Newton Wesley, creador de las lentillas duras.,Llegó a suministrar el 90% de las lentes del mundo

<div dir="ltr" style="text-align: left;" trbidi="on"> Comenta.esta.publicación<br /> <br /> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0GntHaOL06vpADNsCPbP_M_D892k-Q43HBD01dYfwxkO1WScilvkfrxdu8PsKO4B1HU72wnhG2SiY7MnSNzOExQHNAQ9F5EfzBSZTrCf9NDdlY7dC5eT_PD8XB_pAHvsbr04xZSDZSF8/s1600/Newton_Wesley.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0GntHaOL06vpADNsCPbP_M_D892k-Q43HBD01dYfwxkO1WScilvkfrxdu8PsKO4B1HU72wnhG2SiY7MnSNzOExQHNAQ9F5EfzBSZTrCf9NDdlY7dC5eT_PD8XB_pAHvsbr04xZSDZSF8/s400/Newton_Wesley.jpg" width="267" /></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: center;"> </div> <div style="text-align: justify;"> <span style="background-color: white; font-family: Arial, Verdana, sans-serif; text-align: start;">Newton Wesley recibió en 1946, con 29 años, una mala noticia: estaba a punto de quedarse ciego. No había podido superar una enfermedad degenerativa de la córnea que había ido afectando su visión desde niño. Wesley, que precisamente fue uno de los primeros expertos en optometría del mundo, no se derrumbó y se puso manos a la obra. Unos meses más tarde, consiguió junto con el optometrista George Jessen desarrollar las lentillas duras. Un descubrimiento que le permitió seguir viendo hasta el pasado jueves 21 de julio, cuando murió a los 93 años en Freeport (Illinois, EE UU).</span></div> <div style="text-align: justify;"> <span style="font-family: Arial, Verdana, sans-serif;"><br /></span></div> <span style="background-color: white; font-family: Arial, Verdana, sans-serif; text-align: start;"><div style="text-align: justify;"> De procedencia japonesa, el doctor Wesley nació el 1 de octubre de 1917 en Westport (Oregón, EE UU). Alumno aventajado, ya en el instituto se graduó con solo 16 años. Fruto de sus problemas con la vista desde niño, Wesley se interesó pronto en el mundo de la optometría. Por ello se marcó un objetivo, que consistía en buscar una solución para evitar su propio deterioro de la visión y la del resto de las personas con el mismo problema. A los 22 años abrió una consulta en Portland (Oregón) y comenzó a dar clases en la Universidad de North Pacific hasta 1942. Tres años después, su antiguo centro se fusionó con la Universidad del Pacífico y se creó un máster en optometría de gran prestigio hasta nuestros días en EE UU. Wesley perteneció a su Consejo de Administración durante décadas y posteriormente también fue miembro honorífico de la institución.</div> </span><div style="text-align: justify;"> <span style="font-family: Arial, Verdana, sans-serif;"><br /></span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; margin-bottom: 10px; margin-top: 5px; text-align: justify;"> Según Eugenio Claramunt, de la Asociación Española de Optometristas Unidos, Wesley comenzó a preparar el terreno para las lentes de contacto corneales, que conocemos actualmente por lentes rígidas, en 1946, junto con el optometrista George Jessen. Según Claramunt, las lentillas ya existían desde los años treinta, y se fabricaban incluso con cristal. El problema es que no se podían utilizar demasiado tiempo porque resultaban incómodas, al cubrir también la esclerótica (la parte blanca del ojo). Según explica el profesor de la Facultad de Optometría de Illinois, Neil Hodur, las nuevas lentillas que fabricaron Wesley y Jessen cubrían tan solo la córnea, una capa situada debajo de la esclerótica, más pequeña. El resultado: unas lentillas más reducidas, finas y cómodas de llevar durante más tiempo.</div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; margin-bottom: 10px; margin-top: 5px; text-align: justify;"> Visto el éxito de las nuevas lentes, los dos expertos fundaron la Plastic Contact Lens Co., una empresa de venta de lentillas cuyo siguiente paso fue una gigantesca operación de <i>marketing</i> para convencer a los ciudadanos de los años cincuenta de que ponerse lentes de contacto era seguro. Lo lograron: en ese momento, consiguieron suministrar el 90% de las lentillas usadas en el mundo.</div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; margin-bottom: 10px; margin-top: 5px; text-align: justify;"> El propio Wesley hizo un periplo por Estados Unidos para promocionar las lentillas, y logró que famosos como la actriz y cómica Phyllis Diller le ayudaran en su campaña. El optometrista viajó tanto que acabó aprendiendo a pilotar su propio avión para desplazarse por todo el país. Una de sus últimas misiones en el campo de la optometría tuvo lugar en los años cincuenta, cuando pidió públicamente que el diccionario recogiera la palabra <i>lentillas.</i> Consultando hoy en estos libros y enciclopedias, queda claro que también lo consiguió.</div> <div style="text-align: justify;"> <br /></div> <br /> <br /></div>

Newton Wesley, creador de las lentillas duras.,Llegó a suministrar el 90% de las lentes del mundo

Comenta.esta.publicación Newton Wesley recibió en 1946, con 29 años, una mala noticia: estaba a punto de quedarse ciego. No había ...

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How to Address CL Compliance

