YIIIKES,
BusyLizzy
Dilemma
Moderators: Anne Klepacz, John Smith, Sweet
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Lynn White
- Optometrist
- Posts: 1398
- Joined: Sat 12 Mar 2005 8:00 pm
- Location: Leighton Buzzard
hehe...
Ali is right here... PMMA has its advantages but being healthy for the cornea is actually not one of them.
I saw a patient recently who had worn PMMA lenses for years and seemed to have bullied previous optoms to keep wearing them. (Yes there ARE agressive patients out there lol) One of the reasons patients like them (and I am talking corneal lenses here not sclerals) is that they don't break as easily as RGP's and don't grease up as much.
The patient reported no problems and total comfort. However, when looked at with a slit lamp his eyes were a mess and he was well on the way to having serious problems. He also could not see through glasses after removal of lenses because of the "spectacle blur" you get with PMMA caused by corneal swelling.
A few weeks after refitting with RGP's the eyes were clear again and he could now see through his glasses. He was, however, complaining that he felt things get under his lenses now (like dust etc)!!
GOOD!!! I said, thats exactly what we want!
Its hard to comment without seeing your eyes and lenses . Actually its interesting that when I first started to wear soft lenses a good many years ago, I had multiple allergic reactions which were also put down to allergy to the materials. However, time has proven this not to be so - the allergies were all due to other factors including solutions and as Ali says, my own protein build up.
Lynn
Ali is right here... PMMA has its advantages but being healthy for the cornea is actually not one of them.
I saw a patient recently who had worn PMMA lenses for years and seemed to have bullied previous optoms to keep wearing them. (Yes there ARE agressive patients out there lol) One of the reasons patients like them (and I am talking corneal lenses here not sclerals) is that they don't break as easily as RGP's and don't grease up as much.
The patient reported no problems and total comfort. However, when looked at with a slit lamp his eyes were a mess and he was well on the way to having serious problems. He also could not see through glasses after removal of lenses because of the "spectacle blur" you get with PMMA caused by corneal swelling.
A few weeks after refitting with RGP's the eyes were clear again and he could now see through his glasses. He was, however, complaining that he felt things get under his lenses now (like dust etc)!!
GOOD!!! I said, thats exactly what we want!
Its hard to comment without seeing your eyes and lenses . Actually its interesting that when I first started to wear soft lenses a good many years ago, I had multiple allergic reactions which were also put down to allergy to the materials. However, time has proven this not to be so - the allergies were all due to other factors including solutions and as Ali says, my own protein build up.
Lynn
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GarethB
- Ambassador
- Posts: 4916
- Joined: Sat 21 Aug 2004 3:31 pm
- Keratoconus: Yes, I have KC
- Vision: Graft(s) and contact lenses
- Location: Warwickshire
My optom uses PMMA but only where getting the correct lens fit is hard. This is because it is cheaper and quicker for them to get lenses made out of this. You get the lenses to tryout for a short time and report back.
If all is well, you get the RGP lens in the same dimensions as the trial PMMA lens. If not, they try something different. That way you and the hospital are not paying for loads of costly lenses based on this might work.
If all is well, you get the RGP lens in the same dimensions as the trial PMMA lens. If not, they try something different. That way you and the hospital are not paying for loads of costly lenses based on this might work.
Gareth
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Andrew MacLean
- Moderator
- Posts: 7703
- Joined: Thu 15 Jan 2004 8:01 pm
- Keratoconus: Yes, I have KC
- Vision: Other
- Location: Scotland
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Andrew MacLean
- Moderator
- Posts: 7703
- Joined: Thu 15 Jan 2004 8:01 pm
- Keratoconus: Yes, I have KC
- Vision: Other
- Location: Scotland
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Lynn White
- Optometrist
- Posts: 1398
- Joined: Sat 12 Mar 2005 8:00 pm
- Location: Leighton Buzzard
Ahhh Andrew...
I didn't say ME!! I said had bullied their previous optoms!
If a patient starts insisting they know best despite long explanations then I politely ask them to find another practitioner.
This does not mean I do not discuss options and listen to patients but in particular cases like this, where we are discussing PMMA and I (and Ali for that matter) have had years of experience of the damage they can do when not monitored adequately and the professional knowledge to back this up, I feel justified in being firm.
As for using PMMA as a trial lens - this is absolutely no problem and a great idea when you want a quick and cheap option to try out new paramters in a fit. But for actual wear, they can create more problems than they solve.
Lynn[/u]
I didn't say ME!! I said had bullied their previous optoms!
If a patient starts insisting they know best despite long explanations then I politely ask them to find another practitioner.
This does not mean I do not discuss options and listen to patients but in particular cases like this, where we are discussing PMMA and I (and Ali for that matter) have had years of experience of the damage they can do when not monitored adequately and the professional knowledge to back this up, I feel justified in being firm.
As for using PMMA as a trial lens - this is absolutely no problem and a great idea when you want a quick and cheap option to try out new paramters in a fit. But for actual wear, they can create more problems than they solve.
Lynn[/u]
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Ali Akay
- Optometrist
- Posts: 201
- Joined: Thu 09 Jun 2005 9:50 pm
- Keratoconus: No, I don't suffer from KC
- Vision: I don't have KC
- Location: Hertfordshire, UK
Gareth
This is a good idea and some labs make their trial sets in PMMA, but the difference in the lab cost between PMMA and RGP is actually not much (a few pounds per lens).My worry would be for patient to wear PMMA on long term in error which could happen as a result of poor communication, etc.Unless offcourse your practitioner has an arrangement with the lab to supply PMMA trial lenses at greatly reduced prices.Interestingly I know one lab that charges more for PMMA than RGP as they regard it as a one-off!
This is a good idea and some labs make their trial sets in PMMA, but the difference in the lab cost between PMMA and RGP is actually not much (a few pounds per lens).My worry would be for patient to wear PMMA on long term in error which could happen as a result of poor communication, etc.Unless offcourse your practitioner has an arrangement with the lab to supply PMMA trial lenses at greatly reduced prices.Interestingly I know one lab that charges more for PMMA than RGP as they regard it as a one-off!
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GarethB
- Ambassador
- Posts: 4916
- Joined: Sat 21 Aug 2004 3:31 pm
- Keratoconus: Yes, I have KC
- Vision: Graft(s) and contact lenses
- Location: Warwickshire
Ali,
I think the hospital I go to must get PMMA lenses much reduced as they said it was a significant price differance.
Hopsitals, like any other business probably have their preffed suppliers that give the service they want and the reduced rates to encourage the hospuital to keep using them.
It would be easier for a large hospital eye unit to get a larger discount say than you or Lynn as you have a smaller practice and possibly you see fewer patient needing specialist lens care.
I think the hospital I go to must get PMMA lenses much reduced as they said it was a significant price differance.
Hopsitals, like any other business probably have their preffed suppliers that give the service they want and the reduced rates to encourage the hospuital to keep using them.
It would be easier for a large hospital eye unit to get a larger discount say than you or Lynn as you have a smaller practice and possibly you see fewer patient needing specialist lens care.
Gareth
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