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si hy lens experiences
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acemanvx@yahoo.com
medicine forum Guru


Joined: 15 Nov 2005
Posts: 732

PostPosted: Sun Jul 16, 2006 2:04 am    Post subject: Re: si hy lens experiences Reply with quote

serebel wrote:
Quote:
acemanvx@yahoo.com wrote:


B&L may be able to prove her standard of lens care wasnt proper, ie
sleeping in contacts which is a big NO NO. I read an article on that
and B&L says its not the fault of their products but how people dont
take care of their contacts and eyes. If someone cant be responsable
for contacts, he or she needs to stick to glasses.


If sleeping in contacts are a big no-no, why do you extoll ortho-k ?


its as safe as regular wear lens because orthoK is based on RGP and
they are removed every morning so your eyes get all the oxygen. If
orthoK was worn a week or more without removing them then yes, problems
will occur too.
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serebel
medicine forum addict


Joined: 12 Aug 2005
Posts: 81

PostPosted: Sun Jul 16, 2006 2:21 am    Post subject: Re: si hy lens experiences Reply with quote

acemanvx@yahoo.com wrote:
Quote:
serebel wrote:

If sleeping in contacts are a big no-no, why do you extoll ortho-k ?


its as safe as regular wear lens because orthoK is based on RGP and
they are removed every morning so your eyes get all the oxygen. If
orthoK was worn a week or more without removing them then yes, problems
will occur too.



It's still sleeping with lenses in, isn't it? What's the difference?
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acemanvx@yahoo.com
medicine forum Guru


Joined: 15 Nov 2005
Posts: 732

PostPosted: Sun Jul 16, 2006 4:37 am    Post subject: Re: si hy lens experiences Reply with quote

serebel wrote:
Quote:
acemanvx@yahoo.com wrote:
serebel wrote:

If sleeping in contacts are a big no-no, why do you extoll ortho-k ?


its as safe as regular wear lens because orthoK is based on RGP and
they are removed every morning so your eyes get all the oxygen. If
orthoK was worn a week or more without removing them then yes, problems
will occur too.



It's still sleeping with lenses in, isn't it? What's the difference?



Thats how orthoK works and its still much safer than lasik. sleeping in
anything else than orthoK is useless because it wont improve your
vision like orthoK does. Also orthoK is only worn 8 hours every other
night vs. 7-14 days nonstop wear with extend wear contacts.
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Mike Tyner
medicine forum Guru


Joined: 24 Mar 2005
Posts: 1299

PostPosted: Sun Jul 16, 2006 5:45 am    Post subject: Re: si hy lens experiences Reply with quote

<acemanvx@yahoo.com> wrote

Quote:
You have strange beliefs that go against other optometrists who always
say to never sleep in contacts

So how many optometrists participated in this poll you took?

-MT
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Mike Tyner
medicine forum Guru


Joined: 24 Mar 2005
Posts: 1299

PostPosted: Sun Jul 16, 2006 5:48 am    Post subject: Re: si hy lens experiences Reply with quote

<acemanvx@yahoo.com> wrote

Quote:
7-14 days nonstop wear with extend wear contacts.

Whose requirement is that?

-MT
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JohnDoe
medicine forum Guru


Joined: 14 Jun 2005
Posts: 364

PostPosted: Sun Jul 16, 2006 10:53 am    Post subject: Re: si hy lens experiences Reply with quote

acemanvx@yahoo.com wrote:
I am amazed you dont know
Quote:
that its much riskier to sleep in contacts and wear them for a week or
more without taking them out to be cleaned and to let your eyes rest.
You have strange beliefs that go against other optometrists who always
say to never sleep in contacts or if you must, take them out the next
morning and clean them well for dispotists.


Ace I am one of many optometrists who allows his patients to sleep in
contact lenses when appropriate. I do not say "to never sleep in
contacts or if you must, take them out the next morning and clean them
well for dispotists" as you claim I do.

Decisions are all about risk vs benefit and while it is true in general
terms that overnight lens wear is 'riskier' than day wear, for many
people the benefit is worth the risk. You have made your decision about
sleeping in contacts and that's fine, but don't force your opinion onto
others.

You might equally argue that wearing contacts even during the day is
'much riskier' than not wearing contacts, as without contacts you have
zero chance of a contact lens related eye condition. Yet people accept
this risk in return for the benefits that the contacts provide.

Cataract surgery is much, much riskier than any kind of contact lens
wear, yet thousands of intelligent people make the decision to have it
done every year - why? Because the benefit is worth the risk - for them.

Sitting at a computer for hours on end, eating a poor quality diet is
risky behaviour, yet some people appear to have decided that the benefit
outweighs the risk - sound familiar?

