Article on Non-Rx CLs

[mintyjulep]

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http://www.dailymail.co.uk/news/art...-transplant-wearing-20-coloured-contacts.html

 

[thiaeyemd]

As a resident saw this constantly. During my residency had three cases in three years of young adults who needed a corneal transplant after getting a central corneal ulcer from sleeping in contact lenses. Not clear why some people still tell patients that it is ok to sleep in contacts...

 

[syma]

As a resident saw this constantly. During my residency had three cases in three years of young adults who needed a corneal transplant after getting a central corneal ulcer from sleeping in contact lenses. Not clear why some people still tell patients that it is ok to sleep in contacts...

Under ophthalmic supervision and with clear advice there are some patients that can use licensed contact lenses for continuous wear.

And it isn't the patients that are on continuous wear with proper advice and regular check ups that tend to have the complications, it's the patients that lack compliance with their contact lenses with any replacement schedule that do.

To make matters worse for that young girl, she used tap water AND then slept in them.

 

[mclem222]

i disagree. I see a large number of contact ulcers from patients sleeping in their contacts.

 

[KHE]

I disagree to a certain extent. In my practice I see emergency patients in the practice. We are a small town 30 miles outside of a large city and on average I see between 2-4 contact lense associated corneal ulcers a day or about 15-20 a week. Most are patients that are not from our practice but a few are. Almost 95% of those patients are those that sleep in their contacts. I think sometimes the original doctor does not see that sleeping in the contacts is a problem because a large percentage of those patients come to our office. Probably the reason that most ophthalmologists do not like patients sleeping in contacts and some Optometrists see it as ok. Perspective.

Huh? 15-20 corneal ulcers a week? That's a thousand a year. That doesn't seem possible. Are you in some sort of tertiary care center?

Between my partner and I, if I see one a month, I would be shocked. And by that, I mean a true infections ulcer, not a CLARE or a sterile infiltrate.

 

[mclem222]

I am at an optometric/ophthalmologist practice partime

 

[KHE]

I am at an optometric/ophthalmologist practice partime

Huh?

3 months ago you said you've been out two years and you work in a commercial location.

Even combined commercial/combined practice I can't fathom 15-20 ulcers a week. That's 3-4 a day.

Were you actually serious with that comment?

 

[Tippytoe]

Huh?

3 months ago you said you've been out two years and you work in a commercial location.

Even combined commercial/combined practice I can't fathom 15-20 ulcers a week. That's 3-4 a day.

Were you actually serious with that comment?

BUSTED!

 

[mclem222]

I am...I work at a commercial practice three days a week and I work parttime at a referral group doing walk in care one day a week. I also am an owner and work 1 day a week at my own office

 

[Shnurek]

Under ophthalmic supervision and with clear advice there are some patients that can use licensed contact lenses for continuous wear.

And it isn't the patients that are on continuous wear with proper advice and regular check ups that tend to have the complications, it's the patients that lack compliance with their contact lenses with any replacement schedule that do.

I used to wear my continuous wear contact lenses without taking them out for a full 30 days. I did this for about 4 years. My optometrist told me to take them out at night but then I did a little research and saw the FDA stated its OK to keep them in for 30 days so I said screw it, I'll keep em in. Silly me, good thing nothing serious happened, just an acute bacterial infection once. Thankfully, I no longer do this.

 

[KHE]

I am...I work at a commercial practice three days a week and I work parttime at a referral group doing walk in care one day a week. I also am an owner and work 1 day a week at my own office

And between those three situations, you are seeing 15-20 corneal ulcers a week? 😕

 

[Tippytoe]

ODs do exagerate, don't they. I can't tell you how many "Million dollar" practices I've heard about only to go and find out it's a little 1,000 sq ft office with wood paneling and a lime green rotary telephone. The only way they'd be making a million bucks is if they were selling meth and prostitutes on the side.

This thread just goes to show. Don't believe everything you hear. Good or bad.

 

[mclem222]

Well..I appreciate you thinking me an OMD but I am not (though my brother is). I practice in Pottstown PA and have had my practice in place for some time. Doing the walkin clinic I see several ulcers a day. Now, I don't cover the walkin clinic 5 days a week but my experience is no different than the OMDs and ODs that work in the walkin clinic. Yes..it 500-1000 a year I am sure...I am sorry if you guys can't imagine that but it is the truth.

 

[KHE]

Well..I appreciate you thinking me an OMD but I am not (though my brother is). I practice in Pottstown PA and have had my practice in place for some time. Doing the walkin clinic I see several ulcers a day. Now, I don't cover the walkin clinic 5 days a week but my experience is no different than the OMDs and ODs that work in the walkin clinic. Yes..it 500-1000 a year I am sure...I am sorry if you guys can't imagine that but it is the truth.

I ain't buying it.

Pottstown, PA is in Montgomery county. The US census for Montgomery county shows a population of 800,000.

The incidence of corneal ulcers in CL wearers is 130 per 100 000. That means one would expect there to be 1000 cases of corneal ulcers in Montgomery county per year.....

IF EVERYONE IN MONTGOMERY COUNTY WORE CONTACT LENSES.

Which they certainly do not.

But let's assume for a second that every single person in Montgomery county does in fact wear contact lenses.

That would also mean that every single contact lens ulcer somehow found it's way into YOUR walk in clinic or Lenscrafters.

Please.....what a load of crap-o-la.

🙄

 

[Meibomian SxN]

I ain't buying it.

Pottstown, PA is in Montgomery county. The US census for Montgomery county shows a population of 800,000.

The incidence of corneal ulcers in CL wearers is 130 per 100 000. That means one would expect there to be 1000 cases of corneal ulcers in Montgomery county per year.....

IF EVERYONE IN MONTGOMERY COUNTY WORE CONTACT LENSES.

Which they certainly do not.

But let's assume for a second that every single person in Montgomery county does in fact wear contact lenses.

That would also mean that every single contact lens ulcer somehow found it's way into YOUR walk in clinic or Lenscrafters.

Please.....what a load of crap-o-la.

🙄

Too funny! I think its a lie too! But he should definitely run for president as I give him an endorsement for continuing the lame lie!

 

[thiaeyemd]

I am in practice in New Jersey and I would say I do see a lot of corneal ulcers from contact lens use (probably 1-2 a day). I am in a tertiary referal practice. I had some of my staff pull the numbers by ICD-9 code and in 2010 our practice saw 871 corneal ulcers that were emergencies. (ie non surgical). I would say that 85-90% of the time they are related to patients sleeping in the contacts. 10% are just reglar contact users and <.1% are non contact users

In terms of risk from a study out of malaysia

2/100,000 hard contact lenses
2.2-4.1/100,000 soft contact lenses
13.3-20.9/100,000 extended wear soft contact lenses

Just interesting...I think from an eye surgeon perspective..if you are a corneal surgeon and do 5 transplants a year
for central corneal ulcers from extended wear contact lenses, would make you think twice about prescribing them to sleep in...from my opinion...

plus there have been a handful of lawsuits against ophthalmologists for allowing patients to sleep in extended wear contacts..the lawyers have cited "you shouldve known better as an eye surgeon who treats these problems", gotten a few career "experts" who claim all contact lenses are bad, and convinced a relatively uneducated jury that what they did was some major deviation from standard of care (which we all know is not true). That may be affecting the opinion of ophthalmologists as well..

In terms of the numbers mclem was citing...sounds awfully high from the practice he describes...

 

[syma]

First corneal ulcer in AGES today. A patient that was fitted with dailies and ordered monthlies off the internet (American website)



Goes with what I was saying about patient compliance and corneal ulcers.