Bausch & Lomb SofLens Toric Contact Lenses - Manual (Page 3)

TABLE OF CONTENTS PAgE
Introduction 2
Description 2
Lens Parameters Available 3
How the Lens Works (Actions) 4
Indications 4
Contraindications (Reasons Not To Use) 4
Warnings 5
Precautions 6
Adverse Reactions 8
Important Treatment Information for Adverse Reactions 8
Selection of Patients 9
Fitting Procedure 9
Pre-fitting Examination 9
Initial Lens Power Selection 9
Initial Lens Evaluation 10
Criteria of a Well-Fitted Lens 11
Characteristics of a Tight (Steep) Lens 11
Characteristics of a Loose (Flat) Lens 11
Follow-up Care 11
Professional Fitting Sets 12
Wearing Schedule 12
Monovision Fitting Guidelines 12
Patient Selection 12
Eye Selection 13
Special Fitting Considerations 13
Near Add Determination 14
Trial Lens Fitting 14
Adaptation 14
Other Suggestions 15
Handling of Lens 15
Patient Lens Care Directions 15
Frequent Replacement and Disposable Wear 15
Care for a Sticking (Nonmoving) Lens 15
Reporting of Adverse Reactions 16
How Supplied 16
Symbol Reference Guide 17
INTrOduCTION
This package insert and fitting guide has been developed to provide eye care professionals
with information covering characteristics of the BAUSCH & LOMB SofLens® Toric (alphafilcon A)
Visibility Tinted Contact Lens with the Lo-Torque® design and to illustrate fitting procedures. It
is effective as of January 2005 and supersedes all prior fitting guides for the product described.
Please read carefully and keep this information for future use.
This package insert and fitting guide is intended for the eye care professional, but should be
made available to patients upon request. The eye care professional should provide the patient
with the patient instructions that pertain to the patient’s prescribed lens and the recommended
wearing schedule.
dESCrIPTION
The BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted Contact Lens with the
Lo-Torque® design is a flexible shell with toric surfaces. The lens is made from a copolymer
of 2-hydroxyethyl methacrylate, N-vinyl pyrrolidone and 4-tertiary butyl-2-hydroxycyclohexyl
methacrylate, and is 66% water by weight when immersed in a sterile solution of sodium
chloride and a borate buffer. This lens is tinted blue with up to 100 ppm of Reactive Blue Dye
246.
The physical/optical properties of the lens are:
Specific Gravity: 1.075
Refractive Index: 1.390
Light Transmittance
Tinted: C.I.E. value—approximately 99%
Water Content: 66%
Oxygen Permeability: 32 x 10 –11 [cm 3 O
2
(STP) x cm]/(sec x cm 2 x mmHg) @ 35° C
(Polarographic Method)
The SofLens® Toric (alphafilcon A) Visibility Tinted Contact Lenses are tinted blue using Reactive
Blue 246 (1,4-bis[4-(2-methacryloxyethyl) phenylamino]anthraquinone) to make the lens more
visible for handling purposes. The apparent color of the SofLens® Toric (alphafilcon A) Visibility
Tinted Contact Lenses may decrease slightly following repeated disinfection. This will not affect
the safety or performance of the lens.
The BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted Contact Lens is manufactured
using the FormCast™ manufacturing process. The anterior surface of the lens contains the
spherical power, prism ballast and comfort chamfer feature of the SofLens® Toric (alphafilcon
A) Visibility Tinted Contact Lens. The posterior surface is manufactured with a spherocylindrical
curve to accommodate the required astigmatic power.
Prism ballasting stabilizing geometry—increased
thickness from apex to base of lens offers excellent
axis stabilization
Refined aspheric optic zone—anterior and posterior
optic zone diameters are adjusted to minimize
variations in thickness providing optimal stability
360° comfort chamfer—reduces lens mass for
rotational stability
Balanced vertical thickness profile—uniform
mid-peripheral thickness at apex, center, and base
of optic zone enhances rotational stability
Unique bicurve posterior design for optimum
centration and visual acuity
Rounded edges—provide comfort plus optimal
movement over conjunctival tissue
Guide Mark System
Each BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted Contact Lens is marked
with 3 Guide Marks in the lens perimeter, 30 degrees apart at 5, 6, and 7 o’clock. These Guide
Marks give an instant reference for estimating lens rotation and orientation. They are, in effect, a
protractor guide on the lens surface. All guide markings make proper axis orientation and fitting
faster and easier. The center guide mark need not position at 6 o’clock on the cornea.