Don't accuse optometrists of having strange beliefs just because they're
not the same as your personal choices.

By the way, what is a "dispotist"? An evil optometrist who rules with
absolute power?? (<-- Ace don't worry you won't understand this joke)

Dom
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Dr. Leukoma
medicine forum Guru


Joined: 30 Apr 2005
Posts: 1283

PostPosted: Sun Jul 16, 2006 12:51 pm    Post subject: Re: si hy lens experiences Reply with quote

acemanvx@yahoo.com wrote:

Quote:


Yes I am against extend wear contacts and so is my optometrist, he will
only pescribe it if you promise to take them out every night.

Some people have never examined the basis for their beliefs, including
-- unfortunately -- some optometrists. Contact lenses and their
complications have been the subject of numerous studies for decades.
The probability of an eye infection from sleeping in contact lenses is
a consistent well-documented number. The most recent study, published
in the very prestigious medical journal, Lancet, by a group of OMD's,
involved 100,000 patients. It showed that the risk of infectious
keratitis from sleeping in a soft contact lens was 1/500 per year, and
that 13% of those had some loss of vision as a result.

This study was published before silicone-hydrogel lenses. Extensive
post-marketing studies are ongoing for these newer lenses. The results
of those studies, along with the clinical studies, indicate that the
risk of infectious keratitis from sleeping in silicone-hydrogel lenses
is about 1/2500 per year.

On the other hand, I have not seen comparable studies for OK. We
certainly know that infections do occur with OK, but the numbers of
patients followed are relatively few compared to the studies of other
contact lenses. Furthermore, it has been suggested (by others) that
those infections may be more severe, with a higher incidence of vision
loss. Again, we do not know what those numbers are. Does this mean
that OK is safer or riskier compared to other overnight contact lenses
or compared to LASIK? I certainly don't know, and so I don't know how
YOU could know.

Most people are happy to cling to their biases than to ferret out the
facts, including eye doctors.

DrG
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William Stacy
medicine forum Guru


Joined: 01 May 2005
Posts: 1177

PostPosted: Sun Jul 16, 2006 5:51 pm    Post subject: Re: si hy lens experiences Reply with quote

Dr. Leukoma wrote:
Quote:
William Stacy wrote:

Most of the replies I've gotten are from docs who don't use much oasys,
so I'm for now gonna blame oasys and shift more towards Ciba si hys
since everyone seems to love them.


Based upon your sci.med.vision poll? Unbelievable.

DrG




Actually, I also posted to optiboard and odwire groups, which often tend
to give more useful feedback than s.m.v. these days... But mostly, since
I've probably converted over 200 patients to oasys, and am starting to
feel uneasy with the numbers of problems I'm getting with them... What
is it, once burned shame on vistakon, twice burned shame on me?
Unbelievable? Maybe...


w.stacy, o.d.
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William Stacy
medicine forum Guru


Joined: 01 May 2005
Posts: 1177

PostPosted: Sun Jul 16, 2006 5:55 pm    Post subject: Re: si hy lens experiences Reply with quote

acemanvx@yahoo.com wrote:

Quote:
There is something called washing your hands. I am amazed you dont know
that its much riskier to sleep in contacts and wear them for a week or
more without taking them out to be cleaned and to let your eyes rest.

I am just as amazed that you think washing your hands will remove all
dangerous microbes and chemical from them. The only way to assure
completely safe contacts would be to use sterile technique, including
sterile surgical gloves every time, and to dispose of the lenses every
day.

I don't have one patient in my entire practice who would do that regimen.

Your doc is as unrealistic as you are. Well matched pair, I'd say.

w.stacy, o.d.
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Dr. Leukoma
medicine forum Guru


Joined: 30 Apr 2005
Posts: 1283

PostPosted: Sun Jul 16, 2006 9:33 pm    Post subject: Re: si hy lens experiences Reply with quote

William Stacy wrote:

Quote:
Actually, I also posted to optiboard and odwire groups, which often tend
to give more useful feedback than s.m.v. these days... But mostly, since
I've probably converted over 200 patients to oasys, and am starting to
feel uneasy with the numbers of problems I'm getting with them... What
is it, once burned shame on vistakon, twice burned shame on me?
Unbelievable? Maybe...

I had not been a Vistakon fan until they released the Advance for
astigmatism and the Oasys. I haven't logged a single problem with the
Oasys, and I have dispensed many of them as well as others....many,
many more than 200 patients with silicone-hydrogels, including Oasys.

Also, I do wear the lenses, and have tried them all on my own eyes.
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William Stacy
medicine forum Guru


Joined: 01 May 2005
Posts: 1177

PostPosted: Mon Jul 17, 2006 3:26 pm    Post subject: Re: si hy lens experiences Reply with quote

Dr. Leukoma wrote:

Quote:
I haven't logged a single problem with the
Oasys, and I have dispensed many of them as well as others.



