fit too loose. So it may or may not be the buildup causing discomfort. Different materials _do_ have different affinities for an individual's protein. Sounds like hers is sticking too much. She *might* find Proclear Compatibles much better at resisting deposit. She might also find the Acuvue Advance 8.3 better, if she's wearing 8.7, and then the buildup might be a lesser or negligible problem. -MT I've been wearing Acuvue Advance for about a year now. (my first contacts) I find them pretty comfortable. One thing I discovered is that so-called "no-rub" solutions are really a misnomer. I use Opti-free, but found that if I just rinsed the lenses and put them in the case with solution that after several days the lenses would get uncomfortable. Now I gently rub the lens on each side using the solution before storing. This keeps the lens comfortable for the entire period of use. (Advance is a two-week disposable lens.) > My wife recently switched from Frequency 55 lenses to Acuvue Advance. > The trial Advance lenses she used were very clear and lasted over two [quoted text clipped - 10 lines] > > -Jim Given that the trial lenses were fine for the full two weeks, a remote possibility is that the lenses she purchased have some batch quality issues that didn't affect the trial lenses (being from a different batch). Perhaps ask the optometrist for another set of trial lenses to see if they are still OK for the full two weeks. I certainly haven't heard of any batch quality issues affecting Acuvue Advance, but your story reminded me of a problem that a patient of mine had with another brand, later found to be a (minor) manufacturing defect). Just a thought. Dom The first thing I would do it flip the upper eyelids and look for contact lens induced GPC, which is characterized by itching and severe discharge of mucus. This problem has been reported in some patients who have worn silicone-hydrogel lenses, and is thought to be related to the higher stiffness of the material. As has been mentioned, a base curve change or material change may be in order. Also, if it were me, I would be back to my eye doctor for a proper diagnosis. DrG >The first thing I would do it flip the upper eyelids and look for >contact lens induced GPC, which is characterized by itching and severe >discharge of mucus. This problem has been reported in some patients >who have worn silicone-hydrogel lenses, and is thought to be related to >the higher stiffness of the material. >As has been mentioned, a base curve change or material change may be in >order. Also, if it were me, I would be back to my eye doctor for a >proper diagnosis. >DrG My wife and I appreciate all of the helpful Acuvue Advance information. BTW, she did call the eye doctor immediately and he gave her a line about tired eyes, etc., but failed (IMHO) to address the problem. We are going back to our previous eye clinic for a second opinion. My wife has been a contact wearer for 10+ years w/o any problem to date. This is why I had originally asked about something being different with the Acuvue Advance lens. BTW, she is cleaning her lenses more gently now with the disinfectant solution rather than using Lens Plus. I might be that Lens Plus was causing deeper cleaning and damage to the lens. We have the VSP vision insurance and did change from our original clinic to the current one via subtle pressure from VSP. The new clinic reminds me of a managed care facility that brings you in, moves you through the process and then out the door. If you have needs that fall outside of their regular process then good luck fella. Thanks again for all the help, -Jim >My wife recently switched from Frequency 55 lenses to Acuvue Advance. >The trial Advance lenses she used were very clear and lasted over two [quoted text clipped - 6 lines] >Just wondering if others are having similar "dry eye" scratching feeling >with the Acuvue Advance lenses? I recently switched from Acuvue 2 to Acuvue Advance. I think that the Advance lenses are made with built-in dirt magnets. I could wear the Acuvue 2 lenses forever with no cleaning. The Advance lenses frequently get some kind of film over them where I can't see anything. I bought some Clear Care solution and it helps, but I still have to replace them many times more often than the Acuvue 2's. The bad thing about it is the unpredictability of the blurriness. I have a long drive home in the evening. Suddenly, I notice that I can't see a damn thing! (It's worse because I have mono-vision) What am I supposed to do, wait six hours for Clear Care to work? If I wear Acuvue 2's after not enough sleep, they are rather painful, but at least I can see. The Advance are much more comfortable under this condition, but they are very blurry. So I guess it is a trade off: lack of vision or pain. Near the two week mark, the Advance lenses can become quite painful if they have never been cleaned. It was quite a shock the first time because it was a more diffuse pain that I was not on the look out for, so I let it get pretty bad before removing them. These are base curve 8.3, so it is not a fitting problem. I have worn 8.3 for many years. My