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Medical Forum / General / Vision / January 2006PureVision CL sleep-ins have to come out at night
My wife's recently had a cataract op and went from -7 to 0. Hoever, the other eye remains at -7. So a partial rx (-3.50) contact lens allows some residual myopia to read, etc. The optometrist prescribed B+L PureVision Toric: 14mm, BC 8.7, SPH -3.50, CYL -1.75, AX 170. .... which may be left in all day and all night for a month. And for the first 3-4 months this was so. No problem. However now, a year later approx, they are uncomfortable in the day and she feels she has to take them out at night (digitally cleaning them in the morning before re-inserting). This way she recovers from them and is is able to wear them the next day with the least discomfort. What could be happening? Is is possible that a trial CL would be fine for the first few months then become uncomfortable later? Is there something she could be doing, or asking the optometrist? I suggesting cleaning them at night, before storing them, as I do. Is there an optimum time for cleaning (before storing or before re-inserting them)? Thanks Brian  SignatureAuckland NEW ZEALAND Dude, I'd make sheep jokes, but since we were caned by the AB's this year, I'd not win that discussion. A few things, daily wear is OK and the problem is probably related to build-up on the lenses. Cleaning and reinserting in the morning will not be harmful to your wife or the lens. The script seems a bit out, I would be looking at -4.50 or -5.00. She effectively has a 3.50 add, which means holding things a mite close, at around 30cm. Is she booked in for further surgery for the other eye? Cheers grant p.s. Ritchie McCaw is a bloody legend and BOD deserved all he got from Tana and Kev. > Dude, I'd make sheep jokes, but since we were caned by the AB's this > year, I'd not win that discussion. Quite rightly. > A few things, daily wear is OK and the problem is probably related to > build-up on the lenses. Cleaning and reinserting in the morning will > not be harmful to your wife or the lens. > The script seems a bit out, I would be looking at -4.50 or -5.00. She > effectively has a 3.50 add, which means holding things a mite close, at > around 30cm. She can get around well enough with one contact, and read books with Rx readers. > Is she booked in for further surgery for the other eye? No. It's slower to develop. > p.s. Ritchie McCaw is a bloody legend and BOD deserved all he got from > Tana and Kev. I don't follow rugby, sorry ;) B SignatureAuckland NEW ZEALAND p.p.s. you may want to try a clearner like polyclens or Miraflow for cleaning rather than just the Renu/optifree/complete you are currently using. The dedicated cleaner will do a better job. There is no restriction on how long to leave the lenses in the solution. $-6 hours is fine. grant > My wife's recently had a cataract op and went from -7 to 0. > Hoever, the other eye remains at -7. So a partial rx (-3.50) contact lens [quoted text clipped - 17 lines] > I suggesting cleaning them at night, before storing them, as I do. Is there > an optimum time for cleaning (before storing or before re-inserting them)? I've only heard of one person who cleaned in the morning, and that was my sister. She got lazy. She claims that she discovered that it was causing a problem, since they were much easier to clean in the evening, so she stopped that, and started cleaning right after removal again. Does your wife just have one lens, or are these monthly replacement lenses? If just one, is she doing a periodic protein removal? Crud on the lens might cause discomfort. I had cataract in one eye, and the other wasn't done for five years (hadn't progressed at the same rate). My unoperated eye was -10D. I had been wearing contacts for distance in both eyes with OTC readers before the first surgery, so opted to do the same afterwards. I had the unoperated eye corrected for distance with a contact, and then wore the OTC readers for reading. I liked that, but it's personal preference. If she isn't happy, I would suggest a visit to the OD. If she is happy with taking them out every day, and there is no discomfort, I personally wouldn't bother. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > I've only heard of one person who cleaned in the morning, and that was > my sister. She got lazy. She claims that she discovered that it was > causing a problem, since they were much easier to clean in the evening, > so she stopped that, and started cleaning right after removal again. I'd have thought that cleaning prior to storing was best. Is this right? > Does your wife just have one lens, or are these monthly replacement > lenses? If just one, is she doing a periodic protein removal? Crud on > the lens might cause discomfort. Just one. What is periodic protein removal? and how is it done? > I had cataract in one eye, and the other wasn't done for five years > (hadn't progressed at the same rate). My unoperated eye was -10D. I > had been wearing contacts for distance in both eyes with OTC readers > before the first surgery, so opted to do the same afterwards. I had the > unoperated eye corrected for distance with a contact, and then wore the > OTC readers for reading. I liked that, but it's personal preference. > If she isn't happy, I would suggest a visit to the OD. If she is happy > with taking them out every day, and there is no discomfort, I personally > wouldn't bother. There is some discomf during that day - 'bloody hell...' sort of thing. Thanks Bri SignatureAuckland NEW ZEALAND If your wife is wearing only one lens then thats the problem. The Purevision lens is a disposable lens. You buy them in multipacks of 6. You wear one for 30 days continuous (but daily wear is fine and perhaps even preferable) and then you discard it and put in a fresh one. If she's wearing the old trial lens that her doctor gave her ages ago then its undoubtedly dirty with deposits on it and it would be quite irritable to her eye. When a lens