• 7-1-2011 Doctors will no longer get trials for O2Optix
• 1-1-2011 Product availability not guaranteed
• 7-1-2012 O2Optix lens discontinued.

Ciba has been pushing strongly the one month replacement modality which flies in the face of the two week replacement schedule philosophy of their competitor, Vistakon. Ciba’s recommended alternative for those who have been in O2Optix lenses is to have their doctor refit them in Air Optix Aqua.

Walmart will sell out their existing stock of ClearCare, but won’t be reordering more. Here’s from the memo dated 1-24-2011:

• Jan 1, 2001 Ciba Vision has incorporated a substantial cost increase to their Clear Care items throughout the industry.
• We take any and all cost increases very seriously especially if the supplier is unable to justify the significant increase completely.
• In the interest of our customers, we will not carry Clear Care until this matter is resolved.

They go on to suggest that the V.C. associates can ask the Doctor Partners to recommend a suitable alternative product.

Isn’t this what happened to Rubbermaid?

Renu Sensitve

Effective October 21, 2010, Bausch and Lomb will halt the shipment of the Renu Sensitive care kit as they take a different approach to the Renu product in the market

An evaluation will be made in Q2 2011 and a decision will be made at that time as to it (sic) whether or not the shipments will resume.

When I got the Renu Sensitive starter kits a few months ago I was kind of wondering what the deal was. I mean, if I were a patient I’d be wondering, “Why does the same company offer three competing brands of contact lens multi-purpose solution: Renu Fresh (formerly MultiPlus), Renu Sensitive, and BioTrue?”

See also my entry about the ingredients of the common soft contact lens care systems.

I think the label “sensitive” is a complete marketing gimmick. Someone has dryness or redness with their contacts, so instead of asking their eye doctor, their first impulse is to look in the contact lens solution isle and think, “Yah, my eyes are sensitive, so I’ll buy the product that says ‘sensitive’ on it.”

Contact lens solutions vs materials vs corneal staining updated 2010-09-16

FYI:

Contact Lens Solutions Ingredients

Eye Exam Types

For more interesting stats to help you make your business plan, the OBA-CE has compiled these:

• Revenue Per Exam
• Complete Exams per OD Hour
• Annual Revenue Growth Rate
• Internet Site Penetration
• Contact Lens Usage by Lens Type
• Recall System Independent of Vision Center
• Walk-in Ratio
• Contact Lens Exams Percent of Total Exams
• Medical Eye Care Visits as Percent of Total Visits
• Exams Percent of Active Patients
• Professional Fee Income Percent of Total Location Revenue
• Performance Metrics by Years at Location
• "Elite” Practice Metrics
• Performance Metrics for Walmart and Sam’s Club Locations

It’s a one month lens, which is convenient for most people to remember when to toss their now old lenses which will soon become cesspools ripe for eye infections. The reason is because they build up deposits, like this:

Replace your contacts on schedule!!!

Lots of lenses are only two week and toss lenses, but Biofinity is resistant to deposits enough to allow it to be a one month lens. Official and approved.

Biofinity also got an FDA indication for extended wear. In other words, if your doctor thinks your eyes can handle it, Biofinity can be worn one week straight, take it out, clean it, soak it overnight, and then repeat.

Now, I’ve tried this, and while it was totally doable, for me it’s not as comfortable for extended wear compared to Ciba’s Night & Day (by the way, I refuse to call it Air Optix Night & Day Aqua because that is just waaaaaaaay too long a name for a contact lens.) But guess what. That’s just me. Maybe for you it could be fine. However, almost every patient I’ve tried this with comes back a week or two later and says they would rather be Rx’d Night & Day if extended wear was their approved goal.

If you’re just interested in daily wear (taking out every night) or if price is the main consideration, then Biofinity wins over Night & Day because it’s only around $50 per box of 6 lenses rather than Night and Day at ~$70 per box of six. Another consideration is that you can now get Air Optix Aqua (regular, NOT Night & Day) for ~$47 per box. My only beef with that is that it’s basically the same lens as O2Optix which was released as a two week lens, so I’m not sure whether to believe that Ciba wants you to wear a 4 week lens for two weeks or a two week lens for four weeks.

Comfort-wise, it seems to me that the percentage of patients that like the comfort of the Biofinity is about the same percentage of people that like the feel of O2Optix. Now, the only thing is, both those percentages are less compared to Acuvue Oasys comfort. But consider that a year supply of Acuvue Oasys (a 2 week lens) is about ~$272 while Biofinity is around $200.

Biofinity has a great toric lens in case you have low to moderate amounts of astigmatism (0.75-2.50) in one or both eyes. For mild amounts of astigmatism (0.25-0.50 and maybe 0.75), its aspheric optics help mask it for clearer vision compared to contacts without aspheric optics.

