The Buzz is Back
New materials and FDA approvals wake up the continuous wear contact lens market
By Amy Spiezio

Thanks to new developments in materials, dispensers can boost contact lens sales to an eager audience by tempting patients with a pair of hot selling points: Safety and convenience. "I think it's a tremendous opportunity for opticians and patients," says Glenda Secor, OD, Huntington Beach, Calif. "The buzz is back in contact lenses, this is exciting for us."

That sort of optimism on the part of professionals, teamed with the public's desire for the product, is key to the success of extended wear contact lenses. Previous incarnations of contact lenses with 30-day indications have a troubled history. In the 1980s, when media reports of terrible infections and blindness dashed hopes for the product, doctors fearing for their patients' ocular health fled to other extended wear modalities, such as seven-day disposable lenses. "[30-day] extended wear just wasn't what it was cracked up to be," says Secor.

For years, ECPs discouraged sleeping in contact lenses, citing concerns such as corneal edema, oxygen deprivation to the cornea, and infection. But the new hyper Dk lenses allow more oxygen to the cornea without lens removal, and since the FDA approved silicone hydrogel contact lenses for extended wear in 2001 and gas permeable lenses for 30-day use this year, dispensers have studied the data and are embracing the latest effort. "I think the new materials are opening a new realm that is a whole new generation," says Janet Mint, OD, Jacksonville, Fla.

The Menicon Z gas permeable lens was approved by the FDA for 30-day wear this year

STEPS FOR SUCCESS

The market is primed for a resurgence of continuous wear contact lenses--never before has the desire for ease of use and convenience so saturated a culture's psyche. Combine these factors with the public's hunger for the technologically advanced, and a match made in consumer heaven is formed.

There is a massive potential market for continuous wear contact lenses, drawing from users of other contact lenses, eyeglass wearers, those considering Lasik, and new patients. Generally, people who are active and willing to spend more money on themselves are prime candidates, says Walter D. West, OD, FAOO, of Brentwood, Tenn., who has developed a profile of patients who prefer continuous wear contact lenses. "They have a more active lifestyle, are more likely to listen to the radio than watch TV, have more discretionary income, and are more conscious of their appearance. These are patients interested in convenience, but convenience that technology has made safe for them," he says.

A natural user is the patient who self-selects continuous wear contact lens use, even if they're not currently in those lenses. "Patients self-select a lot of the time, primarily for convenience. You can make sure they're at least in extended wear indications," says Secor.

Although patients are lured to continuous wear contact lenses with the temptation of carefree use, for successful wearing, eyecare practitioners should take several steps to ensure eye safety.

Education. Thanks to active promotion of continuous wear contact lenses, consumers are aware of the product. And while some patients are eager to take a shot with the new products, others need reassurances. "After more than a decade of overnight lens use being discouraged, I'm trying to put it as a different category. We are trying to reassure them it's OK to sleep in them," says Secor.

During contact lens training, let your patients know about the improvements in 30-day lenses, such as increased oxygen transmission to the cornea. Inform them about the products' conveniences and the importance of proper eyecare while using continuous wear contact lenses.

Set rules. While letting your patients know about the improved safety factors for continuous wear lenses, set guidelines for use. "Explain how good it can be if you do things right and point out what you lose by not being compliant," says West.

Recommendations for Mint's patients include following lens changing schedules and looking at their corneas frequently to evaluate any ocular changes. Also, although patients can wear the lenses for a month at a clip, she recommends that they take out their lenses once in a while.

In addition, Secor stresses the importance of patients getting into the office quickly if anything unusual happens. "Patients know if they have a red eye, they have to come in." She typically recommends, "If in doubt, take it out. Things just don't get that bad if you act quickly."

	CIBA Vision's Focus Night & Day lenses are now the only 30-day soft lens in the U.S.

Take it slowly. The eyecare professionals interviewed by EB agree that while the 30-day designation has its benefits, continuous wear of contact lenses may not be immediate and may not happen at all for some patients. "Just because it's FDA-approved for 30 days doesn't mean it's for everybody," says Mint.

Her patients in Florida wrestle with regional weather factors that contribute to dry eye and they live with ceiling fans and air conditioning, which sometimes means limited use. "There are a lot of patients who are not comfortable wearing them all day, let alone at night," says Mint.

Keep in touch. In some states, such as Florida, eyecare practitioners are legally required to perform corneal exams every six months on those who sleep in contact lenses. Lee Rigel, OD, Visioncare Associates in East Lansing, Mich., sets appointments before patients leave their initial visit for six months ahead. "If they don't show up, we call."

Taking stock of what the patients have at home is another way to check on compliance. "We know how many contact lenses we dispensed and how many they have left," Rigel says.

Many eyecare practitioners note that noncompliance isn't a big issue, yet. "Because they have only been doing it since the first of the year, I'm still able to keep pretty close tabs," says Secor.

Patients who use continuous wear lenses seem to have more respect for the product. "We seem to be getting better compliance than we did with two-week lenses," West says. "I think it's because they realize they're pushing the envelope anyway. We have them on the leading edge of what can be done."