contact lens - pdf4pro
TRANSCRIPT
4th
ed
itio
nContact lens
Clinical Pocket Guide
The Association of Optometric Contact Lens Educators (AOCLE) is a non-profit organization committed to fostering the highest levels of education in the areas of cornea and contact lenses and supporting the faculty in these areas at each of the North American schools and colleges of optometry.
For more information and an electronic version of this pocket guide, consult our website at; www.aocle.org
Copyright © 2012 AOCLE. All rights reserved.
1
Table of Contents
General CL InfoKey questions ...................................................................... 2CL-related red eye questions ................................................ 2Conversion charts ................................................................ 3 ICD codes ........................................................................... 6Tear film evaluation ............................................................. 8CL solution sampling guidelines ............................................ 9Bottle size (lubricants, gels, lid hygiene) .............................. 10Ophthalmic dyes ............................................................... 12
Soft LensesSoft lens assessment ............................................................ 13Soft lens ID / markings ........................................................ 14Soft lens replacement schedules ........................................... 16 Silicone hydrogels .............................................................. 18Daily disposables ............................................................... 20Soft multifocals ................................................................... 22Soft lens care ..................................................................... 24
GP LensesGP design .......................................................................... 26 GP materials ...................................................................... 28Specialty lenses ................................................................... 30GP lens care ...................................................................... 35
Useful Websites ............................................................ 36
2
• ChiefComplaint:– Whicheyeisaffected?– Howlonghastheproblem
existed?– Arethesymptomsworse,
betterorthesame?– Istheredischarge?Describe.– Istheeyered?– Istherepain?Ratepainon
ascalefrom1to10,10beingtheworst.
– Istheeyesensitivetolight?– Hastherebeenachange
invision?– Haveyouhad(orbeen
aroundsomeonewith)acoldorflu?
– Haveyouselftreated?
• Doyouwearcontacts?– Whattype/brand?– Whatisyourwearingtime?– Howoldisthecurrentpair
oflenses?– Howoftendoyousleep/nap
inyourlenses?– Howoftendoyouthrowout
yourlenses?– Whatkindofcontactlens
solutiondoyouuse?– Whendidyoulastchange
yourlenscase?– Doyouuselensesfor
orthokeratology?
• Otherconsiderations– Allergies(medicine/
environment)– Biomicroscopy/Staining– LidsandLashes– Conjunctiva
– Injection(localized,circumlimbal)
– Cornea– Infiltrate(location,
size)– Edema
– A/CReaction– Previousoccurence– Recenttravel
CLrelatedredeyequestions
KeyQuestions
• Howareyoudoingwithyourcontactlenses?(comfort,visionatdistance-near)• Doyouseewellwithyourlenses?• Howlonghaveyouwornyourlensestoday&onaverage?• Howoldisthispairoflenses?• Whatcaresystemdoyouuseandhowdoyouuseit?Howlonghaveyoubeenonthissolution?• Whendidyoulastreplaceyourcontactlenscase?• Doyouexperienceanyocularredness,irritation,drying,itchingordiscomfort?Ifyes,afterhow
manyhoursofcontactlenswear?• Doyousleepornapinyourlenses?Howlong?Wouldyouliketo?• Areyouinterestedintoric/multifocal/1-daylenses?• Doyouhaveanyquestionsaboutyourcontactlenses?
3
VertexDistanceConversionTable
SpectacleLens PlusLens MinusLens SpectacleLens PlusLens MinusLens
4.00 +4.25 -3.87 9.25 +10.37 -8.37
4.25 +4.50 -4.00 9.50 +10.75 -8.50
4.50 +4.75 -4.25 10.00 +11.37 -8.87
4.75 +5.00 -4.50 10.50 +12.00 -9.37
5.00 +5.25 -4.75 11.00 +12.75 -9.75
5.25 +5.62 -5.00 11.50 +13.37 -10.12
5.50 +5.87 -5.12 12.00 +14.00 -10.50
5.75 +6.12 -5.37 12.50 +14.75 -10.87
6.00 +6.50 -5.62 13.00 +15.50 -11.25
6.25 +6.75 -5.75 13.50 +16.12 -11.62
6.50 +7.00 -6.00 14.00 +16.75 -12.00
6.75 +7.37 -6.25 14.50 +17.50 -12.37
7.00 +7.62 -6.50 15.00 +18.25 -12.75
7.25 +8.00 -6.62 15.50 +19.00 -13.00
7.50 +8.25 -6.87 16.00 +19.75 -13.50
7.75 +8.50 -7.12 16.50 +20.50 -13.75
8.00 +8.87 -7.25 17.00 +21.50 -14.12
8.25 +9.12 -7.50 17.50 +22.25 -14.50
8.50 +9.50 -7.75 18.00 +23.00 -14.75
8.75 +9.75 -7.87 18.50 +23.75 -15.12
9.00 +10.12 -8.12 19.00 +24.75 -15.50
For12mmvertexdistance Fcl=Fspec/1-DFspec
4
Diopter/mmRadiusConversion
Diopters Radius(mm) Diopters Radius(mm) Diopters Radius(mm)
37.00 9.121 43.00 7.848 49.00 6.88737.25 9.060 43.25 7.803 49.25 6.85237.50 9.000 43.50 7.758 49.50 6.81837.75 8.940 43.75 7.714 49.75 6.7838.00 8.881 44.00 7.670 50.00 6.7538.25 8.823 44.25 7.627 50.25 6.7238.50 8.766 44.50 7.584 50.50 6.6838.75 8.708 44.75 7.541 50.75 6.6539.00 8.653 45.00 7.500 51.00 6.6239.25 8.598 45.25 7.458 51.25 6.5939.50 8.544 45.50 7.417 51.50 6.5539.75 8.490 45.75 7.377 51.75 6.5240.00 8.437 46.00 7.336 52.00 6.4940.25 8.385 46.25 7.297 52.25 6.4640.50 8.333 46.50 7.258 52.50 6.4340.75 8.282 46.75 7.219 52.75 6.4041.00 8.231 47.00 7.180 53.00 6.3741.25 8.181 47.25 7.142 53.25 6.3441.50 8.132 47.50 7.105 53.50 6.3141.75 8.083 47.75 7.068 53.75 6.2842.00 8.035 48.00 7.031 54.00 6.2542.25 7.988 48.25 6.994 54.25 6.2242.50 7.941 48.50 6.958 54.50 6.1942.75 7.894 48.75 6.923 54.75 6.16
337.5/radius=diopters
5
Diopter/mmRadiusConversion
Diopters Radius(mm) Diopters Radius(mm) Diopters Radius(mm)