Anyway, my advice is to just try it out. If you like it, buy it. If not, try something else. That’s how I roll. I alternate between wearing Biofinity, Acuvue Oasys, and Night & Day. Mostly Night & Day. But hey, I’ve been wearing contact lenses so long that you could poke me in the eye, and I’d barely feel it. But seriously, I think I have significant corneal hypoesthesia which allows me to tolerate pretty much any lens that gets pushed out into the contact lens market.

Another consideration for you is the compatibility of lens material to your desired contact lens solution system. Some lenses can only tolerate the most expensive solutions. The Biofinity material is pretty much compatible with even the most cheapest of house brand multi-purpose solutions. On average. Your eyes may vary.

I think Biofinity is a quality lens, but take it home along with your Oasys and Night & Day or O2Optix and see which one works best at which price for you.

There, does that answer your question?

Clinical Evaluation of Systane Ultra Safety in Contact Lens Wearers

This investigator- and patient-masked, single-site, randomized, and prospective study involved 45 successful contact lens wearers to evaluate the safety of Systane Ultra Lubricant Eye Drops in contact lens wearers. A currently marketed contact lens rewetting drop was the control solution. Eligible subjects’ baseline biomicroscopy findings, visual acuity, and corneal staining score were recorded. Subjects received either the test or control solution with masked labeling. Subjects were instructed to instill their assigned solution in both eyes: 15 minutes prior to lens insertion, at least one drop during lens wear and another drop immediately following lens removal. After 14 days, biomicroscopy results, visual acuity, and corneal staining score were recorded.

No adverse events were documented for either the test or the control solution. For subjects using Systane Ultra, no statistically significant change was detected in visual acuity or corneal staining score. For subjects using the control solution, the change in visual acuity was not clinically relevant and there was no significant change in corneal staining score.

This clinical study provided evidence of safety and compatibility of Systane Ultra Lubricant Eye Drops in contact lens wearers.

SOURCE: Kading D. A two-week clinical evaluation of the safety of Systane Ultra in contact lens-wearing patients. Clin Ophthalmol 2010;4:27-32.

I have actually wanted to find out whether it binds to and gums up the contact lens. Or is this condition considered part of the “no adverse events.” Also, does it matter whether the contact is a two week lens verses a one month lens?

slippery and wet
needles poke the acute
conquered in one hour

More Optoblog poetry here.

This patient from Dr. Bazan’s office shares her experience.

It really does help to see the doctor to get the best contacts for your eyes. Not only contacts, but info about contact lens solutions. I can’t tell you how many people love ClearCare yet they had never heard of it before I explained it.

I wish people would value the doctor.

BUT, should the law should punish people who buy contacts without a real prescription?

The libertarian in me says no. I should be able to buy antibiotics at the pharmacy without a prescription if I want. The only thing bringing some people in for an eye exam is getting that piece of paper, but it turns out some people don’t even bother with the Rx paper and just game the mail-order system.

The solution? Teach people to value the doctor. We can foster that value every time the patient has an evaluation by explaining how glad we are that they came in. We must be sure to educate how great it is that they had an eye exam whenever:

1. their Rx changes
2. we change their contacts to a better lens for comfort and eye health
3. we recommend a better, more compatible, care system for their eyes and contact lenses
4. we educate them on the latest and greatest options for them, even if they don’t want or require a change in lens or care system
5. they have a medical condition related to their eyes

And I don’t hold the prescription over their heads. The Utah law is that I make the expiration date for two years if their eyes are healthy; however, I frequently mention that it is best to have a yearly eye exam, especially if they note even a subtle change in their vision.

To LASIK or not to LASIK...

I did this one because someone searched for “LASIK comic,” and I’m sure they were sadly disappointment that I didn’t have one.

Now before you get all over me for not spreading sunshine and lollipops about refractive surgery, let me first clarify that the above comic is comical, I thought. If I was told that my chance of winning the lottery was 99%, then I’d probably play it. If I was told that if I played the lottery that I had a 1% chance of dying then I wouldn’t play it.

I feel bad that I have to explain the resurrection reference, but I must make sure that those of you who never went to Sunday school understand that in the resurrection, our spirit will be reunited with our bodies which will be in a perfect form (our bodies, not us), so any LASIK disaster that plagued our days in mortality won’t bother our resurrected body.

My actual opinion regarding LASIK is pretty main stream. If someone really, really wants it and they have the proper medical prerequisites like cornea thickness, refractive error, good eye health, etc. AND they have a really good understanding of the risks and expectations, then I will recommend them to a good surgeon. Perhaps the surgeon that would do my LASIK if I wanted it.

But I don’t want it. I don’t fit the psychological profile since I’m perfectly happy in Night and Day contacts. I’m also rather wary of my family history since I’ve had three close blood relatives get it and most were left still needing glasses or enhancements.