readers' forum

Add Excitement to Your Practice With Silicone Hydrogel Lenses

readers' forum
Add Excitement to Your Practice With Silicone Hydrogel Lenses

Every now and then something comes along in the contact lens field that puts excitement back into our practices. The approval of Focus Night & Day (CIBA Vision) is the first such significant event of the 21st century. Years of research and development have given us a lens that's safe to sleep in for up to 30 days of continuous wear (CW).

This lens presents an opportunity for improving your spherical patients' soft contact lens experience. And don't forget the immediate impact to your bottom line from professional fees for both upgrading patients and new fits.

Practitioners must overcome the reluctance to recommend extended wear (EW) born by past experience. Think of how many patients already sleep in their daily wear (DW) lenses or wear old, soiled or damaged lenses. How many are not compliant with their care systems or suffer from solution hypersensitivity? How many have dropped out of contact lenses altogether because of problems or laziness? Don't let this opportunity pass you by.

I recently started wearing Night & Day on a 30-day CW schedule in one eye for reading. I have no intention of going back. Besides the convenience, Night & Day outperforms my previous daily disposable lens. I have noticed improvement in depth of focus during computer use (aspheric optics), and I experience no end-of-day discomfort.

Facts to Consider

  • Ocular tissue has responded optimally clinically with this lens on the eye.
  • Night & Day resists deposition of mucin, lipids, protein and associated microorganisms.
  • At 24 percent, its water content is lowest on the market. This lens needs less water than other lenses for optimum performance. It also will not tighten on the eye or bind to the cornea.
  • It can prevent and reverse lens-induced neovascularization. In most pre-existing cases, only empty lumen "ghost vessels" remain after patients are switched to Night & Day.
  • Reduced prescription of ­0.50D or more has been observed in many existing myopic lens wearers upgraded to Night & Day. This is believed to result from reversal of edema caused by low Dk hydrogel lenses.


Patients who wear Night & Day on a CW basis should make every effort to be compliant with FDA recommended wearing schedules to minimize risk of infection. To help improve compliance, I place all my CW patients on a schedule that starts the first of the month. Patients discard their lenses the last night of the month. I supply all CW patients with a no-rub AO Sept Clear Care (CIBA Vision) kit should they need to remove their lenses at any time prior to the end of the month. I also instruct them how to recognize and respond to potential problems. The more educated the patient, the lower the potential risk.

Screen all patients thoroughly for obvious contraindications for CW. For those who are not candidates or those who do not desire to wear lenses on a CW basis, Night & Day can also be worn on a DW or EW basis.

I provide patients with a complimentary pair of Night & Day lenses for up to a 30-day trial period. I charge a professional fee, which includes prescribing and six months of follow-up care. If for any reason the patient wants to discontinue or return to his habitual lenses, I retain only a nominal portion of this fee.

Acceptance of Night & Day has been positive. We now have a safe, well-priced product that may meet or exceed patient expectations. Put the excitement back into your practice and reap the rewards as I have.

Dr. Feldman has a private practice on Long Island limited to contact lenses and orthokeratology. He is a fellow of the International Orthokeratology Section.