Contact Lens Quandry

Here's a puzzler worthy of Click and Clack, if you listen to NPR's "Car
Talk."

I've been bearing CSI Daily wear for years and years but started to have
more comfort problems, especially when I switched to a 13.8mm diameter since
the 14.8 was discontinued. The lenses would be a little uncomfortable at
first, then be good for a while, the seem to get coated easily. Switching
them from eye-to-eye seemed to help comfort (?!).

I switched to CIBA Focus Monthlies and it took a while but they're doing
good with one exception: I've got one lens that feels good and produces
stable vision. But I can feel the other lens in my eye (not irritating --
just a presence) and the vision fluctuates, mainly losing close-up vision.
I can put the "good" lens in either eye and it's great (both eyes have same
prescription), so that would suggest the "bad" lens has something wrong with
it. But try as I might with brand new lenses, I can't get one that is
comfortable (in either eye). So why do I have only this one lens that
somehow works?

I finally went to a different doctor and she suggested that the base curve
for these lenses should be 8.9 instead of the 8.6 I've been using, and that
this would produce a better fit that should help. I'm optimistic this will
fix the problem -- but why does that one 8.6 lens work?

Keith

"Keith Morris" <(E-Mail Removed)> wrote in
news:rdSGc.127611$(E-Mail Removed) .com:

> Here's a puzzler worthy of Click and Clack, if you listen to NPR's
> "Car Talk."
>
> I've been bearing CSI Daily wear for years and years but started to
> have more comfort problems, especially when I switched to a 13.8mm
> diameter since the 14.8 was discontinued. The lenses would be a
> little uncomfortable at first, then be good for a while, the seem to
> get coated easily. Switching them from eye-to-eye seemed to help
> comfort (?!).
>
> I switched to CIBA Focus Monthlies and it took a while but they're
> doing good with one exception: I've got one lens that feels good and
> produces stable vision. But I can feel the other lens in my eye (not
> irritating -- just a presence) and the vision fluctuates, mainly
> losing close-up vision. I can put the "good" lens in either eye and
> it's great (both eyes have same prescription), so that would suggest
> the "bad" lens has something wrong with it. But try as I might with
> brand new lenses, I can't get one that is comfortable (in either eye).
> So why do I have only this one lens that somehow works?
>
> I finally went to a different doctor and she suggested that the base
> curve for these lenses should be 8.9 instead of the 8.6 I've been
> using, and that this would produce a better fit that should help. I'm
> optimistic this will fix the problem -- but why does that one 8.6 lens
> work?
>
> Keith
>
>
>

I think that you might want to "focus" on the lens diameter, and not just
the base curve. It almost sounds like a case of GPC, or giant papillary
conjunctivitis, that is aggravated by the mechanical friction of the edge
of the lens. The larger lens diameter changes that interaction. The B&L
Soflens 66 comes in a 14.5 diameter, two-week disposable.

Another generalization is that a tighter lens tends to feel better
initially, again because of the "edge" thing.

Good luck.

DrG

In article <rdSGc.127611$(E-Mail Removed) >,
"Keith Morris" <(E-Mail Removed)> wrote:

> I finally went to a different doctor and she suggested that the base curve
> for these lenses should be 8.9 instead of the 8.6 I've been using, and that
> this would produce a better fit that should help. I'm optimistic this will
> fix the problem -- but why does that one 8.6 lens work?

I believe I answered your query in depth last week, and Dr. G also
provided an appropriate reply. Now that you have a new real live eye
doctor, have her solve the problem for you. It really can't be all that
difficult, and remember, you might find that you need different lenses
parameters in each eye.

