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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience:  Eye Physician and Surgeon
20222826
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This is a question about contact lenses. Can you provide

Resolved Question:

This is a question about contact lenses.

Can you provide me with a list of contact lenses that DO NOT contain Silicone Hydrogel that are suitable for astygmatism. Please include any daily disposable that are available too.

Also Can I get a prescription for contact lenses that lets me choose my own brand or do I have to have the brand that the Dr. prescribes?

Thank you.
Submitted: 2 years ago.
Category: Eye
Expert:  Camille-Mod replied 2 years ago.

Hi, I’m a moderator for this topic and I wonder whether you’re still waiting for an answer. If you are, please let me know and I will do my best to find an Expert to assist you right away. If not, feel free to let me know and I will cancel this question for you. Thank you!

Customer: replied 2 years ago.

 

Yes - still waiting for an answer!

Thank you.

Expert:  Camille-Mod replied 2 years ago.

Sometimes, finding the right Expert can take a little longer than expected and we thank you greatly for your understanding. We’ll be in touch again shortly.

Expert:  Camille-Mod replied 2 years ago.

Thank you for your patience, your business is very important to us, we are waiting on the Expert with the right expertise to come online. Feel free to let us know if you would like us to continue searching for an Expert or if you would like us to close your question. Thank you for your understanding!

Expert:  Dr. Susan replied 2 years ago.
Hello- I am sorry yo have had to wait for a reply. I will have to do a little research on your question because I do not know all of the lenses available off the top of my head! There are so many companies and so many different lenses these days that it is not easy to know what is available. I have a reference book that I need to consult and hopefully I can let you know in the next 24 hours. Thank you for your patience!
Customer: replied 2 years ago.

I'll await your response.

 

Thank you.

Expert:  Dr. James replied 2 years ago.
Hello. It appears Dr. Susan has opted out.

I can help you.

First a few questions.

What is the reason not to wear silicone hydrogels?
What contact lens brands have you tried before?
When was your last visit to the optometrist.

Unfortunately, I can only answer questions on this forum and unable to provide any prescriptions. You will need to see your optometrist for a contact lens fitting to get a prescription.
Customer: replied 2 years ago.

 

it's for my son he has a bad reaction to the silicone lenses.

 

He has tried many different types and they are all uncomfortable. Sorry I don't remember all the names - one of the worst was accuvue oasys for astigmatism. Caused awful irritation...poor guy stuck it out because the optometrist told him that the longer he wears them the more he'll get used to them. But I had to get him to take them out because his eyes were bloodshot and painful.

 

I don't understand this new trend of 'having to become accustomed' to soft lenses. He never seems to 'get used' to them.

 

This has been going on for a couple of years.
We thought we'd give it one more shot before we give up.

 

I am working with a new optometrist and she wants to try lenses without the silicone. He tried some dailies and they were ok but still very difficult to tolerate as they felt dry after 4 hours. But at least they didn't cause the extreme eye irritation that others have in the past. She has ordered 3 non silicon toric lenses but says she doesn't know what else might be available.

I said I'd make some enquiries to see if I could find the name of other non-silicone toric lenses. And that is the reason for my question here.

 

Also the contact lens RX question is just a general one - I can't remember if the RX specifies the brand or not.

 

If its easier, perhaps you can give me a list of what materials to look out for because when I do a search on contact lenses and look at the details not one of them uses the word "silicone hydrogel" so it's impossible for me to ascertain those that don't have it!

 

EG 62% polymer (Senofilcon A). is the details given for Acuvue Oasys for Astigmatism which I'm told contains the problem substance. But it seems these 'new' substances are given different names by different manufacturers??? Is that correct?

 

I basically need a list of the OLD STYLE lenses because I've talked to a lot of people who couldn't tolerate the new style and were absolutely fine with old style. So in desperation I thought I'd suggest this to the doctor.

 

I suppose the perfect lens to try would be Toric, high water content, dailies containing zero amount of the lets call it "new materials" !!! lol but I doubt such a beast exists??....

 

The last trial he completed last week was with the focus dailies Toric. I was told that these lenses have 'no' (zero) silicone but then was told they have 'low' silicone so I have no idea which is correct - do you know?