Guide Markings
30˚ 30˚
(6 o’clock) Center Guide
Diameter
14.5mm
LENS PArAMETErS AVAILABLE
The BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted Contact Lens is a
hemispherical shell of the following dimensions:
Diameter:
14.5mm
Center Thickness: 0.190mm @ -3.00D (varies with power)
Base Curve: 8.5mm
Sphere Powers: +6.00 to -6.00D in 0.25D steps
-6.50D to -9.00D in 0.50D steps
Cylinder Powers: -0.75D, -1.25D, -1.75D, -2.25D and –2.75D
Axis: 0° to 180° in 10° Increments
Lens Prism: Prism is located at the base of the lens to stabilize lens positioning when the
lens is on eye.
Comfort Chamfer: A wedge-shaped tapered section on the anterior surface of the lens from the
3 to 9 o’clock areas. This reduces lens thickness.
HOW THE LENS WOrKS (ACTIONS)
In its hydrated state, the BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted Contact
Lens has a unique Lo-Torque® design that results in excellent stability and when placed on the
cornea acts as a refracting medium to focus light rays on the retina.
INdICATIONS
The BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted Contact Lens is indicated for
daily wear or extended wear from 1 to 7 days between removals, for cleaning and disinfection or
disposal of the lens, as recommended by the eye care professional. The lens is indicated for the
correction of refractive ametropia (myopia, hyperopia and astigmatism) in not-aphakic persons
with non-diseased eyes, exhibiting astigmatism of up to 5.00 diopters, that does not interfere
with visual acuity. The lens may be prescribed for Frequent/Planned Replacement Wear or
Disposable Wear in spherical powers ranging from +6.00D to -9.00D when prescribed for up to 7
days of extended wear and from +20.00D to –20.00D for daily wear.
Note: See the WARNINGS reference to the relationship between lens wearing schedule and
corneal complications.
Frequent/Planned Replacement Wear
When prescribed for Frequent/Planned Replacement Wear, the BAUSCH & LOMB SofLens®
Toric (alphafilcon A) Visibility Tinted Contact Lens is to be cleaned, rinsed and disinfected
each time it is removed from the patient’s eye and discarded after the recommended wearing
period prescribed by the eye care professional. The lens may be disinfected using a chemical
disinfection system.
Disposable Wear
When prescribed for Disposable Wear, the BAUSCH & LOMB SofLens® Toric (alphafilcon A)
Visibility Tinted Contact Lens is to be discarded after each removal.
CONTrAINdICATIONS (rEASONS NOT TO uSE)
DO NOT USE the BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted Contact Lens
when any of the following conditions exist:
• Acute and subacute inflammation or infection of the anterior chamber of the eye
• Any eye disease, injury, or abnormality that affects the cornea, conjunctiva, or eyelids
• Severe insufficiency of lacrimal secretion (dry eyes)
• Corneal hypoesthesia (reduced corneal sensitivity)
• Any systemic disease that may affect the eye or be exaggerated by wearing contact lenses
• Allergic reactions of ocular surfaces or adnexa (surrounding tissue) that may be induced or
exaggerated by wearing contact lenses or use of contact lens solutions
• Allergy to any ingredient, such as mercury or Thimerosal, in a solution which is to be used to
care for the BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted Contact Lens
• Any active corneal infection (bacterial, fungal, or viral)
• If eyes become red or irritated
WArNINgS
After a thorough eye examination, including appropriate medical background, patients should be
fully apprised by the prescribing professional of all the risks with contact lens wear.
Patients should be advised of the following warnings pertaining to contact lens wear:
• Problems with contact lenses and lens care products could result in serious injury to
the eye. It is essential that patients follow their eye care professional’s direction and all
labeling instructions for proper use of lenses and lens care products, including the lens
case. Eye problems, including corneal ulcers, can develop rapidly and lead to loss of
vision.
• When prescribed for Frequent/Planned Replacement Wear, the need for strict compliance
with the care regimen including cleaning of the lens case, wearing restrictions, wearing
schedule, and follow-up visit schedule should be emphasized to the patient.
• Studies have shown that contact lens wearers who are smokers have a higher incidence
of adverse reactions than nonsmokers.