55.00 6.14 61.00 5.53 67.00 5.0455.25 6.11 61.25 5.51 67.25 5.0255.50 6.08 61.50 5.49 67.50 5.0055.75 6.05 61.75 5.47 67.75 4.9856.00 6.03 62.00 5.44 68.00 4.9656.25 6.00 62.25 5.42 68.25 4.9556.50 5.97 62.50 5.40 68.50 4.9356.75 5.95 62.75 5.38 68.75 4.9157.00 5.92 63.00 5.36 69.00 4.8957.25 5.90 63.25 5.34 69.25 4.8757.50 5.87 63.50 5.31 69.50 4.8657.75 5.84 63.75 5.29 69.75 4.8458.00 5.82 64.00 5.27 70.00 4.8258.25 5.79 64.25 5.25 70.25 4.8058.50 5.77 64.50 5.23 70.50 4.7958.75 5.74 64.75 5.21 70.75 4.7759.00 5.72 65.00 5.19 71.00 4.7559.25 5.70 65.25 5.17 71.25 4.7459.50 5.67 65.50 5.15 71.50 4.7259.75 5.65 65.75 5.13 71.75 4.7060.00 5.63 66.00 5.11 72.00 4.6960.25 5.60 66.25 5.09 72.25 4.6760.50 5.58 66.50 5.08 72.50 4.6660.75 5.56 66.75 5.06 72.75 4.64
337.5/radius=diopters
6
ICD-9Codes
Refraction Hyperopia 367.00Myopia 367.10Astigmatismregular 367.21Astigmatismirregular 367.22Anisometropia 367.31Presbyopia 367.40
Cornea Cornealulcer.Unspecified 370.00Cornealulcer.Marginal 370.01Ringcornealulcer 370.02Centralcornealulcer 370.03Superficialkeratitis.Unspecified 370.20Punctatekeratitis 370.21Filamentarykeratinis 370.23Vernalkeratoconjunctivitis 370.32Limbalandcornealinvolvementinvernalconjunctivitis 370.32Ksicca-notsjogren’s 370.33Exposurekeratoconjunctivitis 370.34Neurotrophickeratitis 370.35Keratoconjunctivitis.Unspecified 370.40Cornealneovascularization.Unspecified 370.60Localizedvascularizationofthecornea 370.61Pannus(corneal) 370.62Ghostvessels(corneal) 370.64Keratitis.Unspecified 370.90Cornealopacity.Unspecified 371.00Cornealopacity.Minor 371.01Cornealopacity.Peripheral 371.02Cornealopacity.Central 371.03
Adherentcornealleucoma 371.04Phthisicalcornea 371.05Cornealdeposit.Unspecified 371.10Cornealpigmentationsanterior 371.11Cornealpigmentationsstromal 371.12Cornealpigmentationsposterior 371.13Cornealedema.Unspecified 371.20Cornealedema.Secondary 371.22Cornealedemaduetowearingofcontactlenses 371.24Foldsindescemet’smembrane 371.32Ruptureindescemet’smembrane 371.33Cornealdegeneration 371.40Senilecornealchanges 371.41Recurrentcornealerosion 371.42Band-shapedkeratopathy 371.43Cornealdegenerationsalzmann’snodular 371.46Cornealdegenerationperipheral(ex.Terrien’s) 371.48Hereditarycornealdystrophy.Unspecified 371.50Otheranteriorcornealdystrophies 371.52Keratoconus.Unspecified 371.60Keratoconus.Stable 371.61Keratoconus-acutehydrops 371.62Cornealectasia 371.71Cornealanesthesiaandhypoesthesia 371.81Cornealdisorderduetocontactlens 371.82Cornealdisorder.Unspecified 371.90Cornealabrasion 918.10Cornealforeignbody 930.00Complicationsofcornealgraft 996.51
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ConjunctivaAcuteconjunctivitis,unspecified 372.00Acuteatopicconjunctivitis 372.05Chronicconjunctivitis,unspecified 372.10Simplechronicconjunctivitis 372.11Chronicfollicularconjunctivitis 372.12Vernalconjunctivitis 372.13Otherchronicallergicconjunctivitis 372.14Blepharoconjunctivitis,unspecified 372.20AngularBlepharitis 372.21Contactblepharoconjunctivitis 372.22Conjunctivitis,unspecified 372.30Rosaceaconjunctivitis 372.31Pingueculitis 372.34Pterygium,unspecified 372.40Pinguecula 372.51Conjunctivalconcretions 372.54Symblepharon 372.63Scarringofconjunctiva 372.64Conjunctivalhyperemia 372.71Conjunctivalhemorrhage 372.72Conjunctivaledema 372.73Conjunctivalcysts 372.75
Eyelids and Adnexa Blepharitis.unspecified 373.00Hordeolumexternal 373.11Horneoluminternal 373.12Chalazion 373.20Eczematousdermatitisofeyelid 373.31Contactandallergicdermatitisofeyelid 373.32Parasiticinfestationofeyelid 373.60Otherinflammationofeyelids 373.80
Inflammationofeyelid.unspecified 373.90Entropion.unspecified 374.00Senileentropion 374.01Mechanicalentropion 374.02Cicatricialentropion 374.04Trichiasisofeyelidwithoutentropion 374.05Ectropion.unspecified 374.10Senileectropion 374.11Mechanicalectropion 374.12Cicatricialectropion 374.14Lagophthalmos.unspecified 374.20Ptosisofeyelid.unspecified 374.30Paralyticptosis 374.31Blepharochalasis 374.34Lidretractionorlag 374.41Hemorrhageofeyelid 374.81Edemaoftheeyelid 374.82Retainedforeignbodyoftheeyelid 374.86Dermatochalasis 374.87
Lacrimal System DryEye.unspecified(tearfilminsufficiencyunspecified) 375.15Epiphoria.unspecified 375.20Epiphoriaduetoexcessivelacrimation 375.21Epiphoriaduetoinsufficientdrainage/ 375.22Lacrimalsystem.NOS 375.90
Other Disorders of the Eye Paininoraroundeye 379.91Rednessordischargeoftheeye 379.93
ICD-9Codes
8
Pre-OcularTearFilm(POTF)evaluation
Whitelightevaluation NormalobservationsSpecularreflectionoftheocularsurface regular,smoothsurfaceBlink complete,12-15/min(<TBUT)
Lidappositiongoodappositionwiththeglobealongtheentirelidmargin(noentropion/ectropion)
Punctum openandgoodappositionDebrisinthePOTF minimaltonone
TearMeniscusTMHInf>Sup(0.2-0.4mm)slightcoloration,nofrothingorfoaming,littletonodebris,movementwithblinktowardsthepunctum
Viscosity moderatemovementLashes clear,nodebrisMeibomianglands easilyexpressedwithclearliquidsecretions
VitalStaining Normalobservations
TBUT >10secondsFluoresceinstaining <grade1Rosebengal/Lissaminegreen <grade1JonesTest patentnasolacrymalsystem
TearTests Normalobservations
Schirmer(w/oanesthesia) 5-10mm/5minPRTT/CTT >10mm/15secNIBUT >FluoresceinTBUTULMS/LWE nostainingLIPCOF noneTearferning TypeIorII(Rolando’scriteria)Tearosmolarity <308mOsm/L
9
CLsolutionsamplingguidelines
Contact Lens Solutions– Sampleone(1)starterkitpernewcontactlensfit/refit/changeofsolutionandconsiderawritten
recommendationoftheproducttopromotecompliance– Documenttherecommendedproductinthemedicalrecord– Donotofferthepatientmultiplesamplekits– Donotofferthepatientdifferentstarterkits,asthiswillcontributetopoorcompliance– Educatethepatientontheimportanceofcontactlenscasehygiene,whichiswhyanewcaseisincludedin
eachstarterkit.Recommendreplacingthecaseevery1-3months– Donotbreak-upstarterkitstoprovidepatientswithindividualcomponents– Usingthelatestscientificdata,consideranypotentialCL/Solutionincompatibilitiestoguideyourchoice
ofsolution– Explaintothepatienthowlongthesampleislikelytolastandwhattodothereafter(fillanRx,returnfor
afollow-upvisit,etc.)
