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Posts Tagged ‘contacts’

StainingGrid.com Updated to Include Biotrue

David Langford, O.D. on September 21st, 2010 under Optoblog •  2 Comments

StainingGrid.com has updated their data to show the new Biotrue MPS from B&L.

Contact lens solutions vs materials vs corneal staining

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


It looks like it’s only half as bad as MultiPlus šŸ˜‰
contact lens solution ingredients
(Click image to enlarge.)

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Percentages of Types of Exams from a Walmart Practice

David Langford, O.D. on September 18th, 2010 under Optoblog •  2 Comments

For you optometry students trying to make up numbers for your business plan, here are some percentages from my average Walmart practice:

Eye exam types
In 2007 and 2008 I didn’t track the percentage of patients using insurance because I didn’t have to bill very much back then.

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

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Biofinity Contact Lens Review

David Langford, O.D. on April 17th, 2010 under Optoblog, Reviews •  29 Comments

Since “Biofinity” and “Biofinity contact lens review” are the most frequently searched terms leading to my website, I thought I would give everyone my view of the Biofinity contact lens.
Biofinity Contact Lens Box
Its technical specs can be found at the Coopervision website. Silicone hyrdrogel lenses (the super breathable class of contacts) have been on the market for years, but Coopervision came to the game after Ciba, Bausch & Lomb, and Vistakon. All the latter use a special coating on the surface to make the silicone material wettable for your eye, but Coopervision’s unique Biofinity material is wettable throughout the matrix of the material.

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:

B&L and CL Spectrum photos

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?

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Systane Ultra is Safe for Use with Contact Lenses

David Langford, O.D. on March 20th, 2010 under Optoblog •  1 Comment

Systane Ultra is safe for use while wearing with contact lenses according to a new study.

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?

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Optoblog Haiku #003

David Langford, O.D. on February 19th, 2010 under Optoblog, Poetry •  1 Comment

slippery and wet
needles poke the acute
conquered in one hour

More Optoblog poetry here.

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The CON in Contacts

David Langford, O.D. on February 11th, 2010 under Optoblog •  Comments Off on The CON in Contacts

So apparently people have caught on about the negative verification and con the system to get contacts without actually getting an eye exam.

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.

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LASIK Comic

David Langford, O.D. on February 6th, 2010 under Comics, Optoblog •  Comments Off on LASIK Comic

Should I get my eyes LASERed? That depends...

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.

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Biofinity now at Wal-Mart

David Langford, O.D. on January 30th, 2008 under Optoblog •  Comments Off on Biofinity now at Wal-Mart

CooperVision’s newest lens, the Biofinity, is now available at Wal-Mart. They’re selling it for something like $49.87 (it’s a one month lens).
I guess my private practice is no longer the exclusive provider of Biofinity in the Cache Valley area.

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Wal-Mart Steps in [It] With 1-800 Contacts

David Langford, O.D. on January 17th, 2008 under Optoblog •  7 Comments

Wal-Mart recently announced in a letter that they are “excited to announce a long term alliance between Wal-Mart/Samā€™s Club and 1-800 CONTACTS..”

May Heaven help us, because 1-800 sure isn’t going to. I promptly wrote the following E-mail to Dr. Patel, Wal-Mart’s Director of Professional Relations:

Dr. Patel,
I would advise against any kind of alliance with 1-800 CONTACTS. You’re not the first one to try. Standard Optical, a Utah-based optical chain, aligned with this Utah-based contact lens reseller for a while, and it didn’t last long. You should talk with those in the know about why it didn’t work out.

1-800 is also militant about teaching the general public to force the doctor to make decisions not in their best interest. Everyone inside our industry acknowledges that yearly eye exams are important, but 1800’s own website indoctrinates consumers to mandate to their doctor that prescriptions should expire at the two year mark OR LATER. (see: http://www.1800contacts.com/docAndRx/DocRx-release-1.shtml ). As a Utah eye doctor, I already suffer with practicing in the only state in the nation with a minimum 2-year contact lens expiration date- thanks to 1800’s lobbying power in our Utah legislature.

I had a patient last year, whom if her prescription hadn’t expired, she wouldn’t have come back in to see me for her yearly exam. If she wouldn’t have had her yearly exam, I wouldn’t have noticed an FDT screening visual field defect and reduced vision in one eye that wasn’t there the previous 2 yearly exams. If I wouldn’t have seen her, I couldn’t have referred her to the ophthalmologist who referred her for imaging which found the diagnosis of a brain tumor. A yearly eye exam saved her life, and under 1800’s reign, we are sure to miss these kinds of cases in the future.

If your only goal is to cut costs related to online sales at walmart.com, why not use 1800 as a nameless, behind the scenes
subcontractor? Giving them the limelight is the wrong move for Wal-Mart. An alliance with 1800 disgraces our reputation.

Also, I’ll quote from your FAQ (http://www.walmartod.com/clients/1814/docs/FAQ_Alliance.pdf): “Consumers in that same survey specifically cited cost and ā€œpurchasing them is inconvenientā€ as reasons for over-wearing their lenses.” Wal-Mart boasts about how something like 50% of a town’s population visit their store in any given week. How is stopping by the vision center on their bi-weekly pilgrimage inconvenient? What they meant to say is expensive or don’t have enough money. They expect to buy a box per eye and stretch it as long as possible. The real problem is that people expect a year supply of contacts to be less expensive than glasses just because you throw them away, and most also expect them to be a replacement for, not in addition to, glasses. Change those two perceptions, and you’ll increase your contact lens sales without help from the enemy of 1800 CONTACTS.

Please see my previous blog posts about 1800:
https://optoblog.com/2007/10/09/check-yearly-live-another-year/
https://optoblog.com/2007/07/30/patients-say-the-funniest-things/
https://optoblog.com/2007/03/19/1-800-eat-crap-and-die/

Sincerely,
David Langford, O.D.

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Check Yearly, Live Another Year

David Langford, O.D. on October 9th, 2007 under Optoblog •  3 Comments

Here’s another example of why everyone should consider getting a yearly eye exam despite what Canadian studies say. A college student came in for a routine eye exam to get more contacts since the last doctor made her contact prescription expire only after a year. Everything seemed normal except that this year she didn’t pass the FDT screening field with one eye and that same eye had 20/30 vision. The ONH looked a little pale and both were elevated.

If I was still in Indian Health Service, I could have handled this myself- ordering all kinds of fun tests. But what I’ve learned out in the private sector is that insurance companies HATE it when optometrists order tests. Patients get denial letters on labs. Forget about imaging. Besides, I was having a train wreck day, so I just punted to the ophthalmologist.

Turns out that an MRI ordered by the OMD diagnosed a brain tumor that would have killed her if allowed to fester. I know that because she stopped by last week on a day that I wasn’t there to say thank you. When I heard that, I felt ashamed. I should have been the one to piece together the information and order the scans and have the burden to tell her the bad news.

But regardless of my personal shame, the patient is now okay. She is yet another shining example of why Utah state law should not mandate to me that I have to make prescriptions good for two years. I saw her chart from previous years. No VF defects, 20/20 vision in both eyes- no indication that the next year she would be diagnosed with brain cancer.

Hey 1-800 and your lobbiests! Who knows how many people you will kill or blind because you force by law that every eye doctor in the state of Utah has to make their Rx’s for 2 years.

So everyone: check yearly, see clearly, live longer.

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