gets old like that its impossible to clean it off. If, however, you started with a fresh one and then tried to enzyme it periodically (q weekly) and use Miraflow or similar lipid cleaner you might be able to stretch the lifetime of the lens to a few months. If you haven't cleaned it, and its more than a few months old, then start with a fresh one and you will likely find things go back to the way they were originally. ============ >> Does your wife just have one lens, or are these monthly replacement >> lenses? If just one, is she doing a periodic protein removal? Crud on >> the lens might cause discomfort. > > Just one. > What is periodic protein removal? and how is it done? > > I've only heard of one person who cleaned in the morning, and that was > > my sister. She got lazy. She claims that she discovered that it was > > causing a problem, since they were much easier to clean in the evening, > > so she stopped that, and started cleaning right after removal again. > > I'd have thought that cleaning prior to storing was best. Is this right? Everything I've read suggests cleaning after removal. My sister says that cleaning before insertion doesn't work as well. My sister has worn contacts for 40 years but is not otherwise any kind of authority on contacts. > > Does your wife just have one lens, or are these monthly replacement > > lenses? If just one, is she doing a periodic protein removal? Crud on > > the lens might cause discomfort. > > Just one. > What is periodic protein removal? and how is it done? Back in the olden days, soft contacts were not designed for periodic replacement. I had my first left lens for three years. Every year I went to the OD, and he pronounced it fine. After three years, he said that it was still fine, but that they are only designed to last two years, and recommended that I replace it. I replaced the right lens earlier, only because my prescription changed. Protein gets deposited on lenses, and cannot be removed with normal cleaning. People no longer do protein removal, since most contacts are replaced daily, weekly or monthly. There were two methods of protein removal that I used, the cheap one and the expensive one. I usually used the expensive one. It was US$1.00 each time (both methods used little tablets). These were not invisible deposits. After removal, you could see the crud with your naked eye. Weekly removal was recommended, but I usually stretched it to two weeks. You buy this stuff wherever you get your cleaner and saline. Directions are on the box, and vary according to brand. I switched to monthly lens many years ago, and haven't done a protein removal since. If your wife hasn't done a protein removal in a year, eye irritation would be expected. > > I had cataract in one eye, and the other wasn't done for five years > > (hadn't progressed at the same rate). My unoperated eye was -10D. I [quoted text clipped - 8 lines] > > There is some discomf during that day - 'bloody hell...' sort of thing. If it's been a year, it's time to see the OD anyway. If this is a one month lens as RM has posted, your wife is risking her sight to save a few bucks. Most ODs will look the other way if you choose to extend the life a little (like two months), but a year is just asking for major eye trouble. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > > > Does your wife just have one lens, or are these monthly replacement > > > lenses? If just one, is she doing a periodic protein removal? Crud on > > > the lens might cause discomfort. > > Just one. I'm sorry. by this I meant just the one EYE has the monthly replacement lens. I never for a minute expected anyone here to assume we were using monthly replacement lenses for a year, then wanted help. She uses a monthly disposable and replaces it whenever it gets too uncomfortable, sometimes discarding it after a couple of weeks. I never meant to suggest she uses a monthly disposable for more than a month. Now that I've explained this, would protein removal be a reasonable course of action for a monthly sleep-in lens that has been worn in the daytime only for a week or two? Brian SignatureAuckland NEW ZEALAND No, there is no need for that, there is not going to be enough protein build-up to warrant that. What does her optom say? Is there any build-up on the lenses? Most likely lipid will be causing more problems or dehydration. Get your optom to check the lenses toward the end of the month, at which time it will be easier to pick any build-up on the lenses. grant > > > > Does your wife just have one lens, or are these monthly replacement > > > > lenses? If just one, is she doing a periodic protein removal? Crud on [quoted text clipped - 4 lines] > I never for a minute expected anyone here to assume we were using monthly > replacement lenses for a year, then wanted help. Sorry. > Now that I've explained this, would protein removal be a reasonable course of > action for a monthly sleep-in lens that has been worn in the daytime only for > a week or two? No. Having said that, if it is still time to see the OD, have her wear (or take in) a lens that is not comfortable. Some people throw off more crud than other people, and perhaps the OD will recommend either a different cleaning method, or maybe even protein removal. I doubt it though. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > My wife's recently had a cataract op and went from -7 to 0. > Hoever, the other eye remains at -7. So a partial rx (-3.50) contact lens [quoted text clipped - 23 lines] > -- > Auckland NEW ZEALAND First of all, I am assuming she is changing the lenses every month as directed. It sounds like your wife could be developing contact lens related papillary conjunctivitis, a sort of immune reaction involving itching and excessive mucus buildup on the lenses. The treatment involves discontinuing overnight wear, daily cleaning of lenses, and Patanol or some other agent to reduce the inflammation/allergic response. DrG www.leukoma.com |
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