The dailies weren't bad but he suffered from dry eyes after 2 hours and after 4 hours the dryness was such that he simply had to take them out. the Blink lubricating drops didn't help.

 

So that's where I'm at with this. I hear stories of people suddenly finding that one perfect lens that feels comfortable and I so much want this for my son if it's possible!

 

 

Expert:  Dr. James replied 2 years ago.
The silicone hydrogels are very good contact lens. So it's too bad your son does not tolerate them.

Contact lens fittings is really trial and error to find the one that matches well with the patient. I don't think the idea of "getting accustomed" to contact lenses is new. I recommend patients to try any new contact lenses for at least a week before deciding it is no good.

Brands that my patients have liked include:

Biomedics
Frequency 55
Proclear
Soflens
Optima

Contact lens prescription are specific to the brand, power, and base-curve. So, your optometrist will have to sign off on the exact brand before you can order them.

I'm happy to answer any other questions.
Customer: replied 2 years ago.

 

I hadn't done this before but I just googled Senofilcon and came across these tables which seem to contain the information I was seeking. Here's the link # XXXXX http://www.siliconehydrogels.org/editorials/index_july.asp but it's a pretty old report (2004)

 

Yes I do still have questions numbered 1 thru 8 .

 

"I don't know" is an acceptable answer.

 

1. Focus Dailies Toric contain senofilcon. And senofilcon is a Silicone Hydrogel Material. So do they or don't they contain silicone?? (remember my Optometrist told me they contained ZERO silicone)

 

2. I also came across this study

Link 2: http://www.markennovy.com/en/pdf/Hydrogel_vs_silicone_hydrogel_GC44.pdf

which seems to confirm the problems that my son has been having with silicone material. It seems to conclue that silicone lenses are inferior to the other hydrogel materials listed when it comes to "wettability" and "Mechanical abrasion". And that there are increased complications with silicone which has a "2.5 times higher incidence of non-severe keratitis" than non-silicone materials. Concluding also that this "high oxygen" that all the optometrists have spoken to me about might "lead to a range of undesirable performance characteristics.

Is my understanding of the conclusions of this report correct? Is it a reliable report?

 

3. What's this hioxifilcon material that is mentioned in the report at link 2? Maybe this could be the magic lens my son needs? I did a site search at 1800 contacts and came up with Extreme H2O 54% Toric. Why doesn't your list include these? Do you know anything about these lenses?

 

4. What's the difference between Extreme h20 MC and LC?

 

5. Can you comment on any of the other non-silicone materials mentioned in the report at link 2 as it pertains to my son's search for comfortable lenses? .

 

6. Why has the FIRST lens that my son has been given to try with the last 4 optometrists ALWAYS been an Acuvue lens?

 

7. If you were me and knowing my son's difficulties with contact lense discomfort and his need for toric lenses, what are the top 3 Brands that you suggest he tries? Please specify entire full brand name (e.g please don't just say "Acuvue" because there are so many different types of Acuvue) whether they are daily, bi weekly etc, and also the material they are made from. (e.g. Hioxifilcon etc)

 

8. Do you have any other thoughts/recommendations concerning this whole situation?

 

Many thanks.

Expert:  Dr. James replied 2 years ago.
1. Focus Dailies Toric contain senofilcon. And senofilcon is a Silicone Hydrogel Material. So do they or don't they contain silicone?? (remember my Optometrist told me they contained ZERO silicone)

Focus dailies is made of nelfilcon, which is not a silicone hydrogel. Senofilcon is Acuvue Oasys.

2. I also came across this study
Link 2: http://www.markennovy.com/en/pdf/Hydrogel_vs_silicone_hydrogel_GC44.pdf
which seems to confirm the problems that my son has been having with silicone material. It seems to conclue that silicone lenses are inferior to the other hydrogel materials listed when it comes to "wettability" and "Mechanical abrasion". And that there are increased complications with silicone which has a "2.5 times higher incidence of non-severe keratitis" than non-silicone materials. Concluding also that this "high oxygen" that all the optometrists have spoken to me about might "lead to a range of undesirable performance characteristics.
Is my understanding of the conclusions of this report correct? Is it a reliable report?