practice has been fitting Acuvue Advance for quite a while now, as we were clinical investigators before the lens became commercially available. I have made the following observations about Acuvue Advance in our practice: (1) This is one product where the solution you use really makes a difference. Some patients have a lot of lipids (fats) in their tears, and the silicone hydrogels seem to bound up the patients fat onto the lens and then the lipid substrate holds the detergent component of some solutions. We have had people who were "failing" with Acuvue Advance change over to Aquify for a soaking solution, and they are happy again. The newest version of Renu "with MoistureLock" seems to work much better than the old Renu. (2) Your old Base curve number of 8.3 doesn't mean as much, because the silicone hydrogels are "stiffer" than the Acuvue 2s, so they vault over the cornea more. An 8.3 Acuvue 2 Advance would act like an "8.1" Acuvue 2, which doesn't really exist. Therefore, the take home from this is that you have to think of Acuvue lenses like bedroom slippers that only come in "large" or "small". The way Advance fit, they have the same feel as "not-so-large" and "extra -small." If you were borderline fitting in the old Acuvue 2, they are forgiving enough to fit more sizes. If the measurement of your eyes was always a little too flat for that 8.3 Acuvue, that same size will seem extra small (steep or tight) in the silicone version. (3) Doctor G is right on here. The answer for a lot of people is to wear a silicone hydrogel that fits between the available sizes of the Acuvue Advance, and the O2Optix from CIBA is a great lens that comes in 8.6. By the way, your wife's Frequency 55 is a larger and flatter lens than the Acuvue Advance, and she may have "bombed" with any Acuvue product that is smaller and feels different from what she is used to. > >My wife recently switched from Frequency 55 lenses to Acuvue Advance. > >The trial Advance lenses she used were very clear and lasted over two [quoted text clipped - 33 lines] > These are base curve 8.3, so it is not a fitting problem. I have worn > 8.3 for many years. I hear you, Mike. I try not to let the contact lens companies influence my clinical judgement. If you are not having good luck with the Acuvue Advance, see your eye doctor. There are now four silicone-hydrogel lenses on the market, and all have different chemistry. I have access to all four. At the moment, I am wearing Purevision. DrG >I hear you, Mike. I try not to let the contact lens companies >influence my clinical judgement. [quoted text clipped - 7 lines] > > silicone-hydrogel lenses are evil. Focus lens are the way to go. On what basis can you make that statement? Silicone-hydrogels are a boon to contact lens wearers, including me. There are currently four versions on the market (U.S.), and more on the way. They are all different. However, they are all similar in that they contain silicone, and must be treated in some way to be wettable. None of them may be preferrable to traditional hydrogel lenses for some types of patients. Regardless of your singular experience with one brand, I have many more extremely satisfied patients dating back to 1999. DrG >On what basis can you make that statement? Silicone-hydrogels are a >boon to contact lens wearers, including me. There are currently four [quoted text clipped - 8 lines] > > All I know is the ones I tried were terrible. I could barely keep my eyes open and there was pain. Usually it took a couple of hours for these symptoms to appear. It was like my eyes were dry but I don't think they were. It was weird. Then I went back to Focus 1-2 week and the problem disappeared. Later in the day with focus I do experience dryness but at least I can wear them. I'd be the first to jump on to a superior contact lens. > >On what basis can you make that statement? Silicone-hydrogels are a > >boon to contact lens wearers, including me. There are currently four [quoted text clipped - 17 lines] > wear them. > I'd be the first to jump on to a superior contact lens. Your experience was quite unusual. Apparently your eyes and the Acuvue Advance were not a good match. Make sure you let your eye doctor know what happened. DrG >>My wife recently switched from Frequency 55 lenses to Acuvue Advance. >>The trial Advance lenses she used were very clear and lasted over two [quoted text clipped - 36 lines] >8.3 for many years. > I had the exact same problem!!! It freaked me out. My eyes are very picky about what kind of contacts I can wear. I've been wearing FOCUS 2 week disposables for several years with no problem to speak of. -3.00 8.4 Then the doc said these incredible new accuv. advan. lens were the thing to try. I did and man the painful blurry eye problems I had. He said he didn't see anything wrong with the fit but something was very wrong. I went back to focus asap and the problem went away immediately. > I had the exact same problem!!! It freaked me out. My eyes are very > picky about [quoted text clipped - 8 lines] > problem went away > immediately. And other people have the exact opposite experience. There's a reason