Dilemma

[Tina Sweetland]

What a can of worms..when I first worn hard lenses (back in 1976) perspex were the only things on the market. KC was diagnosed 5 years later and I continued to wear perspex until about 10 years ago. (during the later years holes were drilled in them to let air through) and I was told that I should not wear them for one day a week..really useful when you can only see to the end of your nose (an d glasses aren't an option)....gas perms were then tried .... and they appeared to dry out between blinking...I'm one of those people who doesn't blink very often...and so I do get a build up at 9 o'clock and 3 o'clock..I've also been told that my eyes are naturally really greasy.
I think (but now I'm reall not sure) that my lenses are primarily Perspex...but that they are a bit kinder that the original PMMA lenses....but since Feb 05..every pair that the specialist has fitted gets greasy..and I mean greasy...I can clean them overnight in bleach (he told me to do this) and then rinse and clean in protien cleaner..and by the time I've blinked 5 times they are TOTALLY greasy (like a winscreen smeared with oil) ....so something is going on.....I assumed it was the lenses but now wonder ....maybe I need him to refer me back to the consultant at the Hospital?..I just want a new pair of lenses that I can see out of (and wear for 12 hours a day)...ok...really I want the best of both worlds......don't we all?

[rosemary johnson]

Ali's comment were only for conreal lenses not sclerals:
And I've never worn corneal lenses, so have no experience of them.

In terms of the comfort/fit/vision balance - yeah, well, I apparently throw over all the text books on this!
From y point of view - and they are my eyes! - something that feels comfy if I sit and stare blankly and mindlessly ainto the middle distance, but which I can't see to read out of without screwing my eyes up completely are No Bloody Good! - because screwing the eyes up like that makes the lenses hurt in no time, and I'm better off without the things. And that what ought in theory not to be comfortable is far more comfortable in practice if i can read out of it without having to screw my eyes up.
And I'm talking sclerals here, of course.......
Other people's mileage may vary, of course - it's them who have to live with their eyes.
Rosemary

[rosemary johnson]

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.

Does that really work out well?? - because (at least with sclerals) the different physical nature of the materials means the fit has to be slightly different for RGP and PMMA lenses. SO if you go and try a lens in PMMA, it may feel fine, but a lens the same shape in RGP may well not - and vice versa.
I know (IIRR) Ken's fitting set are made of PMMA, but those are only used to test the fit in terms of clearance, tear flow etc not for you to see how it goes, as it were.
Maybe corneals are different??
Rosemary

[GarethB]

Rosemary,

When I had my lens problems before Christmas, te lens rotation could not be determined because a dot was not on my RGP.

A PMMA lens was made with the same prescription as the RGP and I could not feel a difference comfort wise. As for vision it was just as bad, but with a dot on the lens we could see where the lens turned to.

The hospital now has a PMMA equivelant to my RGP and since sorting the lens problem thta came down to corneal lubrication and hydration I have never been able to tell the difference between the two.

Never worn a PMMA lens for more than four hours so can not say what differenc I would feel beyond that.

[Ali Akay]

Tina,
I am really not sure about using bleach to clean your lenses.Are you using neat bleach overnight? Your lenses would certainly be very well disinfected, but I wonder if the bleach is actually damaging the plastic and making greasing worse? I am sure you rinse them extremely well before wearing!

I know greasing can be a pain and your greasy tears wont help! There are a number of lens related characteristics that would make matters worse:
1.Silicone added to most RGP materials in different ratios is inherently hydrophobic ie it doesnt wet, hence materials with high silicone content tend to be less wettable and hence more prone to greasing. There is a vast range of materials on the market and would certainly be worth trying alternative RGPs.
2.Quality of the lens surface could make a big difference. One good thing about PMMA is that it polishes easily to a very good shine which discourages greasing.RGP materials are more delicate, and need more care during manufacturing.surface quality could be easily damaged if the plastic overheats, etc.and it takes a good technician to make a good RGP lens.Unfortunately you have no control over this as your practitioner decides where to order the lenses from!
3.Cleaning/disinfection regime could make a big difference.As I've already said I have reservations about using bleach.One of the things I find could help with greasing is cleaning the lenses in the morning with Miraflow,rinse it off, and insert with your usual wetting solution.worth a try.
4.Has your optician looked under your eyelids? You may have an allergic reaction which could become a vicious circle- deposits on the lenses irritate your lids which in turn secrete mucus which sticks to the lens and causes more ittitation and it goes on like that!
5.If you are a poor blinker this is something you can improve,sounds silly, but try to look away from your work and have a good blink every so often!

[Tina Sweetland]

Ali

Thanks for this. It was the specialist that advised me to use neat milton bleach about once a month overnight. I think the reason behind this was because I got (and I think my memory serves me right?) I get build up of calcium(I think) on my lenses.....I do clean lenses daily, use protein cleaner once a week and had started to use the solution you suggest (miraflow?..forgotten how to spell it) but that solution appears to react (probably with my eyes?)and I find the Amo Total Care range the best at the moment.....the specialist (sorry I don't know his exact qualifications) has checked the insides of my eyelids.....and nope...nothing.....but a good call......I think that I've always been lucky in that my eyes have been really robust and relitively (god..now I really can't spell) stable...and now (30 years on) I am starting to struggle with my eyes...and I'm not used to it. Reading about others conditions just makes me realise how lucky I am...but I still want to be able to see..and so am keen to try and find a solution. I initially was a hospital patient and then got outsourced to the specialist...maybe I need to ask whether the local eye hospital will give their opition? It's just been 14 months of continually not being able to get a newer pair of lenses. And I now don't have a spare set. So getting slightly critical...but seriously....I'm really grateful for your thoughts......

[Ali Akay]

Tina
If greasing has started being an issue since you were transferred to the community optometrist,it would be worth investigating the lens material they are using.Some high oxygen transmission materials can be problematic.If you were getting on better with lenses supplied from the hospital,worth making some inquiries to see how different your current lenses are from the previous ones.Still not sure about the merit (or otherwise) of using milton,excellent disinfectant, but not sure if helping with greasing.please be very careful about rinsing it off very well, I personally would be very wary about recommending to anyone as I dont fancy being sued if a patient suffers a chemical burn after inserting a lens which hasnt been rinsed properly!

[Sweet]

Hhmm i think that i would be totally reluctant to use bleach to clean my lenses as well, sclerals or otherwise!!! I do need to look into protein removal tablets though as after a bad time with them last summer i have given up!

I do love Miraflow though as it feels like it is doing some good and is easy to rinse off. Recently though i have heard rumours that there is a national shortage? But as i switch periodically i am now back using Boston.

Hoping that you can sort this out soon, Sweet X x X

[John Smith]

Yes, the postoptics site can't get hold of Miraflow at the moment, and won't get any until the summer.

Is anyone else suffering from the lack of this cleaner?

[Tina Sweetland]

My speciailst has ordered a batch as he's heard rumours that it's being withdrawn from the market.

And don't worry Ali...I do rinse my lenses REALLY throughly after using milton.....I wouldn't want to put any horrible solution into my poor eyes.....
I hoefully will see my specialist this week...I'll let you know how I get on