what contacts\vision correction should I choose? (besides glasses)

Discussion in 'Glasses' started by derakht9, Jul 28, 2006.

  1. derakht9

    derakht9 Guest

    Been trying to figure out what I should do, will see the
    ophthalmologist soon.. Here is my prescription (contacts):

    OD: sphere -3.50 cyl -1.25 ax 180
    OS: sphere -3.50 cyl -1.25 ax 010


    I've worn soft contacts for around 7 years and recently have had dry
    eyes + slight corneal impression\red ring after wearing them for a few
    hours, mostly at 3 o'clock around my cornea (left eye). Since the
    problems are dryness and possible lens tightness, I'm thinking to try
    one (or more) of the following lenses, maybe with a larger BC:

    Acuvue Oasis
    Ciba 02Optix
    Purevision
    ProClear Compatibles
    Focus N&D
    Extreme H20


    The Acuvue Advance I currently wear have shown a significant
    improvement over previous lenses, Toric 66's, but above problems still
    exist. My first thoughts are to try the Oasis, not sure they correct
    astigmatism though. Full astigmatism correction is a must..

    - also considering trying RPGs.
    - thought about IOLs but if I am correct these are only for if you are
    having cataract surgery.
    - not going for Lasik.. it's too early.


    Questions:
    - Which above contacts should I try?
    - Would RPGs fix the tightness problem?
    - Does anyone know when Focus Dailies (or any dailies) will become
    available in for my strength astigmatism?


    Thanks
     
    derakht9, Jul 28, 2006
    #1
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  2. derakht9

    Dr. Leukoma Guest

    I would also add Purevision Toric to your list. If you intend to use
    soft lenses, I think you will need a toric lens for that much
    astigmatism. Purevision has a lower water content than A/V Advance and
    will not show as much dimensional variation with the dry eye.

    RGP? I don't think so. At least not the customary type that float up
    and down on the cornea. There are large format lenses on the market,
    called corneascleral lenses, that cover the entire cornea. They don't
    move up and down, and tend to trap moisture in.

    The bottom line is that ALL contact lens wear is made more difficult by
    dry eye. Maybe you should consider evaluation and treatment for that
    first.

    DrG
     
    Dr. Leukoma, Jul 28, 2006
    #2
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  3. derakht9

    drfrank21 Guest

    I agree. My matrix likely would be 1) pure vision toric , 2) proclear
    toric
    (if pure vision doesn't work) and finally would consider punctal
    occlusion
    if the above two choices failed.

    frank
     
    drfrank21, Jul 28, 2006
    #3
  4. derakht9

    derakht9 Guest

    Okay thank you
     
    derakht9, Jul 29, 2006
    #4
  5. derakht9

    Charles Guest

    Are RGPs especially bad with dry eye? I think I have mild dry eye, and
    my doc hasn't expressed any concern regarding my RGP wear.


    --
     
    Charles, Jul 29, 2006
    #5
  6. derakht9

    derakht9 Guest

    Forgot to include something. The dry eyes with contacts is no big deal
    as far as comfort is concerned, it is unwanted, but I am not sensitive
    and can stand it and would much prefer to wear them. My concern is that
    I believe more serious complications could result from continuing to
    wear them such as corneal ulcer or cataract.. am I correct? Can I just
    wear them if I can put up with them? Basically after a few days of wear
    I leave them out for a few days, and repeat..
     
    derakht9, Jul 30, 2006
    #6
  7. derakht9

    Dr. Leukoma Guest

    A symptom is something the patient feels. A sign is something the
    doctor sees. I have seen terrible signs of dry eye and the patient had
    very little awareness. And yes, dry eye can cause corneal defects,
    which predispose to corneal ulcers.

    But, as with most things, there are degrees. There are degrees of dry
    eye. They range form "sub-clinical," i.e. without signs, to "clinical"
    with signs.

    Without a detailed examination, it's impossible to tell where you are
    on that spectrum. The diagnosis and treatment of dry eye is one of the
    most challenging clinical problems that exists.

    DrG
     
    Dr. Leukoma, Jul 30, 2006
    #7
  8. derakht9

    Dr. Leukoma Guest

    I simply tell them that a complete diagnostic workup is necessary to
    prove to the insurance company that the insurance company should pay
    for the treatment. End of debate.

    DrG
     
    Dr. Leukoma, Jul 30, 2006
    #8
  9. derakht9

    callimico66 Guest

    I think it would be helpful for any eye doctor to have someone on staff
    that can REALLY explain HOW to use the various medications, drops,
    ointments, lid-cleansing, etc. to the dry eye patient. My doctor, a
    respected laser surgeon and so-called dry-eye specialist, was not very
    helpful. He handed me some samples of TheraTears drops, another handful
    of sample Omega Oil capsules, and told me to clean my eyelids. At my
    followup appointment, he gave an Rx for Restasis, with no instructions
    or acknowlegment of possible side effects. I experienced terrible
    burning for 3 months and then gave up.

    Since then, I have gotten a lot of info about dry eye on the internet,
    and have learned much. I am now back on the Restasis with no burning,
    and am finally getting a positive effect from it.

    MOST IMPORTANTLY--patients need more counseling about dry eye in the
    doctor's office. Perhaps one of the optometric techs could be a person
    experienced with dry eye--and could take the time to instruct patients
    on a daily eye care routine that would provide relief.

    C
     
    callimico66, Jul 30, 2006
    #9
  10. derakht9

    Dr. Leukoma Guest

    You said it!

    DrG
     
    Dr. Leukoma, Jul 30, 2006
    #10
  11. derakht9

    LarryDoc Guest

    Clearly, he does not deserve the labels of "respected" and "specialist"
    if he is unable or unwilling to provide a clear and concise treatment
    plan and effective follow up.
    Simply and well stated. Send the office a copy!

    LB, O.D.
     
    LarryDoc, Jul 30, 2006
    #11
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