--LB

--
Dr. Larry Bickford, O.D.
Family Practice Eye Health & Vision Care

The Eyecare Connection
http://www.eyecarecontacts.com
larrydoc at eye-care-contacts dot com (remove -)

"Dr. Leukoma" <(E-Mail Removed)> wrote in message
news:Xns951F7009BB640DrLeukoma@207.217.125.203...
> "Keith Morris" <(E-Mail Removed)> wrote in
> news:rdSGc.127611$(E-Mail Removed) .com:
>
> I think that you might want to "focus" on the lens diameter, and not just
> the base curve. It almost sounds like a case of GPC, or giant papillary
> conjunctivitis, that is aggravated by the mechanical friction of the edge
> of the lens. The larger lens diameter changes that interaction. The B&L
> Soflens 66 comes in a 14.5 diameter, two-week disposable.
>
> Another generalization is that a tighter lens tends to feel better
> initially, again because of the "edge" thing.
>
> Good luck.
>
> DrG

It's not GPC, but I do have Meibeomitis. Treating that has greatly improved
the irritation I've *always* had in my left eye. The right eye problem is
not one of irritation but of "feel." The larger CSI lenses did feel better
in the right eye (not new -- but after they were "broken in."

The big BUT in all this is that I have one Focus (14.0 D 8.6 BC) that feels
good in my right eye also! No doctor has been able to figure that one out.

The Soflens 66 won't work as I need a -12.5D (both eyes same). Any other
larger diameter lenses in higher prescriptions?

But the doc thinks the 8.9 BC will be a better fit -- we'll see.

Keith

"LarryDoc" <(E-Mail Removed)> wrote in message
news:larrydoc-(E-Mail Removed)...
> In article <rdSGc.127611$(E-Mail Removed) >,
> "Keith Morris" <(E-Mail Removed)> wrote:
> I believe I answered your query in depth last week, and Dr. G also
> provided an appropriate reply. Now that you have a new real live eye
> doctor, have her solve the problem for you. It really can't be all that
> difficult, and remember, you might find that you need different lenses
> parameters in each eye.
>
> --LB
>
Yes, that's what I thought -- that it shouldn't be all that difficult. But
I've been to several ODs who seemed to be stumped. I think it's because
they are just used to run-of-the-mill issues and not good "detectives."
Unfortunately, most medical and optical professionals are that way these
days -- if you don't have a problem that they've seen before forget it.
Maybe it's because they only have 5 - 10 minutes to actually diagnose and
treat you!

But I'm optomistic that the new Opthamologist I'm seeing is up to the
task -- she's already fixed the Meibomianitis I've had for years that no one
else could seem to identify.

Sorry for being down on the profession -- I know there are good docs out
there, just hard to find.

LarryDoc wrote:
>
> "Keith Morris" <(E-Mail Removed)> wrote:
>
> > I finally went to a different doctor and she suggested that the base curve
> > for these lenses should be 8.9 instead of the 8.6 I've been using, and that
> > this would produce a better fit that should help. I'm optimistic this will
> > fix the problem -- but why does that one 8.6 lens work?
>
> I believe I answered your query in depth last week, and Dr. G also
> provided an appropriate reply. Now that you have a new real live eye
> doctor, have her solve the problem for you. It really can't be all that
> difficult, and remember, you might find that you need different lenses
> parameters in each eye.

I believe, based on my own experience, that soft lens reproducibility
just ain't what it's cracked up to be. I just opened up the 5th lens in
the 6-pack. Once again, the damn thing is off. I can push it into
clearer vision by one of several different eyelid-manipulations, but it
slips back as soon as I stop pushing. All the lenses have been slightly
different, although they are all the same size, lot, etc. It's a
6-pack, for chrissake.

When I called up the optician, he called me back -- I guess he just
noticed that I'd asked for a LOT of replacement lenses and figured that
Cooper was going to start giving him static. When I finally get a good
one I wear it for 3 months (supposed 1-month replacement, yeah, right)
because I know for an absolute fact that the next one is going to give
problems. Yet ONE of the lenses in that 6-pack was fine. He finally
grudgingly said he'd order me another one, but...

$450 for fitting and 2 6-packs. I think I've got a right to be ****ed,
but I know it's not the optician's fault -- he really worked his ass off
trying to fit me.

OK, rant over for now. See you in 3 months. Or maybe next week...