• If a patient experiences eye discomfort, excessive tearing, vision changes, or redness of
the eye, the patient should be instructed to immediately remove lenses and promptly
contact his or her eye care professional.
Extended Wear
The risk of microbial keratitis has been shown to be greater among users of extended wear
contact lenses than among users of daily wear contact lenses. The risk among extended
wear lens users increases with the number of consecutive days that the lenses are worn
between removals, beginning with the first overnight use. Some researchers believe that
these complications are caused by one or more of the following: a weakening of the cornea’s
resistance to infections, particularly during a closed-eye condition, as a result of hypoxia; an
eye environment which is somewhat more conducive to the growth of bacteria and other
microorganisms, particularly when a regular periodic lens removal and disinfecting or disposal
schedule has not been adhered to by the patient; improper lens disinfection or cleaning by
the patient; contamination of lens care products; poor personal hygiene by the patient; patient
unsuitability to the particular lens or wearing schedule; accumulation of lens deposits; damage
to the lens; improper fitting; length of wearing time; and the presence of ocular debris or
environmental contaminants. While the great majority of patients successfully wear contact
lenses, extended wear of lenses also is reported to be associated with a higher incidence and
degree of epithelial microcycsts and infiltrates, and endothelial polymegathism, which require
consideration of discontinuation or restriction of extended wear. The epithelial conditions are
reversible upon discontinuation of extended wear. The risk of microbial keratitis has not been
determined for this lens. Post marketing studies are in progress.
The reversibility of endothelial effects of contact lens wear has not been conclusively established.
As a result, professionals views of extended wearing times vary from not prescribing extended
wear at all to prescribing flexible wearing times from occasional overnight wear to prescribing
extended wearing periods from 1 to 30 days with specified intervals of no lens wear for certain
patients, with follow-up visits, and with proper care regimen.
PrECAuTIONS
Precautions for Eye Care Professionals
• Due to the small number of patients enrolled in clinical investigation of lenses, all refractive
powers, design configurations, or lens parameters available in the lens material are not
evaluated in significant numbers. Consequently, when selecting an appropriate lens design
and parameters, the eye care professional should consider all characteristics of the lens that
can affect lens performance and ocular health, including oxygen permeability, wettability,
central and peripheral thickness, and optic zone diameter.
The oxygen transmissibility value for the commonly prescribed spherical powers of the toric
lenses is lower than the high minus spherical powers. As the cylinder power increases the
oxygen transmissibility decreases. Overall, the toric lens has oxygen transmissibility values
that are from 10% to 50% lower than the value of the spherical lenses in the alphafilcon A
material.
The potential impact of these factors on the patient’s ocular health should be carefully
weighed against the patient’s need for refractive correction; therefore, the continuing ocular
health of the patient and lens performance on eye should be carefully monitored by the
prescribing eye care professional.
• Eye care professionals should instruct the patient to REMOVE A LENS IMMEDIATELY if an eye
becomes red or irritated.
• Fluorescein should not be used while the patient is wearing the lenses, because the lenses
will become discolored. Whenever fluorescein is used, flush the eyes with sterile saline
solution. Wait at least 5 minutes before reinserting the lenses. If it is not possible to flush the
eyes, wait a minimum of 1 hour before reinserting the lenses. If replaced too soon, the lenses
may absorb residual fluorescein.
• The patient should be instructed to always discard disposable lenses and lenses worn on a
frequent/planned replacement schedule after the recommended wearing schedule prescribed
by the eye care professional.
• Some patients will not be able to tolerate extended wear even if able to tolerate the same
or another lens on a daily wear basis. Some patients who are able to tolerate extended wear
will not be able to wear their lenses continuously for 7 days. Patients should be carefully
evaluated for extended wear prior to prescription and dispensing, and eye care professionals
should conduct early and frequent follow-up examination to determine ocular response to
extended wear.
• As with any contact lens, follow-up visits are necessary to assure the continuing health of the
patient’s eyes. The patient should be instructed as to a recommended follow-up schedule.
Handling Precautions
• Always wash and rinse hands before handling lenses. Do not get cosmetics, lotions, soaps,
creams, deodorants, or sprays in the eyes or on the lenses. It is best to put on lenses before
putting on makeup. Water-base cosmetics are less likely to damage lenses than oil-base
products.
