EXTENDED WEAR CONTACT LENSES
CLAO
Introduction
Many people find that wearing contact lenses overnight is a great convenience. Lenses worn overnight don't have to be cleaned and disinfected every day. And people who wear their contact lenses to sleep wake up able to see clearly, even in the middle of the night. But overnight lens wear (called extended wear) is not for everyone. Not all prescriptions are available in extended wear lenses; and some eyes can't take the stress of extended wear. In addition, extended wear increases the wearer's risk of infection and other serious problems. If you are considering extended wear, we recommend that you take time to learn about it, weigh the risks against the benefits, and decide for yourself whether extended wear is right for you. Your contact lens professional will be happy to help you with this important decision.
Who Is Most Interested In Extended Wear?
The people who get the most benefit from extended wear include:
* People who require strong prescriptions. Extended wear gives them good vision 24 hours a day.
* People who want convenience. Extended wear frees them from many of the hassles of daily lens care.
* People whose long or irregular work hours make normal daily lens care difficult. Being able to leave their lenses in helps police officers, fire fighters, doctors and shift workers keep going.
Daily Wear VS. Extended Wear
Most contact lens use is daily wear. This means the contact lenses are taken out each night before going to bed and put back in the next morning. The alternative, extended wear, involves wearing contact lenses continuously, day and night, for up to six nights. One form of extended wear is called flexible wear (or flex wear). In flexible wear the lenses are taken out most 'nights, but on occasion they may be worn overnight. Because the lenses are sometimes worn overnight, flexible wear has similar risks to extended wear and requires use of extended wear lenses. In this pamphlet, we will consider flexible wear as a form of extended wear.
Extended wear is different from daily wear because extended wear puts more stress on the eye, extended wear requires special precautions. First, extended wear requires healthy eyes that can tolerate the added stress. In addition, overnight wear requires the use of special extended wear lenses that are available in both soft and rigid gas permeable (RGP) materia1s. Fortunately, serious eye infection is a rare problem for contact lens wearers. But people who wear their contact lenses overnight have a higher risk of developing infection and other problems than people who take their lenses out every night. Finally, because there is higher risk, extended wear means more frequent check-ups are needed from your eyecare professional. As a result, extended wear lenses can cost more than daily wear.
Hazards of Extended Wear
All contact lens wear involves some risk. The complications that sometimes crop up in extended wear is the same as that can occur in daily wear. However, in extended wear some complications tend to happen more frequently. The most serious complication of extended wear is infection. While rare in any kind of contact lens wear, serious eye infection is more common in extended wear than in daily wear.
Another problem that has been more common in extended wear is called giant papillary conjunctivitis (GPC, for short). In GPC, the inner surface of the eyelid develops an allergic-type reaction to the deposits that form on all contact lenses when they are worn. For extended wear, the lens stays in the eye for longer periods, which increases the chance of GPC. Today, however, disposable and frequent replacement lenses have cut down dramatically on GPC. The buildup' of protein deposits on the contact lens can cause problems in addition to GPC. Deposits reduce comfort; and when lenses get heavily coated, the deposits can even interfere with vision. Again, for most people disposable and frequent replacement lenses offer a simple and effective solution to the problem of contact lens deposits. Finally, the lack of oxygen during sleep while in extended wear can produce a swelling of the cornea called corneal edema. This edema can cause temporary blurred vision. For the short-run, the problem can be treated simply by removing the lens. Changing to an extended wear lens that lets more oxygen through to the eye will solve the long-run problem for some people. For other cases the problem is solved by changing to daily wear.
Safe Extended Wear
Disposable and frequent replacement lenses are definitely helpful in reducing the number of problems associated with extended wear. But they are not the whole answer to the question of safe extended wear. As a wearer, you must still be sure to take good care of your lenses and your eyes. Here are some important rules to follow for safe extended wear:
1) Keep to the wear schedule your eyecare professional has given you.
2) If you use disposable or frequent replacement lenses, replace the lenses as planned.
3) Any time you remove and re-use a lens you've worn, clean, rinse and disinfect the lens carefully before putting it back in your eye.
4) Periodically give your eyes a break and sleep without your contact lenses. (Follow carefully the schedule prescribe by your eye care professional. Usually, one night "off" per week.)
5) .Keep all scheduled follow-up appointments with your eyecare professional, even if some of the visits aren't covered by your health plan.
6) Call your eyecare practitioner immediately if you notice anything unusual about your eye. If there is any suggestion of a problem, see your eyecare practitioner immediately. Call your eyecare practitioner immediately if you experience any of the following warning signs:
Redness
Pain
Sensitivity to light
Blurry vision
Discharge
Irritation
Foreign body sensation
7) At the first hint of a problem with any contact lens-daily wear or extended wear, the lens should be removed. A good rule to follow is: "When in doubt, take it out." If simple eye rest doesn't solve the problem, call your eyecare practitioner immediately.
Conclusion
Many people find extended wear a great benefit, while many others are quite happy with daily wear. If you 1ike the idea of extended wear, and if your eyecare professional tells you that you are a good candidate for extended wear, you will have a decision to make. In deciding between daily wear and extended wear there are important factors to weigh. Your eyecare professional will be happy to discuss the risks, the benefits and the alternatives with you. Then you can make a sound, informed decision. If you do choose extended wear, be sure to follow your eyecare professional's instructions. A careful wearer and regular follow-up examinations can go a long way toward making extended wear a safe and rewarding experience.
CLAO
The above information is taken from the CLAO Patient Information Pamphlet entitled EXTENDED WEAR CONTACT LENSES. Pamphlet Advisors were Gary N. Foulks, MD, Jack Hartstein, MD and Ruth M. Miday, COT. Copyright 1996-2004, Contact Lens Association of Ophthalmologists, Inc.