Rewetting drops– Sampleone(1)bottleofrewettingdropduringtheeyeexaminationandconsiderprovidingawritten
recommendationtopromotecompliance– Documenttherecommendedproductinthemedicalrecord– Donotofferthepatientmultiplesamplebottles– Explaintothepatienthowlongthesampleislikelytolastandwhattodothereafter(fillanRx,returnfor
afollow-upvisit,etc)
General considerations– Useyourdiscretioninsamplingwhenitmaybedifficultforapatienttogettoapharmacy(weekends,
evenings,holidays)– Topromotecompliance,explaintothepatientwhyyouhavechosenthatproduct,sincenotallproducts
arethesame– Educatethepatientthatgenericproductsareusuallynotthesameasthelatestbrandnameproductsand
maychangeinformulationsfromyeartoyear– Instructthepatienttochecktheexpirationdatesonallmedications,includingcontactlenssolutions– Promoteanannualsupplyofcontactlensesoncethefitiscompletetopromotecompliance– Reviewmanufacturer’srecommendationswithrespecttothegivenproduct– UsetheAOCLEHealthyHabitstear-offpadstoeducatenovicewearersorasareviewwithhabitualwearers
10
BottleSize:Lubricants/Rewettingdrops
Brand Name Manufacturer Preservative Bottle Size
AquifyComfortdrops(Canada) Alcon PhosphoricAcid 10mL
BionTears Alcon none unidose
BlinkContacts Abbott OcuPure 10mL
BlinkGelTears Abbott OcuPure 10mL
BlinkTears Abbott OcuPure/none 15mL/30mL/unidose
ClerzPlusLens Alcon Polyquad/ED 5mL/8mL
COMPLETEBlink-N-CleanEyeDrops Abbott PHMB 20mL
COMPLETELubricatingandRewettingDrops Abbott PHMB 15mL
FreshKote Focus Polixetonium 15mL
GenTeal Alcon GenAqua 15mL/25mL
GenTealGel/Geldrops Alcon GenAqua 10mL/15mL
GenTealMilddrops/MildtoModerate Alcon GenAqua 15mL/25mL
I-Drop/I-DropPM(Canada) I-Med none unidose
Liposic(Canada) B+L Cetremide 10mL
Moistureeyes B+L BAK 15mL
OPTI-FREEExpressRewettingDrops Alcon Polyquad/ED 10mL/20mL
OPTI-FREERepleniSHRewettingDrops Alcon Polyquad/ED 10mL
RefreshCelluvisc Allergan none unidose
RefreshContacts Allergan Purite 15mL
RefreshEndura Allergan none unidose
RefreshLiquigel Allergan Purite 15mL/30mL
RefreshOptive Allergan Purite 15mL/30mL
RefreshOptiveadvanced Allergan Purite 10mL
RefreshOptivesensitive Allergan none unidose
RefreshTears Allergan Purite 15mL/30mL
11
Brand Name Manufacturer Preservative Bottle Size
RefreshUltra Allergan Purite 15mL/30mL
Refresh/RefreshPlus Allergan none unidose
ReNuMultiplusLubricating/Rewetting B+L SorbicAcid/ED 8mL
ReNuRewetting B+L SorbicAcid/ED 15mL
SensitiveEyes B+L SorbicAcid/ED 15mL
SootheXP B+L PHMB 15mL
SootheXPExtraProtection B+L PHMB 2.5mL
SootheXtrahydration B+L SodiumBorate 15mL
Systane Alcon Polyquad/none 15mL/30mL/unidose
SystaneBalance Alcon Polyquad 10mL
SystaneContacts Alcon Polyquad 12mL
SystaneGelDrops Alcon Polyquad 10mL
SystaneLiquidGel Alcon Polyquad 15mL
SystaneULTRA Alcon Polyquad/none 10mL/unidose
TearsNaturaleForte Alcon Polyquad 15mL/30mL
TearsNaturaleFree Alcon none unidose
TearsNaturaleII Alcon Polyquad 15mL/30mL
Tearsplus(Canada) Allergan Chlorobutanol 15mL/30mL
TheraTears AVR sodiumperborate 15mL/unidose
TheraTearscontactlenscomfortdrops AVR sodiumperborate 10mL
TheraTearsliquidgel AVR none unidose
PHMB=polyhexamethylenebiguanideED=EdetateDisodiumGenAqua=SodiumPerborate
12
Bottlesize:Gels/Ointments/InsertsBrand Name Manufacturer Preservative Bottle Size
Duolube B+L none 3.5gtubeGenTealPM Alcon none 3.5gtubeHypoTears Alcon none 3.5gtubeLacri-lube Allergan none 3.5/7gtubesLacrisert Atonpharma none 5mg/insertLiposicGel B+L Cetremide 10gtubeRefreshPM Allergan none 3.5/7gtubesSystaneOintment Alcon none 3.5gtubeTearGel Alcon Cetremide 10gtubeTearsNaturalePM Alcon none 3.5gtube
BottleSize:LidHygieneProductsBrand Name Manufacturer Preservative Format
Blephagel I-MED Methylparabens 40gtubeCIL-NET(Canada) Alcon EDTA,BromideDomiphen 100mLCIL-NET(pads)(Canada) Alcon EDTA,Benzylalcohol padsi.lid'nlash I-MED Methylparabens 40gtubei.lid'nlash(Pads) I-MED Borate,Polyethyleneglycol padsOcusoftEyelidcleaner OCuSOFT Quaternium 15foam/padsSteriLid/TheraLid AVR EDTA,Sodiumhydroxide 48mLfoamSystaneLidWipes Alcon Edetatedisodium,Bbenzylalcohol pads
OphthalmicDyeDyes Brand Name Composition Format
Fluorescein Fluorets,FulGlo,BioGlo Fluoresceinsodium1mg stripGloStrips Fluoresceinsodium0.6mg strip
Fluorescein(largemolecule) Fluoresoft Fluoresceinsodium0.35% solutionSoftGlo Flurexondisodium0.5mg strip
Fluorescein/anesthetic Fluress,Fluorox Fluoresceinsodium0.25%Benoxinatehydrochloride0.4% solutionFluorocaine Fluoresceinsodium0.25%ProparacaineHCl0.5% solutionFlura-Safe Flurexondisodium0.35%Benoxinatehydrochloride0.4% solution
Fluorescein/Lissamine Fluramene Fluoresceinsodium1%Lissaminegreen0.5% solutionLissamineGreen Lissaminegreen,GreenGlo Lissaminegreen1.5mg stripRoseBengal Rosebengal,RoseGlo Rosebengal1.5mg strip
13
SoftLensFitAssessmentgood tight loose
Centration full,equal full,equalsuperior,
decentered
Lenscoverscornea completely completely nasalexposure
Acuity clear,stableafterblinkclear,
blur=steepafterblinkblur,
clear=flat
Movement perceptible0.25(ct=0.04)
0.25-0.50(ct=0.06)0.50-1.0(ct=0.12)
less more
Other: Over-K(afterblink)
clear,stable clear,blur=steep
blur,clear=flat
Push-uptest easy difficult easy
Rapid(forcedblink)
smoothmovement
slowmovement
excessivemovement
SoftContactLensSelectionGuideline
Diameter= HVID+2mm(usually14.0-14.5)
BaseCurve: flatK<42.00 =flatterBC 42.00-45.00 =middleBC flatK>45.00 =steeperBC
SoftLensIdentificationMarkings
Bausch+LombProductsSoflens38 PureVisionB+Linversionindicator B+LinversionindicatorMarkingonlens CorrespondingBaseCurveS BC=8.4 PureVision2forastigmatism
lettersat6and9o’clockindicatingsphericalandcylinderpowers(consultmanufacturer’stabletoconvert)
M BC=8.7F BC=9.0
ALCON(FormerlyCibaVision)ProductsAirOptixNight&DayAqua O2Optix/AirOptixAquaMarkingonlens CorrespondingBaseCurve Markingonlens CorrespondingBaseCurveCIBAZ4## BC=8.4 CIBAX6## BC=8.6CIBAZ6## BC=8.6 AirOptixforAstigmatismFocusMonthly CIBAB7## BC8.7Markingonlens CorrespondingBaseCurve AirOptixMultifocalS6 BC=8.6 CIBAPL## LowAddS9 BC=8.9 CIBAPM## MedAddFocusToric CIBAPH## HiAddMarkingonlens CorrespondingBaseCurve Focus2WeekM2 BC=9.2 Markingonlens CorrespondingBaseCurveM9 BC=8.9 N4 BC=8.4Freshlook(Colors,Dimensions,HandlingTint) N8 BC=8.8FLinversionindicator FocusDailiesFreshlookColorblends Sphere,MultifocalNomarkings Nomarkings