why there are a hundred different lenses in 45 different plastics that come in different curves, diameters, optic zones, edge designs and optical considerations. Certainly, for continuous wear/overnight use there is no argument that any lens material prior to silicone hydrogels is completely inappropriate. For daily wear use, many practitioners would argue the same, but we would also still consider the following: If it isn't broken, don't fix it. Different strokes for different folks. Personally, I'm one doc who, when silicone hydrogels are available in a full range of parameters, wont be fitting the other older plastics ever again with the singular exception of daily disposables for sports activities and for those who use lenses only on occasion. --LB, O.D. I don't claim to have as much experience with Si-hydrogels than others on this list, but I have had a few patients seem to do ok with the Advance at first, only to find after a few days or weeks they are not as happy as at first, and want their old lenses back. I'd say I've fit about 100, with maybe 10 or 15 changing back. I don't think they are exactly dirt magnets, but they do seem to have an affinity for lipids, so they seem to get a bit "oily". I haven't run into that with Night and Days, but haven't fit many of those. Pure Vision & O2 optix haven't been available long enough for me to evaluate. w.stacy, o.d. >>> My wife recently switched from Frequency 55 lenses to Acuvue Advance. >>> The trial Advance lenses she used were very clear and lasted over two [quoted text clipped - 48 lines] > problem went away > immediately. question: if a person is trying to find the right lenses and there are so many on the market, what is the amount of time an OD is prepared to spend with a patient to find the perfect fit and vision? I get about 5 mins every week - it's 'try this one - see me in a week' - then I'm out the door. I feel as if I'm being a pest - trying all types of lenses, but not being 100% satisfied with any of them (so far). I'm almost accepting the fact that I'll settle for a not-so-perfect vision so I don't have to bother him anymore. After the initial exam and evaluation, it shouldn't take more than 5 min to evaluate a pair of lenses. I don't put a limit on it, but I often give 2 or 3 lens types at a time, and I don't make anyone wait a full week to check them (I'd rather see them the next day or 2). Don't settle for less; keep bugging 'til you're happy. w.stacy, o.d. > question: if a person is trying to find the right lenses and there are > so many on the market, what is the amount of time an OD is prepared to [quoted text clipped - 4 lines] > accepting the fact that I'll settle for a not-so-perfect vision so I > don't have to bother him anymore. > After the initial exam and evaluation, it shouldn't take more than 5 min > to evaluate a pair of lenses. I don't put a limit on it, but I often > give 2 or 3 lens types at a time, and I don't make anyone wait a full > week to check them (I'd rather see them the next day or 2). Don't settle > for less; keep bugging 'til you're happy. Pretty much the same down here. The initial choice of lenses to try is based on cornea curve, diameter, prescription and patient needs and desires (dry eyes, tight lids, lenses for surfing only, lenses to sleep in or not----stuff like that.) The patients reports on comfort and vision, I see that the fit is correct and we choose the best of the lot. Send them home to try the new lenses in real life and see them again in a couple of days if there's a problem, the next week if not and to finalize the prescription. Contact lenses are supposed be comfortable (if not un- noticeable!), provide excellent vision and do nothing to impact eye health. Don't settle for less unless your particular situation leaves no other choice. --LB, O.D. Just thought I'd mention that my early experiences with this lens are positive. Isn't new technology grand? Keep it coming. DrG > Just thought I'd mention that my early experiences with this lens are > positive. > > Isn't new technology grand? Keep it coming. > > DrG Wouldn't it be nice if Ciba/Norvartis joined the party? They produce their si-hydro product and sit back and watch. They've been talking about torics "coming _______(fill in month here)", "maybe end of ______(fill in year): for over a year with no product in sight. B&L Purevision Toric exists, but not here. And J&J/Vistakon has got an Advance replacement in the works. And that makes sense 'cause who's gonna care about a 60/80DK lens when the rest of the competition is running 110-170DK? Yeah, technology is indeed grand. Too bad lawyers and judges and marketing strategists get in the way. I say sell all the old generation product to 1-800 and leave the good stuff for us! My list of patients waiting for product that doesn't yet exist now exceeds 100. I could make a lot of money and please a lot of people if the manufactures got moving. Why doesn't their marketing big-wigs ask us! --LB, O.D. (and I know that they at least occasionally read this group and "visit" our private list, too.) |
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