• Be sure that before leaving the eye care professional’s office, the patient is able to remove
lenses promptly or have someone else available to remove them.
• Be certain that the fingers or hands are free of foreign materials before touching lenses, as
microscopic scratches of the lenses may occur, causing distorted vision and/or injury to the
eye.
• Always handle lenses carefully and avoid dropping them.
• Do not touch the lens with fingernails.
• Carefully follow the handling, insertion, removal, cleaning disinfecting, storing and wearing
instructions in the Patient Information Booklet for the SofLens® Toric Contact Lenses and
those prescribed by the eye care professional.
• Never use tweezers or other tools to remove lenses from the lens container unless specifically
indicated for that use. Pour the lens into the hand.
Solution Precautions
• Always use fresh unexpired lens care solutions.
• Always follow directions in the package inserts for the use of contact lens solutions.
• Sterile unpreserved solutions, when used, should be discarded after the time specified in the
labeling directions.
• Always keep the lenses completely immersed in the recommended storage solution when
lenses are not being worn (stored). Prolonged periods of drying will damage lenses. Follow
the lens care directions for Care for a Dried Out (Dehydrated) Lens in the patient information
booklet if lens surface does become dried out.
• Do not use saliva or anything other than the recommended solution for lubricating or wetting
lenses.
• Tap water, distilled water or homemade saline should not be used as a substitute for any
component in the lens care regimen since they have been associated with an Acanthamoeba
keratitis infection.
• Never use conventional hard contact lens solutions that are not also recommended for use
with prescribed lenses.
• Do not mix or alternate lens care systems or solutions unless indicated in the lens care system
labeling.
• Do not use chemical disinfection solutions with heat unless specifically indicated on product
labeling for use in both heat and chemical disinfection.
Lens Wearing Precautions
• Never wear lenses beyond the period recommended by the eye care professional.
• If the lenses are prescribed for disposable wear, they are to be disposed of once they are
removed from the patient’s eye. It is important that patients be instructed to always have
available a pair of replacement lenses. In the event that a lens must be removed from
the eye because dust, a foreign body or other contaminant gets on the lens or the lens
becomes dehydrated, the lens should be removed and replaced with a replacement lens. If
replacement lenses are not available, the patient should refer to the Lens Wearing Schedules
section, Disposable Lens Wear, for lens care directions in the BAUSCH & LOMB SofLens® Toric
(alphafilcon A) Visibility Tinted Contact Lens - Patient Information Booklet.
• If the lens sticks (stops moving) on the eye, follow the recommended directions on Care for a
Sticking Lens. The lens should move freely on the eye for the continued health of the eye. If
nonmovement of the lens continues, the patient should be instructed to immediately consult
his or her eye care professional.
• Avoid, if possible, all harmful or irritating vapors and fumes while wearing lenses.
• If aerosol products are used while wearing lenses, exercise caution and keep eyes closed until
the spray has settled.
AdVErSE rEACTIONS
The patient should be informed that the following problems may occur:
• Eyes stinging, burning, itching (irritation), or other eye pain
• Comfort is less than when lens was first placed on eye
• Abnormal feeling of something in the eye (foreign body, scratched area)
• Excessive watering (tearing) of the eyes
• Unusual eye secretions
• Redness of the eyes
• Reduced sharpness of vision (poor visual acuity)
• Blurred vision, rainbows, or halos around objects
• Sensitivity to light (photophobia)
• Dry eyes
If the patient notices any of the above, he or she should be instructed to:
•
Immediately remove the lenses.
• If the discomfort or problem stops, then look closely at the lens. If the lens is in any way
damaged, do not put the lens back on the eye. Place the lens in the storage case and contact
their eye care professional. If the lens has dirt, an eyelash, or other foreign body on it, or the
problem stops and the lens appears undamaged, the patient should thoroughly clean, rinse,
and disinfect the lenses; then reinsert them. After reinsertion, if the problem continues, the
patient should immediately remove the lenses and consult their eye care professional.
If the above symptoms continue after removal of the lens, or upon reinsertion of a lens, or
upon insertion of a new lens, the patient should immediately remove the lenses and contact
his or her eye care professional or physician, who must determine the need for examination,
treatment or referral without delay. (See Important Treatment Information for Adverse Reactions.)
A serious condition such as infection, corneal ulcer, corneal vascularization, or iritis may be
present, and may progress rapidly. Less serious reactions such as abrasions, epithelial stinging
or bacterial conjunctivitis must be managed and treated carefully to avoid more serious
complications.