VistakonProductsNo markings 1 2 3 Inversion Indicator on the following lenses:Acuvue2Colors 1DayAcuvue AcuvueAdvancePlusAcuvueAdvanceforastigmatism 1DayAcuvueMoist AcuvueBifocalAcuvueOASYS(astigmatism/presbyopia) 1DayAcuvueTru-Eye AcuvueOASYS
Acuvue Acuvue2AcuvueAdvance
14
15
SoftToricMarkings
AcuvueAdvance/OASYSforastigmatism
AvairaToric/XRBiofinityToric
BiomedicsToricFrequency55Toric/XR
ProclearToricXRAirOptixforastigmatism
ExtremeH2OToricMultifocalToric
ProclearFreshlookToric/
ColorblendsProclearToric
marksrepresent15°eitherside
F L
PureVisionToricmarksrepresent30°eitherside Purevision2forastigmatism
B&L
A
M
cylinder power indicator
sphere power indicator
16
RecommendedSoftContactLensReplacementSchedules
FDA Group 1 (non-ionic, <50% water)1dayreplacementJ&J 1-DayAcuvueTru-Eye(Canada/UK)J&J 1-DayAcuvueTru-Eye(US)
TwoWeekReplacementCooperVision Avaira(sphere/astig)J&J AcuvueAdvance(sphere/astig) DWJ&J AcuvueOASYS(sphere/astig/MF) EW(7day)J&J AcuvueAdvancePlusMenicon Premio(sphere/toric)
OneMonthReplacementAlcon AirOptixAqua(sphere/astig/MF) EW(7day)Alcon AirOptixNight&DayAqua CW(30day)Alcon O2Optix EW(7day)CooperVision Biofinity(sphere/toric/MF) DW(US),CW(Canada),(30day)CooperVision Encore100(Canada)(sphere/toric)
FDA Group 2 (non-ionic, >50% water)1DayReplacementAlcon DAILIESAquaComfortPlusAlcon DAILIES(sphere/toric/MF)Alcon FreshlookOne-dayB+L BiotrueOnedayB+L Soflens(sphere/toric)CooperVision Proclear1-day(sphere/MF)Sauflon(Centennial) Clariti1day(sphere-Canada/MF-UK)
OneMonthReplacementCooperVision ProclearCompatibles DWHydrogelVisionCorp ExtremeH2O DWSauflon/Centennial Clariti1month
17
FDA Group 3 (ionic, <50% water)OneMonthReplacementB+L Purevision(sphere/astig/MF) CW(30day)
B+L Purevision2HD(sphere/astig)
FDA Group 4 (ionic, >50% water)1DayReplacementCentennial DefinitionEveryday(Canada)
Cooper Clearsight/Biomedic1-day(sphere/toric)
J&J 1-DayAcuvue(sphere/toric)
J&J 1-DayAcuvueMoist(sphere/toric)
TwoWeekReplacementAlcon Freshlook FW
CooperVision Biomedics55Premier DW/EW
J&J AcuvueBifocal DW(2week)
J&J Acuvue2 DW(2week)/EW(1week)
OneMonthReplacementAlcon FocusMonthly DWorEW(7day)
Centennial DefinitionAC(Canada) DW
CooperVision Frequency55(sphere,aspheric,toric) EW
18
Silicone Hydrogels (SiHy)
Company Lensname material FDA Diam BC H2O% Dk Dk/t Modulus Surfacetreatment
1-Day Spherical ALCON(formerlyCibaVision) DAILIESTotal1(UK) delefilconA — 14.1 8.5 33-80 140 156 0.7 WatergradientSiHy
J&J Acuvue1-DayTruEye*(Canada/UK) narafilconA 1 14.2 8.5/9.0 46 100 118 0.66 none-internalwettingagent(PVP)
J&J Acuvue1-DayTruEye*(US) narafilconB 1 14.2 8.5 48 55 65 0.71 none-internalwettingagent(PVP)
Sauflon(Centennial) Clariti1Day/MF*(Canada/UK) filconII3 2 14.1 8.6 56 N/A 86 0.5 AquaGen
2weeks Spherical J&J AcuvueAdvance* galyfilconA 1 14.0 8.3/8.7 47 60 86 0.39 none-internalwettingagent(PVP)
J&J AcuvueAdvancePlus* galyfilconA 1 14.0 8.3/8.7 47 60 62 0.42 none-internalwettingagent(PVP)
J&J AcuvueOASYS* senofilconA 1 14.0 8.4/8.8 38 103 147 0.69 none-internalwettingagent(PVP)
Menicon Premio(Europe) asmofilconA 1 14.0 8.3/8.6 40 129 161 0.90 nanogloss
Toric J&J AcuvueAdvanceforAstig* galyfilconA 1 14.5 8.6 47 60 86 0.39 none-internalwettingagent(PVP)
J&J AcuvueOASYSforAstig* senofilconA 1 14.5 8.6 38 103 129 0.69 none-internalwettingagent(PVP)
Menicon PremioToric(Europe) asmofilconA 1 14.0 8.6 40 129 172 0.90
Multifocal J&J AcuvueOASYSforPresbyopia* senofilconA 1 14.3 8.4 38 103 147 0.69 none-internalwettingagent(PVP)
1month Spherical B+L PureVision balafilconA 3 14.0 8.3/8.6 36 91 101 1.1 plasmaoxidation
B+L PureVision2HD balafilconA 3 14.0 8.6 36 91 130 1.1 plasmaoxidation
ALCON(formerlyCibaVision) AirOptixAqua lotrafilconB 1 14.2 8.6 33 110 138 1 plasmatreatment
ALCON(formerlyCibaVision) AirOptixNight&DayAqua lotrafilconA 1 13.8 8.4/8.6 24 140 175 1.5 plasmatreatment
ALCON(formerlyCibaVision) O2Optix lotrafilconB 1 14.2 8.6 33 110 138 1 plasmatreatment
Cooper Biofinity comfilconA 1 14.0 8.6 48 128 160 0.75 none
Cooper Encore100*(Canada) enfilconA 1 14.2 8.4/8.5 46 100 125 0.5
Sauflon(Centennial) Clariti1month filconII3 2 14.1 8.4/8.8 58 N/A 86 0.5
Toric B+L PureVision2HDforAstigmatism balafilconA 3 14.5 8.9 36 91 91 1.1 plasmaoxidation
B+L PureVisionforAsigmatism balafilconA 3 14.0 8.7 36 91 91 1.1 plasmaoxidation
ALCON(formerlyCibaVision) AirOptixforAstigmatism lotrafilconB 1 14.5 8.7 33 110 108 1 plasmatreatment
Cooper BiofinityToric comfilconA 1 14.5 8.7 48 128 116 0.75
Cooper Encore100Toric*(Canada) enfilconA 1 14.5 8.5 46 100 91 0.5
Multifocal B+L PureVisionMulti-Focal balafilconA 3 14.0 8.6 36 91 101 1.1 plasmaoxidation
ALCON(formerlyCibaVision) AirOptixAquaMultifocal lotrafilconB 1 14.2 8.6 33 110 138 1 plasmatreatment
Cooper BiofinityMultifocal comfilconA 1 14.0 8.6 48 128 160 0.75
*UVblocker dataprovidedbycompanies Dk/tvaluesfor-3.00D
19
Silicone Hydrogels (SiHy)
Company Lensname material FDA Diam BC H2O% Dk Dk/t Modulus Surfacetreatment
1-Day Spherical ALCON(formerlyCibaVision) DAILIESTotal1(UK) delefilconA — 14.1 8.5 33-80 140 156 0.7 WatergradientSiHy
J&J Acuvue1-DayTruEye*(Canada/UK) narafilconA 1 14.2 8.5/9.0 46 100 118 0.66 none-internalwettingagent(PVP)
J&J Acuvue1-DayTruEye*(US) narafilconB 1 14.2 8.5 48 55 65 0.71 none-internalwettingagent(PVP)
Sauflon(Centennial) Clariti1Day/MF*(Canada/UK) filconII3 2 14.1 8.6 56 N/A 86 0.5 AquaGen
2weeks Spherical J&J AcuvueAdvance* galyfilconA 1 14.0 8.3/8.7 47 60 86 0.39 none-internalwettingagent(PVP)
J&J AcuvueAdvancePlus* galyfilconA 1 14.0 8.3/8.7 47 60 62 0.42 none-internalwettingagent(PVP)
J&J AcuvueOASYS* senofilconA 1 14.0 8.4/8.8 38 103 147 0.69 none-internalwettingagent(PVP)
Menicon Premio(Europe) asmofilconA 1 14.0 8.3/8.6 40 129 161 0.90 nanogloss
