2. What every optometrist should
know about prescribing the right
solution for each contact lens
patient

3. In recent times, we have seen the
emergence of serious ocular infections
and

4. In recent times, we have seen the
emergence of serious ocular infections
and resultant contact lens solution recalls.

5.  Fall2005 (CIBA VISION discontinues all lens
care products)
 Summer 2006 ( B&L recalls ReNu
MoistureLoc)
 Fall 2006 ( AMO recalls Complete Moisture
Plus)
 Winter 2006 ( B&L recall of ReNu MultiPlus)

6. ReNu recall
Bausch + Lomb company acknowledged
that polymers in this particular lens
solution formulation easily formed
microbial films under certain conditions
that resulted from poor patient
compliance.

7. These conditions included:
 Topping off contact lens
solution
 not replacing the lens case regularly
 not closing the bottle top between uses

8. When fitting patients with contact lenses,
optometrists utilize their expertise to
choose lenses with attributes that will
best meet each patient’s vision and eye
health needs.

9. Once the lens has been chosen, should
practitioners go one step further and
prescribe a contact lens solution?

10. A patient who:
 is not prescribed a contact lens solution
 receives no explanation as to why a certain
solution is best

11. A patient who:
 is not prescribed a contact lens solution
 receives no explanation as to why a certain
solution is best
may resort to picking a
product based solely on the
sale price or available
coupons.

12. Shortcuts and ways to “save” solution or
extend contact lens wear are common,
even among our best patients.

13. To underscore the importance of their
recommendation, optometrist should write
solution recommendations on a
prescription pad

14. There are two types of contact lens care
systems:

15. There are two types of contact lens care
systems:
 multipurpose contact lens solutions (MPS)
 hydrogenperoxide-based care
systems(HPB)

16. Multipurpose contact lens solutions are dual-
purpose liquids :
 Clean
 disinfect

17. Multipurpose solutions also are called "no-
rub" solutions:
because they are designed to adequately
clean and disinfect lenses with a simple
rinse-and-store method, eliminating the
need to mechanically rub the lenses to
remove lens deposits.

18. many eye care professionals recommend
adding a short, 10-second period of
mechanical rubbing as part of the
cleaning regimen with multipurpose
solutions.

19.  less expensive
 easier
to use than hydrogen peroxide-
based solutions,
 therefore contact lens wearers are more
likely to use multipurpose solutions properly

20. recent years there has been a global recall
of at least one brand of a multipurpose
contact lens solution because of an
outbreak of fungal eye infections associated
with the product

21.  thepreservatives
(varying molecular weights)
 Wettingagents
(harbor opportunistic microbes)
 challengeof cleaning and disinfecting the
newest contact lens material: silicone
hydrogel.

23.  provide effective lens disinfection
 noproduct recalls have occurred due to
outbreaks of eye infections.
 low amounts of corneal staining

24.  one-step
 two-step process

25. Both one-step and two-step HPB lens care
systems after lens disinfection and prior to
wearing the lenses
require neutralization of the hydrogen
peroxide solution.

26. because hydrogen peroxide is an effective
disinfecting agent,

27. because hydrogen peroxide is an effective
disinfecting agent,
but it is toxic to the cornea and must be
converted to saline with a neutralizing
agent to avoid eye injury.

28.  the lenses are placed in a holder within a
cylindrical contact lens case.
 the case is filled with a 3 percent solution
of hydrogen peroxide.
 The bottom of the case contains a solid
disk of a material that immediately begins
neutralizing the hydrogen peroxide.

29.  the contact lens are placed in a lens case
filled with only the hydrogen peroxide for a
specified period of time
A neutralizer is then added to the case to
convert the disinfectant to harmless saline

30. Hydrogen peroxide care systems are
preservative-free and therefore are often
recommended for contact lens wearers
who :

31. Hydrogen peroxide care systems are
preservative-free and therefore are often
recommended for contact lens wearers
who :
may be sensitive to preservatives found
in multipurpose contact lens solutions

32.  one-stepHPB:
may not expose contacts to full-strength
hydrogen peroxide for an adequate period
of time

33.  one-stepHPB:
may not expose contacts to full-strength
hydrogen peroxide for an adequate period
of time
 two-step HPB :
users will forget the neutralizing step and
incur a painful eye injury

34. Opti-Free RepleniSH (Alcon) and Clear
Care (CIBA Vision)
Clear Care could provide longer wear times
than the other MPS system

35. Biotrue
 inspired by the biology of the eye to make wearing
contact lenses easie.
 pH in the range of healthy tears
 keep lenses moist for up to 20 hours
 can be used with all soft and silicone hydrogel lenses.
 Keeps beneficial tear proteins alive

36.  renu® fresh
 renu sensitive
(will soon be available in a convenient clear bottle, and
both the carton and bottle are 100% recyclable)

37. AQuify® 2004
 PRO-GUARD™ lens case.
(reduce lens case contamination when used with
Aquify)
 ideal
for patients that wear their lenses for
extended periods during the day.

38. Clear Care 2001
 one bottle 3% hydrogen peroxide solution
 kills bacteria and germs
 The bottle is marked with a red tip
( caution patients from directly putting in their eyes.)

39. OPTI-FREE® RepleniSH 2006:
 provide
a high level of moisture for patients
wearing all types of contact lenses
 Wettingagent -TearGlyde® formulation( provides
the lenses with a layer of moisture all day)

40. OPTI-FREE PureMoist
 Wetting agent -HydraGlyde® Moisture Matrix(
surrounds lenses in a cushion of moisture to keep
contacts hydrated)
 dual disinfectants POLYQUAD® and ALDOX
 can also be used for sensitive eyes
 reduceslipid deposition and removes protein
deposits.

41.  RevitaLens OcuTec - 2010
 combines the disinfection of a peroxide system with
the convenience of a multi-purpose solution
 OcuTec
- antimicrobial activity even under non-compliant
conditions
-a high effectiveness against Acanthamoeba (single-
celled living organism)

42. - low rates of corneal staining and adverse effects
- - effective protein removal
 leading to tolerability
 less redness
 less end of day dryness

43. Oxysept
 hydrogen peroxide disinfection solution/neutralizer
 Neutralized Oxysept is also nearly identical to
natural tears (viscosity and surface tension)
 the neutralizing tablet eliminates the risk of
residual peroxide
 a natural B12 color has been added
 ideal for sensitive eyes

45. Thank you for your attention
We welcome your questions
,suggestions, comments!