<div dir="ltr" style="text-align: left;" trbidi="on"> Comenta.esta.publicación<br /> <br /> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbo4d32v2f-d_r34CGucu2h2w7keCAxqvDwXcl7yjpMkc93LvZBNpIurktPYtgse0xOX_V-9s21tszbsiNCyNypqkwVeASHlPKjTzdyoyuQBdyaOhSRKhkqYAMF3ihZks7-zrUO6tZfo0/s1600/5.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbo4d32v2f-d_r34CGucu2h2w7keCAxqvDwXcl7yjpMkc93LvZBNpIurktPYtgse0xOX_V-9s21tszbsiNCyNypqkwVeASHlPKjTzdyoyuQBdyaOhSRKhkqYAMF3ihZks7-zrUO6tZfo0/s320/5.gif" width="320" /></a></div> <br /> <br /> <br /> <h5> <span style="font-size: small;"> Here’s a practical, step-by-step, patient-by-patient approach that will help improve contact lens compliance.</span></h5> By Gina Wesley, O.D., M.S.<br /> <br /> <br /> <span style="font-family: Arial;">As doctors, we would like to think that our patients genuinely listen to us and follow all of our instructions. Often, it’s nothing more than a matter of keeping them safe, comfortable and healthy. In a perfect world, we wouldn’t see an emergency case of red eye on a Sunday morning in a patient who failed to heed our recommendations about not sleeping in daily disposable contact lenses. Nor would we receive the phone call from a patient who is begging us to give him another set of trial contacts for those two-week lenses that were prescribed more than two years ago!</span> <span style="font-family: Arial;">For patients, contact lenses truly are a modern enhancement to their daily visual experience. Contact lens technology has become so advanced that it’s easy for patients to assume most of their care habits will keep them visually successful––even if those habits carry over from old-school technology. </span><br /> <span style="font-family: Arial;">So, how can we prevent these avoidable mishaps? Further, can we actually predict who is more likely to be non-compliant? </span><br /> <span style="font-family: Arial;">Contact lenses are medical devices, and patients need to be reminded of that consistently to promote better compliance. Many patients with poor care habits are fortunate to never deal with ocular morbidities. This is due, in large part, to rigorous testing standards established by the FDA for both contact lenses and contact lens solutions.^1-3However, to ensure the lowest risk, there are still several key compliance steps patients should follow. The struggle lies in making your instructions to patients complete, easy and concise, so they will not be forgotten or mistaken.</span><br /> <span style="font-family: Arial;"><b><span style="color: #3a96f2;">The Battle is Ongoing</span></b> <br />The fight to gain patient compliance with contact lens care is not a new one. The first peer-reviewed article addressing this issue was published more than 25 years ago.⁴ A 2009 poll question posted on <a href="http://www.siliconehydrogels.org/" rel="nofollow" target="_blank">www.siliconehydrogels.org</a> asked eye care practitioners to consider in which area of contact lens care and maintenance their patients were least compliant.5 Of 78 participants, the most frequent responses were “failure to replace lenses when scheduled” (55%), followed by “failure to wash hands prior to handling lenses” (18%), “switching care products” (13%) and “inappropriate use of care products” (9%).</span><br /> <span style="font-family: Arial;">Does personal perspective from practitioners in the trenches ring true? What are patients really doing, and can we evaluate their behavior in these recent years of advanced contact lens technology? The booming use of silicone hydrogel (SiHy) and daily disposable (DD) lenses certainly adds a new spin on patient care habits. </span><br /> <span style="font-family: Arial;">Eye care practitioners need to make a conscientious effort to individually address each patient on a case-by-case basis, due to the variety of new lens materials and care products, instead of just making blanket recommendations for wear and replacement. </span><br /> <span style="font-family: Arial;">A recent study conducted at the University of Waterloo’s Centre for Contact Lens Research sought to investigate these very issues.⁷ The authors assessed current recommendations for replacement frequency of SiHy and DD lenses, determined compliance (or noncompliance) with manufacturer-recommended replacement frequency, evaluated contact lens care and investigated reasons for noncompliance.^6,7 </span><br /> <br /> <span style="font-size: small;"><b><span style="font-family: Arial;"><span style="font-family: Arial;">Additional Steps To Improve Compliance</span></span></b></span> <span style="font-family: Arial;">    </span><br /> <span style="font-family: Arial;"> • Put a basket of contact lens cases on your front desk and encourage patients to take them for FREE, because you care about their lens safety. <br />     • Place a message in each dispensed bag of contact lenses that indicates that you will guarantee satisfaction with their lenses if the wearer promises to follow your instructions. Then, have your staff simply fill in those instructions that are particular to that lens and patient. <br />     • Highlight selected portions of articles or studies that show why one solution may be more effective and safer than another, and place these in your reception area and contact lens rooms. <br />     • Offer incentives for patients to switch from old modalities into newer lens types. Ultimately, this will promote patient comfort as well as help reduce patients’ chances of experiencing adverse events. <br />     And, if patients experience adverse events, they need to know that they can come to you for help. So, take the time to educate them about the steps to take in the event of an occurrence, and reiterate that these occurrences are unlikely if they follow your care and compliance instructions. <br />     • Any lens prescription needs to include instructions about care and replacement––both verbal and written. </span><br /> <br /> <br /> <span style="font-family: Arial;">Compliance with recommended replacement frequency varied with modality of lens type. When subjects were asked which replacement frequency had been recommended by their eye care practitioner, the greatest rate of non-compliance was reported for two-week SiHy lenses (22%), followed by DD lenses (10%) and one-month SiHy lenses (2%). Just 4% of patients reported that their practitioner gave no replacement frequency recommendation.⁸ </span><br /> <span style="font-family: Arial;">Remember, confusion may occur if doctors’ recommendations are not in accordance with manufacturers’ recommendations. Patients are savvy researchers. If what you tell them contradicts the prevailing opinion/recommendation, what incentive do they have to follow the remainder of your instructions?</span><br /> <span style="font-family: Arial;">Patients reportedly recognized the significance of replacing lenses on schedule, with 94% of DD wearers, 71% of two-week replacement SiHy wearers and 80% of one-month replacement SiHy wearers rating replacement schedules as either “extremely important” or “important.”⁷ </span><br /> <span style="font-family: Arial;">However, even though most patients deemed replacement schedule an important consideration, there was still a 40% non-compliance rate with replacement frequency compared to manufacturers’ recommended replacement schedules. Even if you remove patients whose doctors prescribed a different replacement schedule from the manufacturer, there was still a 38% rate of non-compliance. The survey found the worst replacement schedule compliance was with the two-week lens modality, followed by monthly and then daily disposable lenses.^6,7</span><br /> <span style="font-family: Arial;">What about contact lens care regimens? About half of those patients surveyed who were wearing SiHy lenses reported using a brand-name solution, and another 9% reported a hydrogen peroxide-based solution. A startling 40% reported they could not recall or did not know the name of their solution, which begs the question of possible generic usage or frequent switching of solutions due to cost and convenience. About half reported replacing lens cases either every three months or sooner, while 36% percent replaced the case every six to 12 months. A surprising 14% said they never replaced their lens case.⁷</span><br /> <div dir="ltr"> <span style="font-family: Arial;"><b><span style="color: #3a96f2; font-size: small;">Signs of Non-Compliance</span></b> <br />Here are some methods you might consider to help garner information from your patients about lens care compliance. </span><br /> <span style="font-family: Arial;">• <i>Ask patients which solution they are using.