Toric J&J AcuvueAdvanceforAstig* galyfilconA 1 14.5 8.6 47 60 86 0.39 none-internalwettingagent(PVP)
J&J AcuvueOASYSforAstig* senofilconA 1 14.5 8.6 38 103 129 0.69 none-internalwettingagent(PVP)
Menicon PremioToric(Europe) asmofilconA 1 14.0 8.6 40 129 172 0.90
Multifocal J&J AcuvueOASYSforPresbyopia* senofilconA 1 14.3 8.4 38 103 147 0.69 none-internalwettingagent(PVP)
1month Spherical B+L PureVision balafilconA 3 14.0 8.3/8.6 36 91 101 1.1 plasmaoxidation
B+L PureVision2HD balafilconA 3 14.0 8.6 36 91 130 1.1 plasmaoxidation
ALCON(formerlyCibaVision) AirOptixAqua lotrafilconB 1 14.2 8.6 33 110 138 1 plasmatreatment
ALCON(formerlyCibaVision) AirOptixNight&DayAqua lotrafilconA 1 13.8 8.4/8.6 24 140 175 1.5 plasmatreatment
ALCON(formerlyCibaVision) O2Optix lotrafilconB 1 14.2 8.6 33 110 138 1 plasmatreatment
Cooper Biofinity comfilconA 1 14.0 8.6 48 128 160 0.75 none
Cooper Encore100*(Canada) enfilconA 1 14.2 8.4/8.5 46 100 125 0.5
Sauflon(Centennial) Clariti1month filconII3 2 14.1 8.4/8.8 58 N/A 86 0.5
Toric B+L PureVision2HDforAstigmatism balafilconA 3 14.5 8.9 36 91 91 1.1 plasmaoxidation
B+L PureVisionforAsigmatism balafilconA 3 14.0 8.7 36 91 91 1.1 plasmaoxidation
ALCON(formerlyCibaVision) AirOptixforAstigmatism lotrafilconB 1 14.5 8.7 33 110 108 1 plasmatreatment
Cooper BiofinityToric comfilconA 1 14.5 8.7 48 128 116 0.75
Cooper Encore100Toric*(Canada) enfilconA 1 14.5 8.5 46 100 91 0.5
Multifocal B+L PureVisionMulti-Focal balafilconA 3 14.0 8.6 36 91 101 1.1 plasmaoxidation
ALCON(formerlyCibaVision) AirOptixAquaMultifocal lotrafilconB 1 14.2 8.6 33 110 138 1 plasmatreatment
Cooper BiofinityMultifocal comfilconA 1 14.0 8.6 48 128 160 0.75
*UVblocker dataprovidedbycompanies Dk/tvaluesfor-3.00D
20
Daily disposables
Company Lensname material FDA Diam BC H2O% Dk/t Specifics
Spherical ALCON(formerlyCibaVision) DAILIESAquaComfortPlus nelfilconA 2 14.0 8.7 69 26 Tripleactionmoisture(AquaReleaseTM)
ALCON(formerlyCibaVision) FocusDAILIES nelfilconA 2 13.8 8.6 69 26 AquaRelease
ALCON(formerlyCibaVision) FreshlookOne-Day nelfilconA 2 13.8 8.6 69 26 blue/gray/green/purehazel
ALCON(formerlyCibaVision) DAILIESTotal1(UK) delefilconA — 14.1 8.5 33 156 WatergradientSiHy
B+L BiotrueONEday nesofilconA 2 14.2 8.6 78 42 HDoptics,HyperGel
B+L SofLensdailydisposable hilafilconB 2 14.2 8.6 59 24 Aspheric
Cooper Biomedics1-Day* ocufilconB 4 14.2 8.7 52 20
Cooper Proclear1-Day omafilconA 2 14.2 8.7 60 37 Asphericfrontsurface
J&J Acuvue1-Day* etafilconA 4 14.2 8.5/9.0 58 26 Inversion1-2-3
J&J Acuvue1-DayMoist* etafilconA 4 14.2 8.5/9.0 58 26 Inversion1-2-3,Lacreontechnology
J&J Acuvue1-DayTru-Eye*(US) narafilconB 1 14.2 8.5 48 65 Inversion1-2-3SiHy
J&J Acuvue1-DayTru-Eye*(Canada/UK) narafilconA 1 14.2 8.5/9.0 46 118 Inversion1-2-3SiHy
Sauflon(Centennial) Bioclear1Day*(Canada) filconIV1 4 14.1 8.6 56 30 AdvancededgetechnologyAquaAtract
Sauflon(Centennial) Clariti1Day*(Canada) filconII3 2 14.1 8.6 56 86 Advancededgetechnology
Sauflon(Centennial) DefinitionEveryday(Canada) methafilconA 4 14.2 8.6 55 30 Aspheric
Toric ALCON(formerlyCibaVision) FocusDAILIESToric nelfilconA 2 14.2 8.6 69 26 AquaRelease,doublethinzone,cyl0.75/1.50
B+L SofLensdailydisposableforastigmatism hilafilconB 2 14.2 8.6 59 22 cyl0.75/1.25/1.75
Cooper Biomedics1DayToric* ocufilconD 4 14.5 8.7 55 19 cyl0.75/1.25
J&J 1DayAcuvueforastigmatism* etafilconA 4 14.5 8.5 58 24 Blinkstabilizeddesign
J&J 1DayAcuvueMoistforastigmatism* etafilconA 4 14.5 8.5 58 24 Blinkstabilizeddesign,Lacreontechnology
Sauflon(Centennial) Clariti1Day*(Canada/UK) filconII3 2 14.1 8.6 56 86 SiHy
Multifocals ALCON(formerlyCibaVision) FocusDAILIESProgressives nelfilconA 2 13.8 8.6 69 26 AquaRelease,center-nearaspheric
Cooper Proclear1DayMultifocal omafilconA 2 14.2 8.7 60 36.6
Sauflon Clariti1dayMultifocal(UK) filconII3 2 14.1 8.6 56 86 Centerneardesign
*UVblocker dataprovidedbycompanies Dk/tvaluesfor-3.00D
21
Daily disposables
Company Lensname material FDA Diam BC H2O% Dk/t Specifics
Spherical ALCON(formerlyCibaVision) DAILIESAquaComfortPlus nelfilconA 2 14.0 8.7 69 26 Tripleactionmoisture(AquaReleaseTM)
ALCON(formerlyCibaVision) FocusDAILIES nelfilconA 2 13.8 8.6 69 26 AquaRelease
ALCON(formerlyCibaVision) FreshlookOne-Day nelfilconA 2 13.8 8.6 69 26 blue/gray/green/purehazel
ALCON(formerlyCibaVision) DAILIESTotal1(UK) delefilconA — 14.1 8.5 33 156 WatergradientSiHy
B+L BiotrueONEday nesofilconA 2 14.2 8.6 78 42 HDoptics,HyperGel
B+L SofLensdailydisposable hilafilconB 2 14.2 8.6 59 24 Aspheric
Cooper Biomedics1-Day* ocufilconB 4 14.2 8.7 52 20
Cooper Proclear1-Day omafilconA 2 14.2 8.7 60 37 Asphericfrontsurface
J&J Acuvue1-Day* etafilconA 4 14.2 8.5/9.0 58 26 Inversion1-2-3
J&J Acuvue1-DayMoist* etafilconA 4 14.2 8.5/9.0 58 26 Inversion1-2-3,Lacreontechnology
J&J Acuvue1-DayTru-Eye*(US) narafilconB 1 14.2 8.5 48 65 Inversion1-2-3SiHy
J&J Acuvue1-DayTru-Eye*(Canada/UK) narafilconA 1 14.2 8.5/9.0 46 118 Inversion1-2-3SiHy
Sauflon(Centennial) Bioclear1Day*(Canada) filconIV1 4 14.1 8.6 56 30 AdvancededgetechnologyAquaAtract
Sauflon(Centennial) Clariti1Day*(Canada) filconII3 2 14.1 8.6 56 86 Advancededgetechnology
Sauflon(Centennial) DefinitionEveryday(Canada) methafilconA 4 14.2 8.6 55 30 Aspheric
Toric ALCON(formerlyCibaVision) FocusDAILIESToric nelfilconA 2 14.2 8.6 69 26 AquaRelease,doublethinzone,cyl0.75/1.50
B+L SofLensdailydisposableforastigmatism hilafilconB 2 14.2 8.6 59 22 cyl0.75/1.25/1.75
Cooper Biomedics1DayToric* ocufilconD 4 14.5 8.7 55 19 cyl0.75/1.25
J&J 1DayAcuvueforastigmatism* etafilconA 4 14.5 8.5 58 24 Blinkstabilizeddesign
J&J 1DayAcuvueMoistforastigmatism* etafilconA 4 14.5 8.5 58 24 Blinkstabilizeddesign,Lacreontechnology
Sauflon(Centennial) Clariti1Day*(Canada/UK) filconII3 2 14.1 8.6 56 86 SiHy
Multifocals ALCON(formerlyCibaVision) FocusDAILIESProgressives nelfilconA 2 13.8 8.6 69 26 AquaRelease,center-nearaspheric
Cooper Proclear1DayMultifocal omafilconA 2 14.2 8.7 60 36.6
Sauflon Clariti1dayMultifocal(UK) filconII3 2 14.1 8.6 56 86 Centerneardesign