--
Cheers,
Bev
<><><><><><><><><><><><><><><><><><><><><><><><><> <><><><>
"Only wimps use tape backup; *real* men just upload their
important stuff on FTP, and let the rest of the world
mirror it " -- Linus Torvalds

> I believe, based on my own experience, that soft lens reproducibility
> just ain't what it's cracked up to be. I just opened up the 5th lens in
> the 6-pack. Once again, the damn thing is off. I can push it into
> clearer vision by one of several different eyelid-manipulations, but it
> slips back as soon as I stop pushing. All the lenses have been slightly
> different, although they are all the same size, lot, etc. It's a
> 6-pack, for chrissake.
>
> When I called up the optician, he called me back -- I guess he just
> noticed that I'd asked for a LOT of replacement lenses and figured that
> Cooper was going to start giving him static. When I finally get a good
> one I wear it for 3 months (supposed 1-month replacement, yeah, right)
> because I know for an absolute fact that the next one is going to give
> problems. Yet ONE of the lenses in that 6-pack was fine. He finally
> grudgingly said he'd order me another one, but...
>
> $450 for fitting and 2 6-packs. I think I've got a right to be ****ed,
> but I know it's not the optician's fault -- he really worked his ass off
> trying to fit me.
>
> OK, rant over for now. See you in 3 months. Or maybe next week...
>

Yes, I thought about that. Especially when some of the new lenses I open
up have had "squiggly" edges, i.e. not retaining a round shape. But have
you ever had a "bad" one finally become "good" if you wear it long enough
(I'm talking days). I have had that experience too. But some of the bad
ones I just have to trash.

Will they replace the "bad" ones for you?

Keith

Keith Morris wrote:
>
> > I believe, based on my own experience, that soft lens reproducibility
> > just ain't what it's cracked up to be. I just opened up the 5th lens in
> > the 6-pack. Once again, the damn thing is off. I can push it into
> > clearer vision by one of several different eyelid-manipulations, but it
> > slips back as soon as I stop pushing. All the lenses have been slightly
> > different, although they are all the same size, lot, etc. It's a
> > 6-pack, for chrissake.
> >
> > When I called up the optician, he called me back -- I guess he just
> > noticed that I'd asked for a LOT of replacement lenses and figured that
> > Cooper was going to start giving him static. When I finally get a good
> > one I wear it for 3 months (supposed 1-month replacement, yeah, right)
> > because I know for an absolute fact that the next one is going to give
> > problems. Yet ONE of the lenses in that 6-pack was fine. He finally
> > grudgingly said he'd order me another one, but...
> >
> > $450 for fitting and 2 6-packs. I think I've got a right to be ****ed,
> > but I know it's not the optician's fault -- he really worked his ass off
> > trying to fit me.
> >
> > OK, rant over for now. See you in 3 months. Or maybe next week...
> >
>
> Yes, I thought about that. Especially when some of the new lenses I open
> up have had "squiggly" edges, i.e. not retaining a round shape. But have
> you ever had a "bad" one finally become "good" if you wear it long enough
> (I'm talking days).

Never. The bad ones stay bad. The best ones move out of position when
I look downward, but they can be brought back easily.

> I have had that experience too. But some of the bad
> ones I just have to trash.

I saved them on the theory that SOMEBODY might want to look at them to
figure out what went wrong, but that's not going to happen. When I got
the second bad one in the 6-pack I asked if he wanted me to return the
whole thing, but he said no.

> Will they replace the "bad" ones for you?

Yes, but I suspect he thinks I'm stockpiling them to save money and I
don't think he'll do it again. I've got one unopened pair left, and I'm
in rather a quandary about what to do when that's on its last legs.
assuming it's actually OK. I can probably order from 1-800-Contactlens
or somebody, but if I have just as many problems with the new ones
(assuming the old ones were just a totally bad batch and I happened to
get lucky) I'll be up **** creek. OTOH, if I order from the guy I'll
probably have to pay twice as much and they'll probably be just as bad
as the ones I've had except he'll be lots less willing to order
replacements.