</i> Don’t ask if they are using the solution you prescribed, because it is too easy for them to simply reply “yes.” Alternatively, you can keep a variety of solutions on hand and when patients remove their lenses, ask them to use the solution that they have at home. </span><br /> <span style="font-family: Arial;">If certain patients hesitate or don’t know which solution to use, you may need to further educate these individuals. Having a colored picture of what most major brand and generic solution bottles look like may also be a useful way to identify current habits. </span><br /> <span style="font-family: Arial;">• <i>Ask patients how often they sleep in their lenses. </i>For most, it’s not an “if,” but a “when.” Acknowledging that it does happen is a safe way to broach the topic with your patient. Most patients don’t like to “get in trouble” at the eye doctor, so encouraging candid communication will only elevate trust levels with your patients. Then, you can gently remind them “when and why” sleeping in certain contact lenses is appropriate or inappropriate. </span><br /> <span style="font-family: Arial;">• <i>Keep patients up to date.</i> It might seem obvious, but talking to a patient who bought less than a year’s supply of lenses from you, has taken two years to come back to you and has no reliable back-up spectacles may reveal some poor wear habits. Take this opportunity to discuss other lenses that may better match patients’ current wear and care habits, the advantages of fresh and sterile lenses, and how technology continues to improve. If they see you as a brand new source of information every year, and understand more about their ocular health and wellness, patients will be more likely to return as you prescribe. </span><br /> <span style="font-family: Arial;">• <i>Discuss removal and cleansing habits.</i> The confusion with rubbing lenses during the cleaning process needs to be clarified, especially with your long-term lens wearers. Ask patients what they do when removing their lenses. Be sure to leave your questions open-ended. You may learn that they are plopping those lenses back into their cases with old solution. </span><br /> <span style="font-family: Arial;">• <i>Ask them to bring in their lens case. </i>One look at its cleanliness will probably give you a better understanding of their care habits than any personal reports. </span><br /> <span style="font-family: Arial;"><span style="font-size: small;"><b><span style="color: #3a96f2;">Steps to Improve Compliance</span></b></span> <br />Now that we have refreshed ourselves on what signs of non-compliance to look for, what can we do to improve compliance?</span><br /> <span style="font-family: Arial;"><b><i>1. Identify those who are likely to be compliant.</i></b> The more simplistic the contact lens care regimen, the easier is it to be compliant. Additionally, the better the material technology, the less likely that complications will arise. And, it is important to note that patients who are fit in monthly or daily lenses often will have better compliance rates.⁶ </span><br /> <span style="font-family: Arial;">Brand new contact lens wearers may be more compliant because they have not yet had any personal or outside influence to alter their care responsibilities. Take the time to foster positive compliance habits in new wearers as well as reinforce the reasons why they should heed your advice. </span><br /> <span style="font-family: Arial;"><b><i>2. Identify those who are likely to be non-compliant.</i></b> Patients who are new to your practice and have been fitted elsewhere may have received advice about contact lens care and replacement that contradicts either your advice or what is in their best interest for health and comfort. </span><br /> <span style="font-family: Arial;">Additionally, long-term contact lens wearers are most likely to slip into poor habits, such as choosing a different cleaning solution because they never did understand why one solution was different from another. Price, convenience or “whatever their spouse bought at the pharmacy” may override a meek recommendation by their eye care practitioner. Overall, being aware of possible ingrained habits will enable your practice to properly unteach non-compliant patients.</span><br /> <span style="font-family: Arial;"><i><b>3. Educate EVERY time.</b></i> It may seem mundane and repetitive, but repeating why a lens needs to be replaced on a specific schedule, why a particular solution should be used with advanced lens materials and why a case should be replaced frequently is important each and every time a patient is in your office. Explanations don’t need to be complex, but should be straightforward clarifications that the patient can relate to.</span><br /> <span style="font-family: Arial;">Here are some simple, yet effective, recommendations: </span><br /> <blockquote> <span style="font-family: Arial;">––<i>“Replace your lenses every month to reduce your risk for infection, improve comfort and guarantee better vision.” </i></span> <br /> <span style="font-family: Arial;">––<i>“This particular cleaning and disinfecting solution is more compatible with the advanced material I fit you in, and other solutions have proven to be less effective.”</i></span> <br /> <span style="font-family: Arial;">––<i>“Replace your case every couple of months to ensure that it isn’t a major source of contamination for your lenses.” </i></span> </blockquote> <span style="font-family: Arial;">These steps will serve to enlighten your contact lens patients as well as add tremendous value to their experience each and every time they are in your office. These simple recommendations are of very little cost to you, but the experience for the patient is priceless.</span><br /> <span style="font-family: Arial;"> </span> <span style="font-family: Arial;">Compliance with contact lenses ultimately depends upon patients following our instructions. Make it easy for them to succeed. With advanced technology, a multitude of lenses and modalities and new care options, you can guide most patients to safe, comfortable and successful experiences with their contact lenses. </span><br /> <i><span style="font-family: Arial;">Dr. Wesley practices in Medina, Minn., where she focuses on primary eye care optometry with an emphasis on contact lenses. She is a fellow of the American Academy of Optometry and was recently awarded the 2011 Minnesota Young Optometrist of the Year award. </span></i><br /> <span style="font-family: Arial;"><i>Dr. Wesley is a consulting lecturer and research investigator for Alcon, Allergan, Revolution EHR and Vistakon. </i> </span><br /> <span style="font-family: Arial;">1. Karpecki PM, Schechtman DL. Microbial threats in CL wear. Rev Optom. 2010 Dec;147(12):69-70. <br />2. United States Food & Drug Administration. Guidance for Industry: Premarket Notification (510(k)) Guidance Document for Contact Lens Care Products. Available at: <a href="http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM080218.pdf" rel="nofollow" target="_blank">www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM080218.pdf</a> (accessed July 6, 2011). <br />3. International Standards Organization ISO 14729. Ophthalmic Optics––Contact Lens Care Products. Microbiological requirements and test methods for products and regimens for hygienic management of contact lenses, 2001. <br />4. Collins MJ, Carney LG. Patient compliance and it’s influence on contact lens wearing problems. Am J Optom Physiol Opt. 1986 Dec;63(12):952-6. <br />5. Silicone Hydrogels. Quick vote results––2009. Available at: <a href="http://www.siliconehydrogels.org/vote_3/vote_history.asp" rel="nofollow">www.siliconehydrogels.org/vote_3/vote_history.asp</a> (accessed July 6, 2011). <br />6. Dumbleton K, Woods C, Jones L, et al. Comfort and vision with silicone hydrogel lenses: effect of compliance. Optom Vis Sci. 2010 Jun;87(6):421-5. <br />7. Dumbleton K, Woods C, Jones L, et al. Patient and practitioner compliance with silicone hyrogel and daily disposable lens replacement in the United States. Eye Contact Lens. 2009 Jul;35(4):164-71. <br />8. Dumbleton K, Woods C, Jones L, Fonn D. How compliant are today’s lens wearers? Available at: <a href="http://www.clspectrum.com/article.aspx?article=104344" rel="nofollow">www.clspectrum.com/article.aspx?article=104344</a> (accessed July 6, 2011).</span></div> </div>