*UVblocker dataprovidedbycompanies Dk/tvaluesfor-3.00D
22
Soft Multifocals
Company Lensname material Diam BC Add Type
1-Day Spherical Alcon(formerlyCibaVision) FocusDAILIESProgressives nelfilconA 13.8 8.6 progto+3.00 centernear,aspheric,AquaRelease
Cooper Proclear1DayMultifocal omafilconA 14.2 8.7 +1.00to+2.50
Sauflon Clariti1daymultifocal*(UK) filconII3 14.1 8.6 low<+2.25,high+2.50to+3.00 centerneardesign,asphericbacksurface
2-4weeks Spherical B+L SofLensMulti-Focal polymacon 14.5 8.5/8.8 low+1.50,high+1.75to+2.50 centernear
Cooper Biomedics/ProclearEP omafilconA 14.4 8.7 +1.00 centerdistance,asphericintermediateandnear
J&J Acuvuebifocal* etafilconA 14.2 8.5 +1.00to+2.50 concentric,centerdistancewith5alternatingzones
J&J AcuvueOASYSforPresbyopia* senofilconA 14.3 8.4 low,mid,high centerdistancewithdualasphericfrontsurfaceoptics
1month Spherical Alcon(formerlyCibaVision) AirOptixAquaMultifocal lotrafilconB 14.2 8.6 low,med,high
B+L PureVisionMulti-Focal balafilconA 14.0 8.6 low+1.50,high+1.75to+2.50 centernear
Blanchard MultiX benzG3X 14.2/14.5 8.4/8.8 upto+2.25
Cooper BiofinityMultifocal comfilconA 14.0 8.6 +1.00to+2.50
Cooper ProclearMultifocal omafilconA 14.4 8.7 +1.00to+2.50 DandNlens
Cooper ProclearMultifocalXR omafilconA 14.4 8.4/8.7 +1.00to+4.00 DandNlens
Toric Cooper ProclearMutlifocalToric omafilconA 14.4 8.8 +1.00to+4.00 DandNlens
*UVblocker
Dataprovidedbycompanies
23
Soft Multifocals
Company Lensname material Diam BC Add Type
1-Day Spherical Alcon(formerlyCibaVision) FocusDAILIESProgressives nelfilconA 13.8 8.6 progto+3.00 centernear,aspheric,AquaRelease
Cooper Proclear1DayMultifocal omafilconA 14.2 8.7 +1.00to+2.50
Sauflon Clariti1daymultifocal*(UK) filconII3 14.1 8.6 low<+2.25,high+2.50to+3.00 centerneardesign,asphericbacksurface
2-4weeks Spherical B+L SofLensMulti-Focal polymacon 14.5 8.5/8.8 low+1.50,high+1.75to+2.50 centernear
Cooper Biomedics/ProclearEP omafilconA 14.4 8.7 +1.00 centerdistance,asphericintermediateandnear
J&J Acuvuebifocal* etafilconA 14.2 8.5 +1.00to+2.50 concentric,centerdistancewith5alternatingzones
J&J AcuvueOASYSforPresbyopia* senofilconA 14.3 8.4 low,mid,high centerdistancewithdualasphericfrontsurfaceoptics
1month Spherical Alcon(formerlyCibaVision) AirOptixAquaMultifocal lotrafilconB 14.2 8.6 low,med,high
B+L PureVisionMulti-Focal balafilconA 14.0 8.6 low+1.50,high+1.75to+2.50 centernear
Blanchard MultiX benzG3X 14.2/14.5 8.4/8.8 upto+2.25
Cooper BiofinityMultifocal comfilconA 14.0 8.6 +1.00to+2.50
Cooper ProclearMultifocal omafilconA 14.4 8.7 +1.00to+2.50 DandNlens
Cooper ProclearMultifocalXR omafilconA 14.4 8.4/8.7 +1.00to+4.00 DandNlens
Toric Cooper ProclearMutlifocalToric omafilconA 14.4 8.8 +1.00to+4.00 DandNlens
*UVblocker
Dataprovidedbycompanies
24
Soft Contact Lens Care
MultiPurposeSolutionTradeName Manufacturer Disinfectant/Preservative Wettingagent Buffer Other
BioTrue B+L PHMB0.00013%andPolyquarternium-10.0001% Hyaluronan Sodiumborate/boricacid pH7.5
Complete Abbott PHMB0.0001% Phosphate pluronicF87(surfactant)
OPTI-FREERepleniSH Alcon 0.001%Polyquad0.0005%Aldox TearGlyde Sodiumborate designedforSiHylenses
OPTI-FREEExpress Alcon 0.001%Polyquad0.0005%Aldox Sodiumborate Tetronic1304(surfactant)
OPTI-FREEPureMoist Alcon 0.001%Polyquad0.0006%Aldox HydraGlyde Boricacid EDTA(chelatingagent)Tetronic1304(surfactant)
Renufresh B+L PHMB0.0001% Sodiumborate/boricacidHYDRANATE(chelatingagent)Tetronic1107(surfactant)
Renusensitive B+L PHMB0.00005% Sodiumborate/boricacid Tetronic1107(surfactant)
RevitaLensOcuTec Abbott Polyquatrium-10.001%,Aldox0.0005% Sodiumborate/boricacid Tetronic904(surfactant)EDTA(chelatingagent)
SauflonAllinOneLite Sauflon polyhexanide0.0001% Sodiumphosphate EDTA(chelatingagent)
SoloCareAqua(Canada) Menicon polyhexanide0.0001% Dexpanthanol "Tromethaminephosphate" PluronicF127(surfactant)
PHMB: polyhexamethylene biguanide
PeroxideTradeName Manufacturer Disinfectant/Preservative Wettingagent Buffer Other
AOSept Alcon 3%H2O2 Phosphate platinumdisk
ClearCare Alcon 3%H2O2 Phosphate platinumdiskpluronic17R4
OcusoftLensCareSystem Ocusoft 3%H2O2 Phosphate platinumdisk
OneStep Sauflon 3%H2O2 platinumdisk
OxyseptUltracare Abbott 3%H2O2 Phosphate platinumdisk
25
Soft Contact Lens Care
MultiPurposeSolutionTradeName Manufacturer Disinfectant/Preservative Wettingagent Buffer Other
BioTrue B+L PHMB0.00013%andPolyquarternium-10.0001% Hyaluronan Sodiumborate/boricacid pH7.5
Complete Abbott PHMB0.0001% Phosphate pluronicF87(surfactant)
OPTI-FREERepleniSH Alcon 0.001%Polyquad0.0005%Aldox TearGlyde Sodiumborate designedforSiHylenses
OPTI-FREEExpress Alcon 0.001%Polyquad0.0005%Aldox Sodiumborate Tetronic1304(surfactant)
OPTI-FREEPureMoist Alcon 0.001%Polyquad0.0006%Aldox HydraGlyde Boricacid EDTA(chelatingagent)Tetronic1304(surfactant)
Renufresh B+L PHMB0.0001% Sodiumborate/boricacidHYDRANATE(chelatingagent)Tetronic1107(surfactant)
Renusensitive B+L PHMB0.00005% Sodiumborate/boricacid Tetronic1107(surfactant)
RevitaLensOcuTec Abbott Polyquatrium-10.001%,Aldox0.0005% Sodiumborate/boricacid Tetronic904(surfactant)EDTA(chelatingagent)
SauflonAllinOneLite Sauflon polyhexanide0.0001% Sodiumphosphate EDTA(chelatingagent)
SoloCareAqua(Canada) Menicon polyhexanide0.0001% Dexpanthanol "Tromethaminephosphate" PluronicF127(surfactant)
PHMB: polyhexamethylene biguanide
PeroxideTradeName Manufacturer Disinfectant/Preservative Wettingagent Buffer Other
AOSept Alcon 3%H2O2 Phosphate platinumdisk
ClearCare Alcon 3%H2O2 Phosphate platinumdiskpluronic17R4
OcusoftLensCareSystem Ocusoft 3%H2O2 Phosphate platinumdisk
OneStep Sauflon 3%H2O2 platinumdisk
OxyseptUltracare Abbott 3%H2O2 Phosphate platinumdisk
26
GasPermeableLensDesignBennettMethod
GasPermeableBaseCurveSelection(MinusLenses)
CornealCylinder BaseCurveplano-0.50D 0.50-0.75DFlat
0.75-1.00D 0.25-0.50DFlat
1.25-1.50D OnK-0.25Flat
1.75-2.00D 0.25DSteep
2.25-2.50D 0.50DSteep
2.75-3.00D 0.50-0.75DSteep
Forpluslensesfit0.25-0.50Dsteeperthanthoserecommendedforminuslenses.