The article you referenced expresses the opinion of the author and as such his inherent bias. He does not feel the increase oxygen capabilities of the silicone hydrogels offers any advantage. Many will argue the opposite point of view. He may have some points with wettability and comfort. In general, however, silicone hydrogels have become the dominant lenses prescribed and well tolerated by most patients. These are the lenses I prefer on my patients and the lenses I wear myself.

3. What's this hioxifilcon material that is mentioned in the report at link 2? Maybe this could be the magic lens my son needs? I did a site search at 1800 contacts and came up with Extreme H2O 54% Toric. Why doesn't your list include these? Do you know anything about these lenses?

Alden HP lenses and Satureyes are brands made of hioxifilcon. These are the available brand I see listed in my current contact lens booklet. There's no magic lenses. This is an older material and likely branded with many different names. The difficulty with getting fitted for older materials is that your optometrist will not have trials samples. In that case, you optometrist may have to order them specifically for your son. The drawback is that you may not have the opportunity to try them out before ordering them. I do not have experience with this material.

4. What's the difference between Extreme h20 MC and LC?

I'm not sure about this one.

5. Can you comment on any of the other non-silicone materials mentioned in the report at link 2 as it pertains to my son's search for comfortable lenses?

If your son has tried non-silicone hydrogel brands, he's probably tried some of those materials mentioned. For my patients who don't like silicone hydrogel, then tend to do better with Proclear (omafilcon). Realize also that it's not just about the actual material itself. Each company also puts there own coatings on the lenses to help with wettability and comfort.

6. Why has the FIRST lens that my son has been given to try with the last 4 optometrists ALWAYS been an Acuvue lens?

Because Acuvue is the most popular lens brand and most patients do well with. They have many lens powers available as trials and patients can order them readily at most places because it is so popular. Overall, Acuvue is a good brand of lenses.

7. If you were me and knowing my son's difficulties with contact lense discomfort and his need for toric lenses, what are the top 3 Brands that you suggest he tries? Please specify entire full brand name (e.g please don't just say "Acuvue" because there are so many different types of Acuvue) whether they are daily, bi weekly etc, and also the material they are made from. (e.g. Hioxifilcon etc)

Proclear (omafilcon), Frequency 55 (methafilcon), Biomedics (ocufilcon). These lenses are usually 1 month disposable.

8. Do you have any other thoughts/recommendations concerning this whole situation?

Overall, I think the silicone hydrogel contact lenses are very good. I'm not sure the specific problem your sone is having with these lenses. He may have dry eyes or ocular allergies which make contact lens of any type difficult. I would recommend you continue working with your optometrist to see which brands may work with him. With some of the less popular brands, ordering trial lenses for fitting may be difficult.

Best of luck!
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
Dr. James and other Eye Specialists are ready to help you
Customer: replied 2 years ago.

 

Thank you.

Customer: replied 2 years ago.
Just wanted to let you know that for both me and my son the biomedics are perfect and there is no discomfort whatsoever. We are both completely unable to feel them at all. Ahhh...just like the old days.

It took a bit of persistence (and initially resulted in one very irritated optometrist who like all the others insisted that the new style lenses couldn't possibly be the cause of the discomfort) but nevertheless I'm delighted at the outcome.

Like my son - I too have been unable to wear contact lenses for years and was told it was due to my age and 'dry eye'. I am delighted to report that the biomedics are perfectly comfortable all day for me too! there is zero dryness (guess my 'dry eye' has spontaneously resolved itself? lol)

I have at least a dozen friends who are going to try the biomedics brand because they too are having awful problems with dry eye and discomfort. A few have resorted to laser surgery but most can't afford that.

Ironically my optometrist herself had to have laser surgery because she couldn't find a comfortable pair....

I wanted to give you this feedback in an attempt to persuade you to keep an open mind to my belief that there is something WRONG with some of these new lense materials/coatings for a large minority of people.

I've come across a lot of rumours about kickbacks and doctor's relying on lense manufacturers for their education...but I don't believe that for one minute.

Thank you again for discussing this matter with me and for sharing your opinion - it was helpful in the successful outcome I have had.

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