How to Address CL Compliance

Comenta.esta.publicación Here’s a practical, step-by-step, patient-by-patient approach that will help improve contact lens complia...

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Retiran del mercado de determinados lotes de lentes de contacto Acuvue® Oasys®

<div dir="ltr" style="text-align: left;" trbidi="on"> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhtn0ahGw4-9klXUt5DOILt_crLX_0IUmy2-W6g1tfT00FJQoJw1qQe9sT_lbZ435koQ9ObVXar_XjqYhZOjkPh_i-nYKiM9KRHoBSK56tJ9NvtYY3kIK6VAWB3DQ7fAvcrZFCKevg3zyw/s1600/cierranboticas.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhtn0ahGw4-9klXUt5DOILt_crLX_0IUmy2-W6g1tfT00FJQoJw1qQe9sT_lbZ435koQ9ObVXar_XjqYhZOjkPh_i-nYKiM9KRHoBSK56tJ9NvtYY3kIK6VAWB3DQ7fAvcrZFCKevg3zyw/s1600/cierranboticas.jpg" /></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <br /> <div align="justify" style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> La Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), ha sido informada por la empresa Johnson & Johnson Medical Iberia, de la retirada del mercado de determinados lotes de lentes de contacto Acuvue® Oasys® (senofilcon A), fabricadas por Johnson & Johnson Vision Care Inc., EEUU, al haberse detectado problemas en su fabricación que podrían ocasionar a los usuarios enrojecimiento ocular e incomodidad al utilizarlas. Las lentes Acuvue® Oasys® (senofilcon A) están diseñadas para la corrección de la miopía. El problema detectado es que debido a una interrupción aislada en el proceso de aclarado de las lentes de una línea de fabricación de Acuvue® Oasys® (senofilcon A), las lentes de determinados lotes tienen niveles de un agente diluyente más altos de lo esperado, lo que podría afectar al comportamiento de la lente debido a la reducción de la humectabilidad. Mayor información en el siguiente Link:</div> <a href="" style="background-color: white; color: #0066cc; font-family: Arial, Verdana, sans-serif; font-size: 13px; outline: none;">http://www.aemps.gob.es/informa/notasInformativas/productosSanitarios/seguridad/2012/01-2012_PS.htm</a><br /> <a href="" style="background-color: white; color: #0066cc; font-family: Arial, Verdana, sans-serif; font-size: 13px; outline: none;"><br /></a> <a href="" style="background-color: white; color: #0066cc; font-family: Arial, Verdana, sans-serif; font-size: 13px; outline: none;"><br /></a></div>

Retiran del mercado de determinados lotes de lentes de contacto Acuvue® Oasys®

La Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), ha sido informada por la empresa Johnson & Johnson Medical ...

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Cross linking para frenar el queratocono

<div dir="ltr" style="text-align: left;" trbidi="on"> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-TuAmn0V_GJHwNwByYH3U-2d36cdr7VI5NVaF6zRcoP6fi85uiAB-VW7QMPyn5Xc6xud4bkBi1vXGtvT1QLyixkwAC1XKNT9hHYsFrvIodr7SitFP-HdSXhC76-_g4zLItFF-Kwe4Fxw/s1600/Queratocono-cross-linking-intacs.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-TuAmn0V_GJHwNwByYH3U-2d36cdr7VI5NVaF6zRcoP6fi85uiAB-VW7QMPyn5Xc6xud4bkBi1vXGtvT1QLyixkwAC1XKNT9hHYsFrvIodr7SitFP-HdSXhC76-_g4zLItFF-Kwe4Fxw/s1600/Queratocono-cross-linking-intacs.jpg" /></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: justify;"> <br /></div> <br /> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <div style="color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px; text-align: -webkit-auto;"> Un seguimiento de tres años de 50 pacientes de entre 13 y 30 años tratados de <strong>queratocono</strong>en el Instituto de Microcirugía Ocular (IMO) de Barcelona con la técnica conocida como <strong>cross linking</strong>, ha puesto de manifiesto la eficacia de este tratamiento para frenar la progresión de la enfermedad, principal causa de <strong>trasplante de córnea</strong> en jóvenes.</div> <div style="color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px; text-align: -webkit-auto;"> A diferencia de otros tratamientos, que no frenan la enfermedad, el <strong>cross linking</strong> impide que el<strong>queratocono</strong> avance en un 95% de los casos y mejora la regularidad de la córnea y, por tanto, la visión, en un 75% de los pacientes, según los resultados del estudio llevado a cabo en el IMO. El tratamiento, por tanto, se confirma como una alternativa altamente efectiva para prevenir y evitar el trasplante de córnea que puede requerir un <strong>queratocono</strong> muy evolucionado. De hecho, el <strong>queratocono</strong>, que provoca una alteración morfológica de la superficie <strong>corneal</strong>, es la primera causa de trasplante <strong>corneal</strong> en pacientes jóvenes, “algo que logrará cambiar la futura aplicación generalizada del <strong>cross linking</strong> como tratamiento de referencia para esta patología”, según el Dr. Óscar Gris, de la Unidad de Córnea del IMO, uno de los centros pioneros en España en la aplicación de esta técnica. El seguimiento de 50 pacientes tratados desde entonces en el Instituto, confirma el buen resultado del tratamiento.</div> <h2 style="color: #333333; font-family: Verdana; line-height: 16px; margin: 0px; padding: 0px; text-align: -webkit-auto;"> <a href="http://www.blogger.com/blogger.g?blogID=3847540156974127949" name="TOC-Queratocono-y-astigmatismo" style="color: #0066cc; outline: none;"></a>Queratocono y astigmatismo</h2> <div style="color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px; text-align: -webkit-auto;"> El <strong>queratocono</strong>, patología que hace que la córnea adquiera forma de cono en vez de redondeada, puede ser progresivo y provoca <strong>astigmatismo irregular</strong> que muchas veces no se puede corregir ni con gafas, ni con lentes de contacto rígidas. Precisamente, la aparición o el aumento de astigmatismo –un defecto de refracción que, a diferencia de la <strong>miopía</strong> y la<strong>hipermetropía</strong>, no evoluciona de forma natural con la edad– es el principal factor diagnóstico de la enfermedad.</div> </div> <div style="background-color: white; color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px;"> El <strong>queratocono</strong> casi siempre afecta a los dos ojos, pero <strong>es asimétrico</strong>, por lo que generalmente uno progresa más rápido. En la mayoría de los casos tiene una base genética, aunque no es necesariamente hereditario. También puede, raramente, aparecer como consecuencia de una cirugía refractiva con láser.</div> <div style="background-color: white; color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px;"> Según explica el Dr. Óscar Gris, promotor del estudio junto al Dr. José Luis Güell, también del IMO, “se trata de una enfermedad bastante frecuente, de la cual se diagnostican <strong>cada vez más casos</strong>, gracias a las técnicas de exploración que cada vez son más sensibles. Algunos de los pacientes se diagnostican casualmente en los estudios previos a la cirugía de miopía o astigmatismo”. En ocasiones, el <strong>queratocono</strong> se queda en la fase inicial y no llega a desarrollarse ni a progresar (queratocono frustre). Por el contrario, los casos más severos pueden terminar con el <strong>trasplante de córnea</strong> como única solución.</div> <div style="background-color: white; color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px;"> “De ahí la importancia de la aplicación precoz del <strong>cross linking</strong>, que puede evitar el trasplante en muchos casos en los que, de otro modo, éste hubiera tenido que llevarse a cabo”, explica el oftalmólogo.</div> <div style="background-color: white; color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px;"> Generalmente, los casos más graves afectan a los pacientes más jóvenes, en los que la enfermedad suele ser especialmente agresiva. “<strong>Cuanto más joven, más riesgo de progresión</strong> y más rápida la evolución”, advierte el Dr. Gris. Por el contrario, a partir de los 40 años, el<strong>queratocono</strong> no suele progresar, ya que la edad hace que la córnea se vuelva rígida de forma natural.</div> <div style="background-color: white; color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px;"> Precisamente, el <strong>cross linking corneal</strong> logra aumentar la <strong>rigidez de la córnea</strong>, que en el queratocono se encuentra debilitada. La técnica consiste en la administración de unas gotas de vitamina B2 (Riboflavina) en la superficie de la córnea, hasta conseguir que la vitamina penetre adecuadamente en el interior. Posteriormente, la córnea se expone a una luz ultravioleta de baja potencia. La unión de la vitamina con la luz ultravioleta provoca una reacción química que hace que aumente el grosor de las fibras de colágeno y los enlaces entre ellas, logrando dicha rigidez corneal.</div> <div style="background-color: white; color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px;"> Fuente : http://www.acceso.com/es_ES/notas-de-prensa/el-cross-linking-corneal-logra-frenar-el-queratocono-y-en-muchos-casos-mejora-la-vision/69631/</div> <div style="background-color: white; color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px;"> <br /></div> <div style="background-color: white; color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px;"> <br /></div> <div class="separator" style="clear: both; text-align: center;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZZ9z-peSn6obZyA1Nq1wyw4vS6LQgKQHU-8MMiiGB_kbd_Qn4Ieon__ILWxm161E0ShOQZSlrezHN8IahDpRZ30DBnNhv8eWzJbcfLFBHjvRgcABAigy29bG_YIwMFcJcWzGYwoKU6aA/s1600/bolle.jpg" /><a href="https://sites.google.com/a/infolentes.com/info-lentes/bolle" target="_blank">https://sites.google.com/a/infolentes.com/info-lentes/bolle</a></div> <div style="background-color: white; color: #333333; font-family: Verdana; font-size: 12px; line-height: 16px;"> <br /></div> </div>