TetracurveDesign TricurveDesign>8.8mmOAD <8.8mmOAD
SCR=BCR+0.8mm/0.3mm SCR=BCR+1.0mm/0.3mm
ICR=SCR+1.0mm/0.2mm PCR=SCR+2.0mm/0.3mm
PCR=ICR+1.4mm/0.2mm
Bothshouldbeblendedmediumideally
OADof8.4-8.8for>45.50DKreadinganddecreaseOZD
OADof9.4-9.6for<41.50DKreadingandincreaseOZD
AdjustmentsofBaseCurveandPower
0.25DchangeinPowerforeachBCchangeof0.05mm
SAM(SteeperAddMinus)orFAP(FlatterAddPlus)
FlattenBC0.25D(0.05mm)foreachincreaseinOAD&OZof0.5mm
SteepenBC0.25D(0.05mm)foreachdecreaseinOAD&OZof0.5mm
27
GPCenterThicknessEstimationPower 20to49Dk 50+Dk
-1.00 0.18 0.19
-2.00 0.16 0.18
-3.00 0.14 0.16
-4.00 0.14 0.15
-5.00 0.13 0.14
>-6.00 0.13 0.14
RulesofThumbIncreasecenterthickness0.02mmforhighDkmaterials
Increasecenterthickness0.02mmforeachdiopterofcornealastigmatism
Lenticularfor>-6.00and>+3.00,CNbevelfor-4.00to-6.00
GasPermeableLensDesignMidKMethod
OAD 8.5mm 9.0mm 9.5mm
BC avgK avgK-0.50D avgK-1.00D
OZ 7.3mm 7.8mm 8.3mm
ICR/W BC+1.0mm/0.2 BC+1.0mm/0.2 BC+1.0mm/0.2
PCR/W BC+3.0to5.0mm/0.4 BC+3.0to5.0mm/0.4 BC+3.0to5.0mm/0.4
10.50/0.4 11.25/0.4 12.25/0.4
K>45.50usesmallerOAD
K<41.50uselargerOAD
28
Name Type DK W.A. R.I. S.G.AlbertaLensS* SA 66 8.6 1.48 1.13AlbertaLensSM-2* SA 45 9.0 1.48 1.12Accucon FSA 25 <25 1.46 1.16BostonII SA 12 20 1.47 1.13BostonIV SA 19 17 1.47 1.10BostonEO* FSA 58 49 1.43 1.23BostonEqualens* FSA 47 30 1.44 1.19BostonEqualensII* FSA 85 30 1.42 1.24BostonES* FSA 18 52 1.44 1.22BostonXO* FSA 100 49 1.42 1.27BostonXO2* FSA 141 38 1.42 1.19Flosi* FSA 26 23.5 1.46 1.12Fluorex300 FSA 30 12.6 1.47 1.11Fluorex500 FSA 50 13.3 1.46 1.11Fluorex700 FSA 70 15.3 1.46 1.10Fluoroperm30 FSA 30 12.8 1.47 1.14Fluoroperm60 FSA 60 14.7 1.45 1.15Fluoroperm92 FSA 92 16 1.45 1.10Fluoroperm151 FSA 151 42 1.42 1.10HybridFS FSA 31 0 1.45 1.18Hydro2 FSA 50 <5 1.46 1.15MeniconZ* FSA >163 24 1.44 1.20ONSI-56* FSA 56 7.2 1.45 1.21OP-2 FSA 15.9 17 1.47 1.12OP-3 FSA 30 21 1.46 1.12OP-6 FSA 60 26 1.45 1.11OP-10 FSA 97 23 N/A 1.13O-PermF30 SA 31 <25 1.47 1.09O-PermF60 FSA 62 19.2 1.45 1.13Optacryl60 SA 18 25 1.47 1.13
GPMaterialGuide
29
Name Type DK W.A. R.I. S.G.OptimumClassic* FSA 26 12 1.45 1.19OptimumComfort* FSA 65 6 1.44 1.17OptimumExtra* FSA 100 3 1.43 1.16OptimumExtreme* FSA 125 6 1.43 1.15OptimumHR1.51* FSA 50 33 1.51 1.04OptimumHR1.53 FSA 26 42 1.53 1.04ParagonHDS* FSA 58 14.7 1.45 1.16ParagonHDSHI* FSA 22 44 1.54 1.12ParagonHDS100* FSA 100 42 1.44 1.10ParagonThin* FSA 29 12.8 1.46 1.14ParapermEW SA 56 26 1.47 1.07ParapermO2 SA 16 23 1.47 1.12SA18* SA 18 <25 1.47 1.13SA32* SA 32 <25 1.47 1.10SGP SA 22 <30 1.48 1.13SGPII SA 44 <30 1.47 1.13SGP3 FSA 44 <20 1.48 1.13Sport-Sight(30) FSA 30 12 1.47 1.14Tyro97* FSA 97 23 1.44 1.19PMMA XXX 0 18 1.49 1.20
SA=SiliconeAcrylate W.A.=WettingAngle FSA=FluorosiliconeAcrylate R.I.=RefractiveIndex N/A=NotAvailable S.G.=SpecificGravity *=UVBlocker
30
Specialty: Large Diameter
TradeName Manufacturers Diameter(mm) BaseCurve/SAG SpecificsCCMS CustomCraftLensServiceofNV 13.0-17.0 Many BackToric,FrontToric,Keratoconus,reversegeometry,multifocal
Digiform LancasterContactLens,Inc. 15.0(18.0soon) AnyBC Custommade
Digiform(L1/RK1/G1/N1) Tru-FormOptics,Inc. 14.0-16.5 6.2-9.8 Bitoric,bifocalavailability
DynaSemi-Scleral LensDynamics,Inc. 13.5/14.0/14.5/15.0/15.5/15.8 AnyBC,w/woreversegeometry BostonXO,ContamacExtra,MeniconZ;Fttorics,multifocals,Quadedgelifts
DynaScleral LensDynamics,Inc. 16.0-19.5 AnyBC,w/woreversegeometry BostonXO,ContamacExtra,MeniconZ;Fttorics,multifocals,Quadedgelifts
EB15.0 ABBAOptical,Inc. 15.0 w/woreversegeometry Fitfromtrialsetandcustomizedforeachpatient
EssilorPerimeter EssilorContactLens 14.0-14.8 7.0-7.8(OZ) BostonXO2
GBL ABBConCiseContactLens 10.8-12.5 AnyBC Astigmatic,IrregularCorneaandMultifocaldesigns
ICDlens ABBConCiseContactLens 16.5 BasedonSagitalDepth Fittingsetavailable
ICDScleralLens ValleyContax 16.5 SAG HDS100
JupiterScleral EssilorContactLens 15.0-20.2 w/woreversegeometry Custommade
Maxim AccuLens,Inc. Many Many Custommade
Mini-Scleral ABBConCiseContactLens 12.5 AnyBC
MSD BlanchardContactLens 15.8and18.0 360-580microns Midperipherallymbalzone,decrease,standard,increase,doubleincrease
OcuFlex55 Ocu-EaseOpticalProducts,Inc. Anysize AnyBC Custommade
OneFit Blanchard 13.8/14.3(standard)/14.6mm 6.90-8.50mm Tyro97,BostonXO/XO2
PuresiteSemi-scleral DiversifiedOphthalmics,Inc. 14.0 5.50-7.90(.20steps)Variety-3to-8 13lensfittingset
Sclerallens LancasterContactLens,Inc. 12.0-15.0orlarger AnyBC Custommade
Semi-Scleral ABBAOptical,Inc. 13.5 AnyBC Loanersetsavailable
SO2Clear ArtOptical 13.0-15.0 9.50-5.83 Multiplefittingoptions-presbyopicavailable
SurgicalC4 ABBAOpticalInc. 9.0-11.0 AnyBC Postsurgical,Reversegeometrydesign,Loanersetsavailable
TruScleral Tru-FormOptics,Inc. 18.0 AnyBC Radialventing
Valley15(mini-scleral) ValleyContax 15.0 AnyBC madeinHDS100orBoston
Valley16 ValleyContax 16.0 AnyBC/SAG madeinHDS100orBoston
Valley18 ValleyContax 18.0 AnyBC/SAG madeinHDS100orBoston
31
Specialty: Large Diameter
TradeName Manufacturers Diameter(mm) BaseCurve/SAG SpecificsCCMS CustomCraftLensServiceofNV 13.0-17.0 Many BackToric,FrontToric,Keratoconus,reversegeometry,multifocal
Digiform LancasterContactLens,Inc. 15.0(18.0soon) AnyBC Custommade