Are you saying not one oasys patient has gone back to a previous lens
design? Of my 200 patients, I'd say 10 or 15 have stated a distinct
preference for their older lenses...

w.stacy, o.d.
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Dr. Leukoma
medicine forum Guru


Joined: 30 Apr 2005
Posts: 1283

PostPosted: Mon Jul 17, 2006 8:41 pm    Post subject: Re: si hy lens experiences Reply with quote

William Stacy wrote:

Quote:

Are you saying not one oasys patient has gone back to a previous lens
design? Of my 200 patients, I'd say 10 or 15 have stated a distinct
preference for their older lenses...

I am not saying that. What I am saying is that I have not documented
any of the pathology that you say you have seen.

Some, albeit few patients have wanted to go back to their previous
lenses. Those patients by an large were wearing Acuvue, were covered
by a vision care plan such as VSP, and always indicated cost concerns
as the underlying reason.

DrG
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Anon E. Muss
medicine forum Guru Wannabe


Joined: 22 May 2006
Posts: 136

PostPosted: Tue Jul 18, 2006 4:14 am    Post subject: Re: si hy lens experiences Reply with quote

On 15 Jul 2006 05:25:34 -0700, "Dr. Leukoma" <drg@leukoma.com> wrote:

Quote:

Anon E. Muss wrote:

1. They deposit easier, and in some cases, much easier. I have had a
couple patients that couldn't even get a week's wear out of them. For
most people, this isn't a problem.

????? Again, not my experience. But, then again, I don't use Acuvue
Advance.

I have attributed this to inadequate tear exchange between the contact
lens and the cornea. I have eliminated this in the vast majority of
cases by switching patients to the 8.6 BC. The ones that still have
problems (flat corneas) I instruct to remove the lenses periodically
(as often as daily), rinse them off with saline and insert back into
the eye. Even using artifical tears a couple times a day might help.

It depends on the modulus. Si-hy lenses are quite "rubbery," and tend
to show greater movement on the eye than HEMA lenses in my experience.
Tight lens syndrome is virtually unheard in my practice with Sy-hy
lenses. I am in the Southwest, BTW, where dry eyes are pandemic. In
fact, Texas has the dubious distinction of being near the top of the
list for dry eye symptoms in a recent survey.

[snip]

Both of these problems (Si-Hy CLs depositing easier and stagant
tears/inadequate tear circulation under contact leading to
CLARE/keratitis [not tight lens syndrome]) occuring have been
documented, mentioned and discussed in several journal articles over
the past couple years.

You are fortunate that your patients haven't experienced these.

And, to think of it, I haven't experienced them with Oasys, probably
because I don't fit it as much as other Si-Hy CLs.
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Dr. Leukoma
medicine forum Guru


Joined: 30 Apr 2005
Posts: 1283

PostPosted: Tue Jul 18, 2006 11:13 am    Post subject: Re: si hy lens experiences Reply with quote

Anon E. Muss wrote:

Quote:
[snip]

Both of these problems (Si-Hy CLs depositing easier and stagant
tears/inadequate tear circulation under contact leading to
CLARE/keratitis [not tight lens syndrome]) occuring have been
documented, mentioned and discussed in several journal articles over
the past couple years.

Sorry, but can you cite the article(s)? I am aware that si-hy lenses
are more prone to lipid spoilation.
Quote:

You are fortunate that your patients haven't experienced these.

Yes, I am.

Quote:
And, to think of it, I haven't experienced them with Oasys, probably
because I don't fit it as much as other Si-Hy CLs.

Well, I started using Purevision quite heavily in 1999, and then
switched to Focus N&D of necessity. I've used them all.

I'm not saying there isn't room for improvement. But, I've been taking
symptomatic patients out of their hydrogels and putting them into
silicone-hydrogels for so long now, and with such stellar results, that
nobody can convince me that they are by far the better option for most
SCL wearers. This is despite whatever articles you might have read in
the "throwaway" journals.

DrG
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Dr. Leukoma
medicine forum Guru


Joined: 30 Apr 2005
Posts: 1283

PostPosted: Tue Jul 18, 2006 11:25 am    Post subject: Re: si hy lens experiences Reply with quote

Anon E. Muss wrote:

Quote:

You are fortunate that your patients haven't experienced these.

And, to think of it, I haven't experienced them with Oasys, probably
because I don't fit it as much as other Si-Hy CLs.

What on earth are you fitting?

I sometimes go weeks without fitting a single HEMA lens, with the
possible exception of Proclears or XC.

A revolution in contact lens fitting practices IS occurring out there.

DrG
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