Cross linking para frenar el queratocono

Un seguimiento de tres años de 50 pacientes de entre 13 y 30 años tratados de  queratocono en el Instituto de Microcirugía Ocular ...

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Cuando un hongo afecta tu vista

<div dir="ltr" style="text-align: left;" trbidi="on"> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjfZ757TJmbfzEi9v4fqKXmqnc6IwyKmErui79dg5IB3nPkyXfRTEIv7lp6n0KwYFWI6_qU1kjGF6Hn2VZde7GZHCuf9vF5Ish4367sIbki05zzPOI5FCCVPKWX7D5FgKsTPKg6oZ4UVNs/s1600/3.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="222" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjfZ757TJmbfzEi9v4fqKXmqnc6IwyKmErui79dg5IB3nPkyXfRTEIv7lp6n0KwYFWI6_qU1kjGF6Hn2VZde7GZHCuf9vF5Ish4367sIbki05zzPOI5FCCVPKWX7D5FgKsTPKg6oZ4UVNs/s320/3.jpg" width="320" /></a></div> <div class="separator" style="clear: both; text-align: center;"> <br /></div> <div class="separator" style="clear: both; text-align: justify;"> <br /></div> <br /> <div style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; margin-top: 8px; padding: 0px;"> <em>¿Usas lentes de contacto? Presta atención: el uso inadecuado de los lentes de contacto o una lesión en el ojo pueden ser causa de la queratitis fúngica, una infección ocular que, si no se trata a tiempo, puede provocar otros trastornos, incluyendo la ceguera.</em></div> <div style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; margin-top: 8px; padding: 0px;"> Los ojos son órganos muy delicados que hay que cuidar con mucho esmero. Entre las muchas enfermedades que pueden afectarlos seriamente al punto de poner en peligro la visión, está la <strong>queratitis fúngica</strong> (o sea, la inflamación de la córnea que proviene de un hongo).  La córnea, por cierto, es la capa curva, transparente y anterior del ojo que protege al iris, que es lo que le da el color a los ojos (café o marrón, verde, azul, etc.) y a la pupila (el punto negro situado en el centro del iris, que es el orificio por donde penetra la luz al interior del ojo).</div> <div style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; margin-top: 8px; padding: 0px;"> Aunque hay otros tipos de queratitis (producidas por bacterias, parásitos como las amebas o lesiones, por ejemplo), la queratitis fúngica consiste en una infección de la córnea, provocada por un hongo, casi siempre por un hongo llamado <em>Fusarium</em>, que suele encontrarse en la tierra, el agua y las plantas, especialmente en los climas cálidos. Si la queratitis es superficial, afecta las capas más cercanas a la superficie de la córnea y, cuando se cura, no deja cicatrices, pero si es profunda, afecta las capas interiores de la córnea, y es posible que queden cicatrices que pueden llegar a afectar la vista, dependiendo de su localización.</div> <div style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; margin-top: 8px; padding: 0px;"> La queratitis fúngica puede presentarse por distintas <strong>causas</strong>:</div> <ul style="background-color: white; clear: both; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; list-style-position: outside; list-style-type: none; margin: 10px 0px 0px; padding: 0px;"> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">A menudo se presenta después de una lesión en la córnea, sobre todo si es provocada por alguna materia vegetal que entre en el ojo (como puede ocurrir si te das un golpe fuerte en el ojo con una rama grande).  Esta es la causa principal, así que ten cuidado si trabajas en el jardín. Un par de gafas protectoras es lo más conveniente.</li> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">Hay riesgos de desarrollarla si usas lentes de contacto. Para minimizar estos riesgos, es recomendable que no uses los lentes por largos períodos de tiempo.  Cuando los limpies, no te  olvides de frotarlos y enjuagarlos cuidadosamente y de reemplazar el estuche con frecuencia. En general, debes seguir al pie de la letra las indicaciones del oftalmólogo o el profesional que trate tus ojos.</li> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">También las personas con una enfermedad crónica o recurrente en la superficie del ojo son más susceptibles a contraer la queratitis fúngica, así como las que tienen un sistema inmunológico debilitado si se exponen al hongo.</li> </ul> <div style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; margin-top: 8px; padding: 0px;"> Para que reconozcas sus <strong>síntomas</strong>, éstos son los más comunes:</div> <ul style="background-color: white; clear: both; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; list-style-position: outside; list-style-type: none; margin: 10px 0px 0px; padding: 0px;"> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">Visión borrosa.</li> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">Enrojecimiento inusual del ojo.</li> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">Dolor en el ojo que comienza de pronto.</li> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">Aumento en la sensibilidad a la luz.</li> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">Lagrimeo excesivo.</li> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">Secreción del ojo.</li> <li style="background-image: url(https://sites.google.com/a/infolentes.com/info-lentes/inter/cuandounhongoafectatuvista); background-repeat: no-repeat no-repeat; list-style-position: outside; list-style-type: none; margin: 0px 0px 5px 8px; padding: 0px 0px 0px 8px;">Sensación de tener un cuerpo extraño en el ojo.</li> </ul> <div style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; margin-top: 8px; padding: 0px;"> Si notas alguno de estos síntomas, sobre todo si se presenta de repente, ve enseguida al oftalmólogo. Debes comenzar el tratamiento lo antes posible. Si se demora, puede dar lugar a la pérdida de la visión.</div> <div style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; margin-top: 8px; padding: 0px;"> Para determinar el tipo de queratitis, el oftalmólogo tal vez deba raspar ligeramente el ojo, para tomar una pequeña muestra y hacer un cultivo para comprobar si hay infección y determinar el tipo de infección. Para tratar la queratitis fúngica, normalmente se usan ungüentos o gotas antifúngicas en los ojos, además de medicamentos orales. Si eso no basta para eliminar la infección, podría ser necesario recurrir a la cirugía, incluyendo a veces un trasplante de córnea. En algunos casos, incluso la cirugía no basta para restaurar la visión y puede producirse un deterioro de la vista llegando a la ceguera.</div> <div style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 13px; line-height: 18px; margin-top: 8px; padding: 0px;"> Aunque la queratitis fúngica puede llegar a ser una enfermedad seria, hay una clave para tratarla con éxito: desde luego la prevención; pero si se presenta, prestar atención a sus síntomas y acudir al oftalmólogo inmediatamente si notas que alguno de ellos.</div> <div> <br /></div> </div>