They're Cooper Frequency 55 torics, recommended for 1 month's wear. The
optician said I could safely wear them for 2 months, and I've been
wearing them for 3 months. I see/feel no difference between brand new
ones and 3-months-old ones, except when the new ones are wrong. Is it
conceivable that if I use the protein-remover tablets on them every few
months I could wear them longer? I don't seem to form protein deposits,
but I have no way to really know.

When it's cataract time, I'm wondering what I should do -- one
possibility is have lasik to get rid of the astigmatism that has caused
so much trouble, have regular (instead of toric) distance (rather than
close-up) IOLs put in, and then get multifocal soft contacts to make up
any difference in power and FINALLY spare me the necessity of having
glasses on my nose. I wonder what the odds are that everything would
work out nicely...

--
Cheers,
Bev
***********************************************
"A complete lack of evidence is the surest sign
that the conspiracy is working." -- Tanuki

In article <(E-Mail Removed)>,
The Real Bev <(E-Mail Removed)> wrote:

> When it's cataract time, I'm wondering what I should do -- one
> possibility is have lasik to get rid of the astigmatism that has caused
> so much trouble, have regular (instead of toric) distance (rather than
> close-up) IOLs put in, and then get multifocal soft contacts to make up
> any difference in power and FINALLY spare me the necessity of having
> glasses on my nose. I wonder what the odds are that everything would
> work out nicely...

So when might cataract time be? Perhaps technology will catch up with
your needs and there will be a exactly what you need with minimal risk
and maximum results. There's some pretty cool stuff under development,
you know. The industry is well aware of the increasing market (read:
$$$) for advanced optical technology as the baby boomers move into "that
age"---you know, that big bubble of population that allegedly has huge
amounts of discretionary income? At least those who didn't loose it all
in the slot market.

Hang in there, girl. I'm with ya.

--Larry

--
Dr. Larry Bickford, O.D.
Family Practice Eye Health & Vision Care

The Eyecare Connection
http://www.eyecarecontacts.com
larrydoc at eye-care-contacts dot com (remove -)

> Yes, but I suspect he thinks I'm stockpiling them to save money and I
> don't think he'll do it again. I've got one unopened pair left, and I'm
> in rather a quandary about what to do when that's on its last legs.
> assuming it's actually OK. I can probably order from 1-800-Contactlens
> or somebody, but if I have just as many problems with the new ones
> (assuming the old ones were just a totally bad batch and I happened to
> get lucky) I'll be up **** creek. OTOH, if I order from the guy I'll
> probably have to pay twice as much and they'll probably be just as bad
> as the ones I've had except he'll be lots less willing to order
> replacements.

I'm been getting Focus Monthlies from www.visiondirect.com. The cost is
$22.96 for (6). My Optomotrist said he'd match mail order but he said his
cost is higher than $22.96. I feel bad not getting them from him but I did
pay him $$$ for my whole family for check-ups, lens fittings and glasses.
Also, there isn't nearly enough consumer competition in the health-care
system, so I guess I really don't feel so bad after all. They're cheap
enough so that if one isn't working I just throw it away.

>
> When it's cataract time, I'm wondering what I should do -- one
> possibility is have lasik to get rid of the astigmatism that has caused
> so much trouble, have regular (instead of toric) distance (rather than
> close-up) IOLs put in, and then get multifocal soft contacts to make up
> any difference in power and FINALLY spare me the necessity of having
> glasses on my nose. I wonder what the odds are that everything would
> work out nicely...
>
I'm in the same boat -- but Lasik won't work for my extreme myopia. The
best option for me when contacts finally don't work seems to be IOLs (either
for cataacts or a clear lense eschange ). They are working on IOLs now that
have some focusing ability, and probably correction for astigmatism as well.
My theory is every year I can wait is another year the technology (and
UNDERSTANDING OF RISKS) advances.

Keith





> Cheers,
> Bev
> ***********************************************
> "A complete lack of evidence is the surest sign
> that the conspiracy is working." -- Tanuki