“Do you sleep in your contact lenses?”
This is a question we undoubtedly ask our patients on a daily basis. While answers may vary from all the time, sometimes, here and there, or absolutely not, the inevitable truth is some of our patients regularly sleep in their lenses, whether they admit to it or not.
Extended wear contact lenses do have their place in eye care, and can accommodate patients with a particular lifestyle.
Practitioners should consider taking a proactive approach to these particular patients. If your patient is going to sleep in a lens, make sure you are prescribing a contact lens that is approved for extended wear. As lens technology and materials have improved over time, so have lens options for these wearers.
What lenses are approved for extended wear?
The U.S. Food and Drug Administration (FDA) determines which contact lenses are approved for extended wear for overnight use. Many of these lenses are made of silicone hydrogel, a material that allows more oxygen to permeate through the lens.
Extended wear contact lenses are usually soft lenses that allow ample oxygen to pass through the lens matrix. This particularly enables the contact lens to be worn for overnight or continuous wear.
The FDA recommends that the particular length of continuous wear depend on lens type and “your eye care professional’s evaluation of your tolerance for overnight wear.”
What are the risks associated with overnight lens wear?
Contact lens extended wear poses a higher risk of microbial keratitis, a devastating infection, that can lead to blindness.2 Studies have shown the incidence of contact lens-related microbial keratitis to be 4.1 per 10,000 wearers per year for daily wear (take the lenses out of the eyes at night to clean and store them), and 20.9 per 10,000 wearers per year for extended wear (sleep in lenses overnight).2
Other major risks include corneal neovascularization, inflammation and ocular irritation, especially in cases of hypoxia. Giant papillary conjunctivitis is another major complication prevalent in extended contact lens wear,3 and can lead to the generation of pro-inflammatory mediators. It’s also thought to be one of the greatest reasons for contact lens dropout.
Extended wear lenses can still be a good option for certain types of patients, especially if prescribed appropriately with the proper wearer and contact lens in mind.
Why Acuvue Oasys®
1. FDA approved
Acuvue Oasys® is FDA approved for extended wear of six consecutive nights.
Compliance, which is a concern in any wear modality, may be improved with this particular schedule, as patients may be more likely to remember that every Sunday, it’s time to change their lenses and use a fresh pair on Monday morning. This is a great alternative for those practitioners who do not view thirty day extended wear favorably.
2. Comfort and Health
Acuvue Oasys® is comprised of silicone hydrogel (senofilcon A), and has a high Dk/t, 121,that provides 98% of available oxygen to the open eye. HYDRACLEAR®PLUS Technology embeds high volume moisture-rich wetting agents, helping to improve wettability and reduce lens awareness for all day comfort.5
All contact lenses from Johnson & Johnson Vision Care, Inc. meet the ANSI and ISO standards for either Class 1 or Class 2 UV blocking. Acuvue Oasys® Contact Lenses offer UV protection, blocking at least 96% of UV-A and 99% of UV-B radiation, one of the highest UV protection available in any contact lens.
Compliance, regardless of modality, plays an important role in ocular surface health. Johnson & Johnson Vision Care, Inc. has made compliance easier by offering lenses in a convenient 54 pack. Not only does this ensure the patient receives an annual supply, but with 54 lenses, patients will be more inclined to change them accordingly and adhere to the proper wearing schedule.
Things to consider:
- Ask your patients if they sleep in their lenses or even occasionally sleep in their lenses.
- Get to know your patients. Ask them about their lifestyle. Are they very active? Do they spend a lot of time outdoors? Do they have difficulties with handling or dexterity limitations?
- Educate your patients on lens options that provide the best comfort and health for their eyes. Communication is key with your patients.
- Stress proper compliance of contact lens wear, and educate patients on the risks associated with non-compliance. Selling annual supplies of contacts may help improve compliance with wear modality.
- Carefully evaluate the fit of the contact lens you select for your patient. If they are extended wearers, make sure you are evaluating the fit and health of the eye after a period of extended wear.
- Choose the absolute best lens that will provide the best comfort and maintain a healthy ocular surface.
ACUVUE OASYS® Brand Contact Lenses are indicated for vision correction for daily wear (worn while awake) or extended wear (worn while awake and asleep for up to 6 nights/7 days). Relevant Warnings: Patients should be cautioned that proper use and care of contact lenses are essential for the safe use of these products. Serious eye problems, including corneal ulcers, can develop rapidly and in rare cases lead to loss of vision. The risk of serious problems is greater for extended wear vs. daily wear and smoking increases this risk. Patients should be instructed not to expose contact lenses to water while wearing them, due to the risk of infection, and to discard and replace them if they are submersed in water during wear. Side Effects: Potential side effects include infiltrative keratitis; other less serious side effects include irritation, dryness, itching, or discomfort. Relevant Precautions: Patients should be instructed to immediately remove their lenses and promptly contact their eye care professional if they experience any problems. Contraindications: Lenses should not be prescribed for routine vision correction if patients have any eye infection, eye disease, inflammation, systemic disease that may be affected by or impact lens wear, severe dry eye, certain allergic conditions, use certain medications (ex. some eye medications), experience eye discomfort, excessive tearing, redness, reduced corneal sensitivity or other eye problems. Additional Information: It is recommended that the contact lens wearer first be evaluated on a daily wear schedule. If successful, then a gradual introduction of extended wear can be followed. Consult the package insert for complete information, or contact VISTAKON® Division of Johnson & Johnson Vision Care, Inc., by calling 1-800-843-2020 or by visiting www.acuvueprofessional.com.
WARNING: UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. You should continue to use UV-absorbing eyewear as directed. NOTE: Long-term exposure to UV radiation is one of the risk factors associated with cataracts. Exposure is based on a number of factors such as environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV-blocking contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other eye disorders. Consult your eye care practitioner for more information.
- Robertson O.D., Ph.D, Danielle M. “The Effects of Silicone Hydrogel Lens Wear on the Corneal Epithelium and Risk for Microbial Keratitis.” Eye Contact Lens39.1 (2014): 67-72. Pubmed. Web. 26 June 2015.
- Tagliaferri, MS, Angela, Thomas E. Love, PhD, and Loretta Szczotka-Flynn, OD, PhD. “Risk Factors for Contact Lens-induced Papillary Conjunctivitis Associated with Silicone Hydrogel Contact Lens Wear.” Eye Contact Lens 40.3 (2014): 117-22. Pubmed. May 2014. Web. 26 June 2015.
- Guillon, Michel, and Cécile Maïssa. “Long-term Effects of the Extended Wear of Senofilcon A Silicone Hydrogel Contact Lenses on Ocular Tissues.” Optometry – Journal of the American Optometric Association 81.12 (2010): 671-79. Web. 26 June 2015.
- “ACUVUE® OASYS®Brand Contact Lenses with HYDRACLEAR®PLUS.”ACUVUE® OASYS® Brand Contact Lenses. Johnson & Johnson Vision Care, Inc, 2015. Web. 01 July 2015.