Cuando un hongo afecta tu vista

¿Usas lentes de contacto? Presta atención: el uso inadecuado de los lentes de contacto o una lesión en el ojo pueden ser causa de l...

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Top 10 Ways to Fail with Multifocal Contacts - 10 Modos en que fallan los Lentes de Contacto Multifocales

<div dir="ltr" style="text-align: left;" trbidi="on"> <span style="font-family: Arial; font-size: xx-small;">.</span><br /> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <img src="https://sites.google.com/a/infolentes.com/info-lentes/_/rsrc/1352508625211/inter/top10waystofailwithmultifocalcontacts-10modosenquefallanloslentesdecontactomultifocales/1.gif" /></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <br /> <b><span style="font-size: xx-small;">Improved stereoacuity is one reason for the increased popularity of multifocal contact lenses, as seen in this patient with a well-fit aspheric multifocal gas permeable lens. </span></b><span style="font-size: xx-small;"><i>Photo: Edward S. Bennett, O.D.</i></span><b><span style="font-size: xx-small;"> </span></b></div> <br style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;" /> <h5 style="background-color: white; font-family: Arial, Verdana, sans-serif;"> <a href="http://www.blogger.com/blogger.g?blogID=3847540156974127949" name="TOC-Try-ignoring-comfort-or-raising-patient-expectations-or-not-even-offering-multifocal-lenses.-That-ll-chase-away-all-those-pesky-presbyopes." style="color: #0066cc; outline: none;"></a>Try ignoring comfort or raising patient expectations—or not even offering multifocal lenses. That’ll chase away all those pesky presbyopes.</h5> <span style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;">By Melanie Denton, O.D.</span><br /> <br style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;" /> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">With 74 million baby boomers born between the years of 1946 and 1964, it comes as no surprise that a great deal of these patients are now looking for presbyopic solutions.¹ </span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">In an ideal world, our patients would love for us to just wave a magic wand and restore the accommodative ability of their crystalline lenses. But instead, we resort to running down the list of their options, each with pros and cons, and letting them choose whatever seems like the best one. The problem is, none of the options are just <i>perfect</i>. Sometimes it seems easier to stop after explaining progressive add lenses, and get them to the optical already. </span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">But now more than ever, technology has advanced to a point where viable options <i>do</i> exist. And with the number of multifocal lens fits increasing more than 136% since 2005, the time to adapt your practice to this growing demographic is now.^2,3</span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">So, how can you incorporate the sometimes challenging and time-consuming task of fitting your presbyopes in multifocal contact lenses (MFCLs)? </span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">Unfortunately, there are many ways to go wrong. Here are some of the most commonly made mistakes (in no particular order)—and ways to circumvent them:</span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <br /></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;"><span style="color: mediumvioletred;"><b><span style="font-size: small;">1. Don’t tell your emerging presbyopes about multifocal lenses.</span></b></span><br />A sure way to guarantee that you won’t fit any multifocal lenses is to never talk about them! And, there’s no question that, by the time you’re done with an exam and explained the options to the patient (for the 10th time that day!), it can be tempting to just the leave out the whole discussion. </span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">I understand: There just seems to be so <i>many</i> things to educate our patients about. Have you ever finished with the exam, dropped the patient off in optical, and then your optician comes back saying, “We’re all done with glasses selection, but he/she would really like a contact lens fitting, too”? How can you remedy that situation? Luckily, there are several ways to plant the idea in the patient’s head long before you’re running down the laundry list of options:</span></div> <ul style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <li><span style="font-family: Arial; font-size: x-small;"><i>Utilize your waiting room.</i> The waiting room is a perfect place to subtly inject the idea of MFCLs into the patient’s psyche. Especially if you have a sub-waiting area. At my practice, we leave the general waiting room mostly free of marketing material, and instead place those materials in the sub-waiting area. Typically, patients are more concerned with filling out paperwork or socializing with other patients when they first arrive.<br /><br />But once they’ve begun their exam, spent some time with our staff, and are dilating, they are (hopefully) in the mode of getting their eye exam. At this point, carefully placed posters, brochures, or even custom-made signage directing patients to ask you about MFCLs work nicely.</span></li> <li><span style="font-family: Arial; font-size: x-small;"><i>Utilize your support staff.</i> Think about it––do your patients spend more time with you, or more time with your staff? There are many ways staff members can let patients know that MFCLs may be an option for them. One example: while the technician enters the patient’s age or chief complaint of “blurred vision at near,” he or she may simply say, “Have you heard that there are contact lenses for that nowadays? Make sure to ask Dr. Denton if you’re a candidate.”</span></li> </ul> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;"><span style="color: mediumvioletred; font-size: small;"><b>2. Don’t address comfort issues!</b></span><br />An estimated 20 to 30 million Americans have early-stage signs or symptoms of dry eye, with the disease being more common in older individuals (45 years and older).⁴ Also, contact lenses have been shown to increase dryness. Silicone hydrogel lenses, preferred because of the health benefits they provide, are also an inherently hydrophobic material. And, despite lens manufacturers’ efforts to create a hydrophilic surface, lenses tend to revert back to being hydrophobic after a few hours of wear.</span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <br /> <span style="font-family: Arial; font-size: x-small;">If we don’t have a discussion with these patients regarding comfort, we risk losing them after they get home and the lenses lose wettability, thus changing the lid interaction with the lens, the stiffness or modulus of the lens, and the comfort. It’s best to make sure the patient knows that comfort might become an issue—and if it does become an issue, what they can do to make lens wear tolerable.</span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">The first variable to consider in keeping a lens comfortable is the contact lens solution. Luckily, there are several good options to enhance patient comfort. Specifically, hydrogen peroxide solutions have produced favorable results for patients with wearing discomfort. This solution seems to work even better if the patient is sensitive to solution preservatives.