IMPOrTANT TrEATMENT INFOrMATION FOr AdVErSE rEACTIONS
Sight-threatening ocular complications associated with contact lens wear can develop rapidly, and
therefore early recognition and treatment of problems are critical. Infectious corneal ulceration is
one of the most serious potential complications, and may be ambiguous in its early stage. Signs
and symptoms of infectious corneal ulceration include discomfort, pain, inflammation, purulent
discharge, sensitivity to light, cells and flare and corneal infiltrates.
Initial symptoms of a minor abrasion and an early infected ulcer are sometimes similar.
Accordingly, such epithelial defect, if not treated properly, may develop into an infected ulcer.
In order to prevent serious progression of these conditions, a patient presenting symptoms
of abrasions or early ulcers should be evaluated as a potential medical emergency, treated
accordingly, and be referred to a corneal specialist when appropriate. Standard therapy for
corneal abrasions such as eye patching or the use of steroids or steroid/antibiotic combinations
may exacerbate the condition. If the patient is wearing a contact lens on the affected eye when
examined, the lens should be removed immediately and the lens and lens care products retained
for analysis and culturing.
SELECTION OF PATIENTS
Persons who require vision correction and who would not or could not adhere to a recommended
care or replacement regimen for BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted
Contact Lenses or are unable to place and remove the lenses should not be provided with them.
Failure to follow handling and cleaning instructions could lead to serious eye infections which
might result in corneal ulcers.
Patient communication is vital because it relates not only to patient selection but also to ensure
compliance. It is also necessary to discuss the information contained in the Patient Information
Booklet with the patient at the time of the initial examination.
Patients selected to wear BAUSCH & LOMB SofLens® Toric (alphafilcon A) Visibility Tinted
Contact Lenses should be chosen for their motivation to wear contact lenses, general health and
cooperation. The eye care professional must take care in selecting, examining and instructing
contact lens patients. Patient hygiene and willingness to follow the eye care professional’s
instructions are essential to their success.
A detailed history is crucial to determining patient needs and expectations. Your patient should
be questioned regarding vocation, desired lens wearing time (full or part time), and desired lens
usage (reading, recreation or hobbies).
Initial evaluation of the trial lens should be preceded by a complete eye examination, including
visual acuity with and without correction at both distance and near, keratometry and slit lamp
examination.
It is normal for the patient to experience mild symptoms such as lens awareness, variable vision,
occasional tearing (watery eyes) and slight redness during the adaptation period. Although the
adaptation period varies for each individual, generally within one week these symptoms will
disappear. If these symptoms persist, the patient should be instructed to contact their eye care
professional.
FITTINg PrOCEdurE
1. Pre-Fitting Examination
A pre-fitting patient history and examination are necessary to:
• determine whether a patient is a suitable candidate for daily wear contact lenses
(consider patient hygiene and mental and physical state),
• make ocular measurements for initial contact lens parameter selection,
and
• collect and record baseline clinical information to which post-fitting examination results
can be compared.
A prefitting examination should include spherocylinder refraction and VA, keratometry, and
biomicroscopic examination.
2. Initial Lens Power and Base Curve Selection
a. Select the initial trial lens from the Toric Diagnostic Lens Set with a power most similar
to the patients refractive needs, or order a diagnostic lens to the prescription which most
closely matches that of the patient.
b. Place the lens on the eye and allow the lens to remain on the eye long enough (10
to 20 minutes) to achieve a state of equilibrium. Small variations in the tonicity, pH of
the lens solutions, and individual tear composition may cause slight changes in fitting
characteristics.
c. Allow any increase in tear flow to subside before evaluating the lens. The time required
will vary with the individual.
3. Initial Lens Evaluation
a. To determine proper lens parameters, observe the lens relationship to the eye using
a slit lamp. The toric diagnostic lens is used to optimize lens fitting characteristics and
determine axis orientation. Lens power is determined by the spectacle refraction.
• Rotation evaluation: The center guide mark should locate at the inferior limbus. The
additional guide marks at 30° on either side can be used as reference points, and to
help the eye care professional assess axis orientation and stability. Once oriented,
rotational rocking should be limited to less than 5°.
