I would never recommend Focus Dailies as a bandage lens. For one, they
are not approved for overnight wear. Another reason is that the oxygen
permeability is such that significant corneal swelling will occur.
Corneal swelling would be undesirable in this situation as it can lead
to further epithelial problems.

DrG
http://www.coppellfamilyeyecare.com

I used a Focus Night and Day plano lens after laser surgery. I
switched to Focus Dailies with the doctors permission. The Dailies
have a half diopter but to me that's no different from the plano lens.
I like that I can put the Daily lens in in the morning and toss it
out in the afternoon. For your situation, you could try Focus
Dailies at night. I could never get used to cleaning soft lenses.
Single use lenses solves the problem.

Thank you for your reply, Dr. Leukoma.

The only thing I have tried thus far is to remove them, rinse with
Unisol preservative-free saline, and reinsert. I have not rubbed them
with anything, including the saline. I have used GenTeal drops a few
times in my eyes while the lenses were in, which is something my doctor
suggested. No antibiotic, and no ointments.

One thing I really like about these N&D lenses is that they are so easy
to handle compared to the Accuvue I used previously for normal social
contact lens wear. That lens was much thinner and would always flip
inside out.

Doctors have different strategies in dealing with erosions. Mine i
t
remove the lens as soon as the erosion is healed, and then switch th
patient to a hypertonic petrolatum ointment such as Muro 128 at nigh
for prophylaxis. Perhaps your doctor has seen similar or bette
results using the therapeutic lens for a longer period of time

However, if the lens is fogging, then it does need to be removed fo
cleaning. This should not pose any risk whatsoever, so long as th
defect has closed, which usually only takes a few days to occur
Cleaning may be as basic as rubbing and rinsing the lens wit
non-preserved saline, or a 6 hour soak in a hydrogen peroxide-base
system such as Clear Care -- which is currently difficult to fin
because of a temporary suspension in manufacturing. But, there ar
other brands out there

In some cases, a therapeutic lens can actually improve the vision i
cases of map dot-fingerprint dystrophy, simply by creating a smoothe
refracting surface over the lakes and islands of epithelium

Dr
http://www.coppellfamilyeyecare.co

What, if anything, have you tried? The only type of cleaning I do is
to rub my lens with saline, followed by a hydrogen peroxide
disinfection overnight. Research has shown that most micro-organisms
are removed from the lens surface by rubbing and rinsing. Disinfection
takes care of the rest. Please observe that I have used the word 'rub'
several times without the word 'no' in front of it.

Of course, we don't really know what type of deposit is on the surface
of your lens, and whether or not it can be removed so easily. Are you
using an antibiotic along with the the therapeutic lens?

DrG

Thank you for your reply, Dr. Leukoma.

My doctor tried putting me on Muro 128 ointment at night several months
ago with a previous erosion episode. Unfortunately, the Muro only
exacerbated the problem, causing my eye to swell up to the point where
it could barely be opened at all. We tried the Muro several times,
always with the same result. It seems I have an atypical reaction to
the Muro. That is one reason my doctor went to the lenses instead. We
had just been through four months of various topical treatments, none
of which kept the erosions from recurring.

To clarify, to restore the clarity of the lenses, is it acceptable to
remove the Night & Day lenses and merely rinse them with unpreserved
saline and reinsert? Or, do they need something beyond just saline?

Doctors have different strategies in dealing with erosions. Mine is to
remove the lens as soon as the erosion is healed, and then switch the
patient to a hypertonic petrolatum ointment such as Muro 128 at night
for prophylaxis. Perhaps your doctor has seen similar or better
results using the therapeutic lens for a longer period of time.

However, if the lens is fogging, then it does need to be removed for
cleaning. This should not pose any risk whatsoever, so long as the
defect has closed, which usually only takes a few days to occur.
Cleaning may be as basic as rubbing and rinsing the lens with
non-preserved saline, or a 6 hour soak in a hydrogen peroxide-based
system such as Clear Care -- which is currently difficult to find
because of a temporary suspension in manufacturing. But, there are
other brands out there.

In some cases, a therapeutic lens can actually improve the vision in
cases of map dot-fingerprint dystrophy, simply by creating a smoother
refracting surface over the lakes and islands of epithelium.

DrG
http://www.coppellfamilyeyecare.com

Yes, the problem is a combination of swelling while the eye is shut and
the drying out of the tear layer, so the cells in the erosion area
stick to the back of the lid, and as you open your eye, it will tear
some tissue away. You can use a lubricant like lacrilube if you feel
you are going to nap and are not near your lenses.

dr grant

Jan, thank you for your reply.

The reason for switching from the Accuvue Advantage is because they
start at a half power and are not available in plano. Because I was
told to wear them 24/7---including during the day when I wear
progressive eyeglasses---my vision was overcorrected at all distances
and I could not see clearly enough to read, type, etc.

If I end up wearing the contacts only at night, then the half power
would not be a drawback for me. I will check back with my corneal
specialist to inquire about wearing them only at night.

Many Thanks

Thank you for your reply, Dr. Grant.

I will ask my doctor about night only wear. That makes sense to me.
That way I could keep wearing my eyeglasses only during the day and
switch to the contact lenses just before bedtime.

For your patients who are on a night only wear schedule, could erosions
occur from, say, an afternoon nap of a couple of hours, or dozing off
during a long airplane flight?

Many Thanks