</span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">Newly released solutions that contain surfactants and increase the wettability of lenses can also be the key to keeping patients comfortable in their lenses for the long term. </span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">It’s also important to educate MFCL patients about appropriate artificial tears. In fact, there are some artificial tears that they will want to avoid, because certain tears can actually affect the lens modulus and alter vision. In general, I like to prescribe tears that contain a natural wetting agent (such as hyaluronic acid) or are preservative-free.</span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <br /></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <br /></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;"><span style="color: mediumvioletred; font-size: small;"><b>3. Allow the patient to expect “perfect” results.</b></span><br />There’s no better way to fail at MFCL fitting than to let patients think that their lenses will do what their crystalline lens used to. </span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">Also, if you don’t take the time to find out what patients spend their time doing, you will very likely miss the mark in fitting their lenses. Possibly the singlemost important step in selecting the right patients for a multifocal fit, and ensuring that they will have success, is letting them know what can be expected from these lenses. </span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">I learned from some very good mentors that this phrase works well: “My goal is to get you through most tasks, most of the time. If you’re looking to settle in with a good book and read for six hours or drive a long way at night, your progressive add lenses will be a better bet. But, if you want to be able to do most things—sit down to dinner and not have to pull out reading glasses, for example—then I can most likely make you happy.”<br />In other words, make sure the bar is so low that they have to trip over it!<br /><b><span style="color: red; font-size: small;"><br /><span style="color: mediumvioletred;">4. Test monocular acuties, and allow the patient to compare acuities monocularly.</span></span></b><br />At least once a week, I encounter a patient who swears he loves his lenses, except one eye is better than the other at near/distance, or both! It reminds me of the old joke: “Doc, it hurts when I do <i>this</i>!” The inevitable punchline: “Well then, stop doing that!” </span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">When fitting MFCLs, test monocular acuities and ensure neither eye is lagging behind. But, above all, emphasize to the patient that the new rule is: Use both eyes at all times! One eye may be skewed toward distance and the other toward near, but they will always perform better together.</span></div> <span style="background-color: white; font-family: Arial; font-size: x-small;"><span style="color: mediumvioletred; font-size: small;"><b>5. Don’t use real-world examples in your exam room.</b></span><br />Remember, you live in a black and white world in your exam room. When the patient leaves, she does not live in a black and white world. Color and contrast needs are extremely variable from patient to patient, and it helps to find out what their specific needs are.<br /></span><br /> <div> <span style="background-color: white; font-family: Arial; font-size: x-small;"><img border="0" src="https://sites.google.com/a/infolentes.com/info-lentes/_/rsrc/1352508625273/inter/top10waystofailwithmultifocalcontacts-10modosenquefallanloslentesdecontactomultifocales/2.gif" /></span><br /> <span style="background-color: white; font-family: Arial; font-size: x-small;"><br /></span> <span style="background-color: white; font-family: Arial; font-size: x-small;"><b><span style="font-size: xx-small;">Use visual aids and images to help better explain multifocal contact lenses to potential patients. </span></b><span style="font-size: xx-small;"><i>Image: Eyeimaginations.</i></span></span><br /> <span style="background-color: white; font-family: Arial; font-size: x-small;"><br /></span> <span style="background-color: white; font-family: Arial; font-size: x-small;"><span style="font-family: Arial; font-size: x-small;">I believe that there’s no substitute for the good ‘ole “college try”—in other words, at least one week of wearing the lenses in their world to see if they are performing well. Often, I preface a patient’s week trial of their lenses by saying, “OK, these are working well in my exam room, but let’s see how they perform in your world. Pay attention to how they are working and we will address any issues when you return.”<br />In addition, keep magazines, phone books, newspapers or other reading materials in the room for some real-world trials. Maybe you could even install a street sign at the end of a long hallway in your office? (Just kidding!)</span><span style="font-family: Arial; font-size: x-small;"><span style="color: mediumvioletred;"><b><span style="font-size: small;">6. Don’t learn about different multifocal options.</span></b></span><br />We all have our go-to lens, but what happens when it just isn’t working? If you don’t know the alternatives, you might inadvertently cause a dropout.</span></span><br /> <span style="background-color: white; font-family: Arial; font-size: x-small;"><span style="font-family: Arial; font-size: x-small;">Soft multifocal lenses are designed using the concept of simultaneous vision. This means that the patient is viewing distance and near images at the same time. When two distinct images fall on the retina concurrently, the patient loses a bit of contrast sensitivity and gains stereopsis. (Which is, by the way, something to mention when comparing these lenses to monovision.) </span></span><br /> <span style="background-color: white; font-family: Arial; font-size: x-small;"><span style="font-family: Arial; font-size: x-small;">There are currently two types of simultaneous vision lens designs: concentric and aspheric. </span></span><br /> <ul><span style="background-color: white; font-family: Arial; font-size: x-small;"> <li><span style="font-family: Arial; font-size: x-small;"><i>Concentric</i> lenses utilize a distance or near optical zone, which makes pupil size and lens centration critical for the fit. These come in distance-centered, near-centered, pupil-intelligent and aspheric-blended varieties. These lenses tend to work best for emerging or early presbyopes with low add powers.</span></li> <li><span style="font-family: Arial; font-size: x-small;"><i>Aspheric</i> designs offer a gradual change in power from the center to the periphery. They have either an anterior surface or posterior surface aspheric design, and they work particularly well for modified monovision.