Fitting Guide for Hard and Soft Contact Lenses

Fast versus gradual adaptation of soft daily disposable contact lenses in neophyte wearers

“…Efron (2018) [4] Soft CL wearers should initially start with 4 hours and increase by 2 hours each day to 12 hours of wear per day (maximum).…”

“…[1] The practice of constraining these initial wear times has been advocated by various authors in many of the key texts still used to train new ECPs (Table 1). [2][3][4][5][6][7][8] Typical proposed wear schedules vary from 2-4 hours on the first day followed by incremental increases of 1-2 hours daily until a maximum recommended wear time is achieved. A recent web-based survey of 186 ECPs from 26 countries gathered data on how silicone-hydrogel (daily disposable and re-useable) lenses were prescribed over the first week of wear [1] and found that there was no significant difference in how these two modalities were managed and that the majority of respondents advised wearing the lenses for 2-4 hours on the first day and gradually building-up to 'as long as comfortable' by the end of the first week.…”

The Size, Location, and Clinical Severity of Corneal Infiltrative Events Associated With Contact Lens Wear

“…The two classic techniques used to clean contact lenses with solutions are 1) to place the lens on the palm of one hand and rub the lens in a circular motion with the index finger of the other hand, and 2) to rub the lens between the index finger and thumb. 27 In both cases, there is a tendency for the cleaning effect to be concentrated toward the center of the lens, which leads to a higher concentration of deposits such as denatured proteins in the lens periphery compared with the more thoroughly cleaned lens center. 28 Lens deposits can compromise corneal integrity in a number of ways such as having a direct mechanical effect; harboring environmental antigens and causing an immunologic reaction in the adjacent cornea; or harboring microorganisms and inducing an infection in the underlying cornea.…”

Corneal infiltrative events

“…39 In both cases, there is a tendency for the cleaning effect to be concentrated towards the centre of the lens, which leads to a higher concentration of deposits, such as denatured proteins, in the lens periphery compared to the more thoroughly-cleaned lens centre. 40 Lens deposits can compromise corneal integrity in a number of ways, such as the following: direct mechanical whereas Lam et al 16 and Stapleton et al 18 surveyed both ophthalmologists and optometrists.…”