Experts address dangers of improper contact lens substitution in new contact lenses and prior eye paper

A recently published review article discusses the dangers and consequences of inappropriate soft contact lens substitution by consumers and resellers, providing an objective and evidence-based perspective on a globally proliferating problem. Not all soft contact lenses are created equal (Efron N, et al .; doi.org/10.1016/j.clae.2021.101155) is now in press by Contact Lens and Anterior Eye, the peer-reviewed journal of the British Contact Lens Association.

Its authors represent some of the most prominent researchers in the field of contact lenses: Nathan Efron, Phillip Morgan, Jason Nichols, Karen Walsh, Mark Willcox, James Wolffsohn and Lyndon Jones, who is director of the Center for Ocular Research & Education (CORE ).

The article details the multifactorial reasons why trained eye care professionals choose a particular contact lens, including a patient’s previous ocular anatomy and physiology, lens handling, appearance, lifestyle and affordability. However, these critical considerations can be ignored when shopping from unregulated vendors or even regulated vendors who don’t understand that not all soft contact lenses are the same.

The research considers 16 independent properties of the material, design, optics and other properties of soft contact lenses, evaluating why these properties might be appropriate for a given lens wearer. These include surface treatment, internal wetting agents, oxygen permeability, water content, modulus, total diameter, radius of the rear optical zone, thickness, edge profile, rear surface design, optical design, power, color (tint), UV protection, wearing mode and replacement frequency.

The article then highlights the problems that may be encountered when using contact lenses other than those that have been specifically prescribed. Substitution of all but one of the considered properties (rear surface design) has been shown to be linked to at least one – and up to six – potential sources of patient dissatisfaction and adverse ocular events.

The authors write that “Given the wide range of parameters and properties available, few soft contact lenses are identical in their clinical performance. The consequences of improper replacement of soft contact lenses can range from physical or visual discomfort to significant physiological complications.

“While highly trained eye care professionals appreciate the differences between soft contact lenses, this is not well understood by some regulators, various retailers and the general public. My co-authors and I believe that there are substantial opportunities to better illustrate these variations and the very real consequences of inappropriate substitution. We hope this document serves as a reference to move this discussion forward, ”said Dr Jones.

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