</span></li> </span></ul> <div> <span style="background-color: white; font-family: Arial; font-size: x-small;"><span style="font-family: Arial; font-size: x-small;"><img border="0" src="https://sites.google.com/a/infolentes.com/info-lentes/_/rsrc/1352508625322/inter/top10waystofailwithmultifocalcontacts-10modosenquefallanloslentesdecontactomultifocales/3.gif" /></span></span></div> <span style="background-color: white; font-family: Arial; font-size: x-small;"><span style="font-family: Arial; font-size: x-small;"><br /></span><b><span style="font-size: xx-small;">Soft multifocal lenses are designed for simultaneous vision, in which light rays pass through distance and near zones at the same time. Multifocal lenses are designed with aspheric curves (left) or concentric configurations (middle, right).</span></b></span><br /> <span style="background-color: white; font-family: Arial; font-size: x-small;"><br /></span></div> <span style="background-color: white; font-family: Arial; font-size: x-small;"> </span><br /> <span style="background-color: white; font-family: Arial; font-size: x-small;">The availability of two lenses of similar design having different power gradients provides the ability to overcome problems related to poor contrast sensitivity. Poor contrast sensitivity (as opposed to improper lens power) may be the indication for a particularly sensitive patient’s inability to achieve satisfactory distance vision.<br /><span style="color: mediumvioletred;"><b><span style="font-size: small;"><br />7. Don’t be selective—try MFCLs on everyone!</span></b></span><br />Before you travel down the MFCL road, be sure to know the patient’s expectations. As I said before, they work for “most patients most of the time.” But certain presbyopes may suffer from severe dry eye, work in a meticulous environment that requires perfect vision and contrast sensitivity, or just may not be good candidates for various other reasons. </span><span style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"></span><br /> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">There’s no substitute for getting to know your patients’ needs and expectations. Do this with face-to-face time or a simple questionnaire to facilitate quicker screening.</span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <br /></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <br /> <span style="font-family: Arial; font-size: x-small;"><span style="color: mediumvioletred;"><b><span style="font-size: small;">8. Don’t over-refract.</span></b></span><br />As great as it would be if we could empirically select a lens and achieve visual perfection right off the bat, it is almost always necessary to implement some sort of over-refraction. I find that using the phoropter for these situations is not the most effective strategy. Nor is pulling out your entire trial lens set from optometry school and ending up with 50 loose lenses strewn about. </span></div> <span style="background-color: white; font-family: Arial; font-size: x-small;">Use simple flipper bars, purchased or acquired from various contact lens manufacturers, and perform quick trials for the patient by using real-world materials rather than black-on-white charts. Remember, we’re trying to get the patient away from focusing on these charts. Sure, I want the patient to be 20/20, but sometimes as long as they’re 20/Happy (and meeting minimum visual acuity requirements, of course), then I’ve done my job.<br /></span><br /> <div> <span style="background-color: white; font-family: Arial; font-size: x-small;"><img border="0" src="https://sites.google.com/a/infolentes.com/info-lentes/_/rsrc/1352508625367/inter/top10waystofailwithmultifocalcontacts-10modosenquefallanloslentesdecontactomultifocales/4.gif" /></span><br /> <span style="background-color: white; font-family: Arial; font-size: x-small;"><br /></span> <span style="background-color: white; font-family: Arial; font-size: x-small;"><span style="color: black; font-family: Arial; font-size: x-small;"><b><span style="font-size: small;"><span style="font-size: xx-small;">Make sure the fit is legit. This patient’s multifocal RGP, which sat nasally on the right eye, was fitting too tightly. Notice the indentation of the lens on the temporal cornea after its removal. </span></span></b><span style="font-size: small;"><span style="font-size: xx-small;"><i>Photo: Mile Brujic, O.D.<br /></i></span></span></span></span></div> <span style="background-color: white; font-family: Arial; font-size: x-small;"> </span><br /> <span style="background-color: white; font-family: Arial; font-size: x-small;"><b><span style="color: mediumvioletred; font-size: small;">9. Don’t be proactive.</span></b><br />As with just about everything, it’s up to you to ensure that you build a successful multifocal lens practice. Discuss the idea of contact lenses and offer the patient a quick trial of contacts to use in-office while picking out glasses. Once the lenses are in, and the patient sees how comfortable they are and how much more clearly they can see, you’ve planted the idea of contact lenses. </span><span style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"></span><br /> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;">Then, remove the lenses before they leave, and give them the option of scheduling a fitting.</span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;"><b><span style="color: mediumvioletred; font-size: small;">10. Do it all yourself.</span></b><br />Make sure your team knows your goals in establishing your practice as the place to go for clear vision at all distances without relying on glasses. Get them excited about it by fitting your presbyopic employees and let them sing your praises. Designate your contact lens technician to do simple trial lens over-refractions when possible.</span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: x-small;"><br />Successfully fitting multifocal lenses is a big practice-builder and has the potential to generate patient referrals—while giving patients real solutions without having to leave your practice. </span></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <i><span style="font-family: Arial; font-size: x-small;">Dr. Denton is in private practice in Burnsville, N.C. She is a fellow of the American Academy of Optometry, an executive board member of the Ocular Surface Society of Optometry, and director of mentorship for Women of Vision.</span></i></div> <div style="background-color: white; font-family: Arial, Verdana, sans-serif; font-size: 13px;"> <span style="font-family: Arial; font-size: xx-small;">1. U.S. Census Bureau. U.S. Interim Projections by Age, Sex, Race, and Hispanic Origin: 2000-2050. Available at: <a href="http://www.census.gov/population/www/projections/usinterimproj" rel="nofollow" style="color: #471264; outline: none;" target="_blank">www.census.gov/population/www/projections/usinterimproj</a>. Accessed September 2011.<br />2. inVentiv Advance Insights Contact Lens Report. Data ending December 2010.<br />3. Cleveland Research Company. 2009. Third Quarter 2009 Contact Lens Research Summary. Press Release.<br />4. Moss SE, Klein R, Klein BE. Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol. 2000 Sep;118(9):1264-8.</span></div> </div>

Top 10 Ways to Fail with Multifocal Contacts - 10 Modos en que fallan los Lentes de Contacto Multifocales

. Improved stereoacuity is one reason for the increased popularity of multifocal contact lenses, as seen in this patient with a well-f...

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