Thanks for all the great input from everyone. It was really helpful.
Things are great here in the Grove... I think Pacific is a great
school for the most part. Yeah, opt school still takes four years. It
seems like they keep having to cram more and more into the same amount
of time though. I guess that's bound to happen, as we get more
priveledges and technology advances.

acemanvx[at]yahoo.com wrote:
- quote -

You don't see any because you aren't a doctor. I believe that the
*optometry student* was interested more in the brand than a normal
distribution of refractive error.

DrG

Hello, it appears that anywhere from -1.5 to -4 is the most commonly
pescribed. The fact begs is about 2/3 of myopes are in that range. Very
low myopes dont really need correction so they dont wear glasses nor
contacts. Theres alot less high myopes so you dont see too many -6s and
beyond.

zurc2800[at]pacificu.edu wrote:
- quote -

In my practice:

#1 = Oasys

#2 = Oasys

#3 = Oasys

#4 = Proclear/BMXC, Focus N&D, Purevision

DrG

On 29 Jun 2006 14:16:34 -0700, "CatmanX" <drgrant[at]ozemail.com.auwrote:

- quote -

*Talking from a patient's perspective here:

Because patients find them very comfortable, provide excellent vision,
and they are widely available. Extended contact lens "abusers" like
them because they eye generally remains comfortable up until the point
CLARE or bacterial keratitis kicks in. Patients generally don't like
lenses that "tell" or "remind" them that they are abusing themselves.

Also, some patients are extremely cost conscious. When I have tried
different contact lenses in the past to try and keep him up with
modern technology and contact lens advancements, his first question is
always whether these lenses can be obtained at CostCo. This same
patient just last week that to stick with his Acuvue2 over Oasys
because of the $5-$10/box difference. I thoroughly educated him about
the advantages of silicone hydrogel contacts, but he is motivated
primarily by price rather than what is best for his eyes. I moved him
to Advance a couple years ago, but he went back to Acuvue2 the
following year because they were $5/box cheaper at CostCo.

He wears the lenses on a daily wear basis (albeit stretching them out
to last about 3 weeks against my recommendations) and has no obvious
contact lens related complications, so ethically it would not be right
for me to insist he wears what is best rather than what which is
adequate.

*Talking from an OD's perspective here:

I think Acuvue were great lenses for the time, just like gentamicin
was great at the time for bacterial keratitis. Now, it is old,
outdated and deprecated technology. For me, Acuvue (and other
standard HEMA disposable SCLs) are never a first choice, but rather
one of the last choices.

Prior to silicone hydrogels, ODs just "accepted" a certain amount of
microcystic edema and limbal neovascularization. In 6/2006, there is
almost never a reason to put up with those contact lens related
problems.

- quote -

Likwise, I prefer to prescribe silicone hydrogels as much as possible.
For essentially spherical patients, I tend to prescribe CibaVision's
Focus Night & Day for people who insist on wearing the lenses between
7 and 30 days of EW. For <7d of EW, I tend to use Ciba's O2Optix and
Acuvue's Oasys (I like these lenses but the 8.4 BC limits my use to
steeper corneas). For daily wear, I use a mix of O2Optix, Advance and
Oasys. I used PureVision a lot in the past, but I stopped using them
during the period they were off the US market and never started up
again once they came back (that and the fact that my B&L rep is a
major flake).

And daily disposables have a good place for selected patients.

- quote -

Certainly.

I generally stick to a certain core group of lenses so I can be
thoroughly familiar with them -- know how they work, feel,
complications, idiosyncracies, etc.

And I don't do a lot of experimentation, unless a certain type of
contact lenses promises real benefits.

There were a lot of soft contact lens materials that made a lot of
promises (in between HEMA and silicon hydrogels), but I think the only
one that really lived up to the promises were the Proclears.

I hate acuvues with a passion. Can't understand why anyone would use
them. Advance are certainly an improvement. I use primarily PureVision
and dailies in my practice these days.

Most optoms stick to a certain brand they are comfortable with, and
particularly chain stores are more likely to push or offer only a small
range of lenses so the optoms don't have a choice.

dr grant

I'll echo dr frank.

- quote -

I believe that's mostly because of marketing by commercial opticals and
the pre- silicone hydrogel mass marketing of two week disposable
lenses. J&J did a great promo job. And it's actually a good lens for
what it is, compared. Among private practitioners, at least......
- quote -

Likewise. Purevision in toric and multifocal is the only player in that
catagory, at the moment. I no longer fit "standard" HEMMA plastics.
- quote -

Proclear is also my other primary soft lens of choice.
- quote -

I would disagree, at least in my neighborhood. Our colleagues are a
little slow in adopting new designs, especially multifocals and to a
lesser extent, torics. But you asked about spherical.
- quote -

4 years? I STILL takes that long to become an OD eye doc? ;-0)

LB, O.D.

zurc2800[at]pacificu.edu wrote:
- quote -


How's Forest Grove these days ( you must be doing an externship
this summer)?

If you're asking the actual statistics on the most commonly
rx'ed cl's it is likely the acuvues.

Silicone hydrogels are really taking over; I'm fitting these for both
refit and new fit patients. My top choices are the 02 optix and
night and days but I do fit many Pure Vision as well.

Among the non-silicone lenses, my top choices are the proclears
and the vertex/encores.

I don't see any reluctance among my colleagues in fitting
new materials in the U.S. versus our European counterparts.
But you have to separate the hype versus the actual
performance, whether new cl materials or new medications,
on the market.

Best of luck in your 4th yr at Pacific.

frank

i believe (could be wrong) that Acuvue 2 is still the #1 brand of
contact lenses sold in the US. but it is rapidly losing market share
to the newer competitively-priced silicone hydrogel (sihy) lenses (AV
Advance, 02 Optix, etc.)

i believe there is almost no reluctance on the part of doctors to
switch their patients to sihy lenses. they are clearly better.

aside from any input from the patient (habitual lenses, brand
preference based upon their previous experiences, etc.) i guess my
favorite spherical disposable lens is 02 Optix.

i can't say much about European fitting practices vs. american. i just
don't know.

===============
zurc2800[at]pacificu.edu wrote:
- quote -

Hello everybody,
I am a third year Optometry student at Pacific University. In clinic
today, my attending doctor gave my group an assigmnet so we could get a
better feel for what's being used out there in terms of soft CL's.
Instead of going around and asking professors (like everyone else,) I
thought I'd get on here and ask some of you out there in the real
world. Which lenses do you prefer to use on a typical young, roughly
spherical patient? Have you noticed much reluctance for docs to move
to new materials like silicone hydrogel and wearing schedules (rather
than the old 2 wk?) I've heard that the Europeans have been much more
likely to adopt new modalities than their American counterparts.
Thanks a bunch,
-Levi Z.