• Movement: The lens should provide discernible movement with:
– Primary gaze blink
– Upgaze blink
– Upgaze lag
• Centration: The lens should provide full corneal coverage.
b. Determine contact lens power. When the toric diagnostic lens does not have a power
equivalent to their spectacle Rx, Sphero-cylinder over-refractions will often be inaccurate
and confusing. Therefore it is usually preferable to use the spectacle Rx as the only basis
for the contact lens power. The sphere and cylinder power of the spectacle Rx becomes
the sphere and cylinder power of the contact lens. There are two exceptions:
1. If spectacle cylinder power falls between available contact lens cylinder powers,
prescribe the lesser contact lens cylinder power. The sphere power can be increased
-0.25D to compensate if desired. Of course this can vary depending on your
interpretation of the patient’s subjective responses.
Example:
Spectacle Rx -2.00 -1.00 X 180
Contact Lens Power Ordered -2.25 -0.75 X 180
2. When the spectacle lens power in any principle meridian is greater than 4.00D, the
spectacle refraction should be vertexed to the corneal plane. This can affect both the
sphere and cylinder powers ordered.
Example:
Spectacle Rx -5.00 -2.75 X 180
Contact Lens Power Ordered -4.75 -2.25 X 180
c. Determine contact lens axis. Note the orientation of the guide marks relative to the
vertical meridian. Regardless of which eye the lens is on , if the rotation is clockwise but
stable, note the amount of rotation, add it to the refractive cylinder axis and order the
resulting axis. If the rotation has stabilized counter-clockwise, again note the rotation,
subtract it from the refractive axis and order the resulting axis. The guide marks can be
used to help you calculate the axis of the desired Rx lens.
For Example:
Spectacle Rx -2.50 -1.25 X 80
Rotation 20° clockwise
Final Lens Prescription: -2.50 -1.25 X 100
d. Select patient’s lenses.
e. Evaluate orientation of final Rx lenses. The orientation of the prescription should be
the same as that observed for the Fitting Set Lenses. For example, if the lens rotated
clockwise 15° then the final prescription lens should also rotate clockwise 15°.
4. Criteria of a Well-Fitted Lens
If the initial lens selection fully covers the cornea, provides discernible movement after a
blink, is comfortable for the patient and provides satisfactory visual performance, it is a well
fitted lens and can be dispensed.
5. Characteristics of a Tight (Steep) Lens
A lens which is much too steep may subjectively and objectively cause distortion which
will vary after a blink. However, if a lens is only marginally steep, the initial subjective and
objective vision and comfort findings may be quite good. A marginally steep lens may be
differentiated from a properly fitted lens by having the patient gaze upward. A properly
fitted lens will tend to slide downward approximately 0.5mm while a steep lens will remain
relatively stable in relationship to the cornea, particularly with the blink.
With your finger, gently rotate the lens approximately 45° to the temporal side. It should
reorient within 5 to 10 blinks back to the same stabilized position.
6. Characteristics of a Loose (Flat) Lens
If the lens is too flat, it will:
– Decenter, especially on post-blink.
– Have a tendency to edge lift inferiorly and sit on the lower lid, rather than positioning
between the sclera and palpebral conjunctiva.
– Have a tendency to be uncomfortable and irritating with fluctuating vision.
– Have a tendency to drop or lag greater than 2.0mm on upgaze post-blink.
7. Follow-up Care
a. Follow-up examinations are necessary to ensure continued successful contact lens wear.
From the day of dispensing, the following schedule is a suggested guideline for follow up.
• 24 hours
• 10 days
• 1 month
• 3 months
• every six months thereafter
At the initial follow-up evaluations the eye care professional should again reassure the
patient that any of the previously described adaptive symptoms are normal, and that the
adaptation period should be relatively brief. Depending on the patients prior experience
with contact lenses and/or continuous wear, the eye care professional may consider
prescribing a one week period of daily wear adaption prior to beginning extended wear.
b. Prior to a follow-up examination, the contact lenses should be worn for at least 4
continuous hours and the patient should be asked to identify any problems which might
be occurring related to contact lens wear.
c. With lenses in place on the eyes, evaluate fitting performance to assure that CRITERIA
OF A WELL FITTED LENS continue to be satisfied. Examine the lenses closely for surface
deposition and/or damage.
d. After the lens removal, instill sodium fluorescein [unless contraindicated] into the eyes
and conduct a thorough biomicroscopy examination.
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