Digiform(L1/RK1/G1/N1) Tru-FormOptics,Inc. 14.0-16.5 6.2-9.8 Bitoric,bifocalavailability
DynaSemi-Scleral LensDynamics,Inc. 13.5/14.0/14.5/15.0/15.5/15.8 AnyBC,w/woreversegeometry BostonXO,ContamacExtra,MeniconZ;Fttorics,multifocals,Quadedgelifts
DynaScleral LensDynamics,Inc. 16.0-19.5 AnyBC,w/woreversegeometry BostonXO,ContamacExtra,MeniconZ;Fttorics,multifocals,Quadedgelifts
EB15.0 ABBAOptical,Inc. 15.0 w/woreversegeometry Fitfromtrialsetandcustomizedforeachpatient
EssilorPerimeter EssilorContactLens 14.0-14.8 7.0-7.8(OZ) BostonXO2
GBL ABBConCiseContactLens 10.8-12.5 AnyBC Astigmatic,IrregularCorneaandMultifocaldesigns
ICDlens ABBConCiseContactLens 16.5 BasedonSagitalDepth Fittingsetavailable
ICDScleralLens ValleyContax 16.5 SAG HDS100
JupiterScleral EssilorContactLens 15.0-20.2 w/woreversegeometry Custommade
Maxim AccuLens,Inc. Many Many Custommade
Mini-Scleral ABBConCiseContactLens 12.5 AnyBC
MSD BlanchardContactLens 15.8and18.0 360-580microns Midperipherallymbalzone,decrease,standard,increase,doubleincrease
OcuFlex55 Ocu-EaseOpticalProducts,Inc. Anysize AnyBC Custommade
OneFit Blanchard 13.8/14.3(standard)/14.6mm 6.90-8.50mm Tyro97,BostonXO/XO2
PuresiteSemi-scleral DiversifiedOphthalmics,Inc. 14.0 5.50-7.90(.20steps)Variety-3to-8 13lensfittingset
Sclerallens LancasterContactLens,Inc. 12.0-15.0orlarger AnyBC Custommade
Semi-Scleral ABBAOptical,Inc. 13.5 AnyBC Loanersetsavailable
SO2Clear ArtOptical 13.0-15.0 9.50-5.83 Multiplefittingoptions-presbyopicavailable
SurgicalC4 ABBAOpticalInc. 9.0-11.0 AnyBC Postsurgical,Reversegeometrydesign,Loanersetsavailable
TruScleral Tru-FormOptics,Inc. 18.0 AnyBC Radialventing
Valley15(mini-scleral) ValleyContax 15.0 AnyBC madeinHDS100orBoston
Valley16 ValleyContax 16.0 AnyBC/SAG madeinHDS100orBoston
Valley18 ValleyContax 18.0 AnyBC/SAG madeinHDS100orBoston
32
Specialty: Kone
TradeName LensMaterial Diameter BaseCurve
ABBA-Kone ParagonHDS Madetoorder Madetoorder
AccuCone Any 8.4/9.0 Madetoorder
AKS Any Madetoorder Madetoorder
APK Any Madetoorder Madetoorder
AS-15 BostonXO 8.0-12.2 Madetoorder
AS-18 BostonXO 8.0-12.2 Madetoorder
AS-20H BostonXO 8.0-12.2 Madetoorder
AsphericCone Any Madetoorder Madetoorder
AsphericK Any Madetoorder Madetoorder
C5 Any 8.0-9.4 5.0-7.5
Cak Any Madetoorder Madetoorder
cCone Any Madetoorder Madetoorder
CentraCone BostonES,EO 8.2/8.6/9.0(standard) 5.3-7.6
CentraConeBi-Symmetry BostonES,EO 8.2/8.6/9.0(standard) 5.3-7.6
CLCK Any Madetoorder Madetoorder
ClearKone Hybrid 14.5Madetoorder(Vault100-600)
ComfortCone Fluoroperm30 7.8-9.5 Madetoorder
Conforma-K BostonES,XO Madetoorder Madetoorder
CVC Any Madetoorder Madetoorder
Dist-O-Cone Fluorex300/ParagonHDS 8.0/8.5/9.0 5.63-7.03
DynaIntra-Limbal BostonXO 11.2(Standard),Custom Madetoorder
eCone Any Madetoorder Madetoorder
Formcon Any Madetoorder Madetoorder
Globus Any 7.5-9.5 5.0-7.0
HorizonCone Any 8.0/8.5/9.0/9.5 Madetoorder
HydroKone HioxifilconA/MethafilconA 12.0-17.0 4.1-9.3
33
K-2Design Any Madetoorder Madetoorder
KeraSoft2 HioxifilconB11 14.0/14.5/15.0 8.0/8.2/8.4/8.6
KeraSoft3 Siliconehydrogel 14.0/14.5/15.0 8.0/8.2/8.4/8.6
KeraSoftIC Siliconehydrogel 14.0/15.5 7.4/9.4
Kone Any Madetoorder Madetoorder
Ksphere Any Madetoorder Madetoorder
McGuireCone Any Madetoorder Madetoorder
Ni-cone Any Madetoorder Madetoorder
OneFitkeratoconus Tyro97,BostonXO/XO2 13.8/14.3(standard)/14.6 6.90-8.50
OpalCone Any 9.0-10.5 5.0-11.0
PellucidAsphericBackSurface BostonXO Madetoorder Madetoorder
ProConeAspheric BostonXO Madetoorder Madetoorder
Pro-ECC Any Madetoorder Madetoorder
QuadraKone Any Madetoorder Madetoorder
RoseK BostonMaterials 8.7(Standard)/Custom Madetoorder
RoseK2IC BostonMaterials Madetoorder Madetoorder
RoseK2PG BostonMaterials Madetoorder Madetoorder
RoseK2NC BostonMaterials Madetoorder Madetoorder
SK2000 BostonXO Madetoorder Madetoorder
SoperCone Any Madetoorder Madetoorder
SuperCone Any Madetoorder Madetoorder
Tru-Kone BostonES,EO,XO Madetoorder Madetoorder
Ultima-K ParagonHDS Madetoorder Madetoorder
ValleyKone Any Madetoorder Madetoorder
VIPCone Any Madetoorder Madetoorder
xCone Any Madetoorder Madetoorder
ZenithLD BostonES,EO,XO 10.8-11.5 Madetoorder
TradeName LensMaterial Diameter BaseCurve
34
Specialty: Hybrid
TradeName LensMaterials Diameter BaseCurve
SynergeyesAPaflufoconD(center)/HemiberfilconA(skirt)
14.5 7.1-8.0mm
SynergeyesDuette(HD/MF)
RGPcenterDK130/SiHylensskirt(DK184)
14.5 7.1-8.1mm(0.2mmsteps)
SynergeyesKCPaflufoconD(center)/HemiberfilconA(skirt)
14.5 5.7-7.1mm(0.2mmsteps)
SynergeyesMultifocalPaflufoconD(center)/HemiberfilconA(skirt)
14.5 7.1-8.0mm
SynergeyesClearKonePaflufoconD(center)/HemiberfilconA(skirt)
14.5 Vault:100-600(0.50µsteps)
Specialty: Ortho-K
TradeName LensMaterial Diameter BasecurveBERetainer BostonEqualensII Madetoorder Madetoorder
Dreamlens BostonEqualensII Madetoorder Madetoorder
Emerald BostonXO,EqualensII 9.8-10.6mm Madetoorder
Jade BostonXO,EqualensII 9.8-11.4mm Madetoorder
OKSeries BostonXO 8.0-12.2mm Madetoorder
Orthofocus BostonXO,EqualensII Madetoorder Madetoorder
OrthoTool ParagonHDS100 7.0-12.0(0.5mmsteps) 6.5-10.5mm
ParagonCRTDualAxis ParagonHDS,HDS100 7.0-12.0(0.5mmsteps) 6.5-10.5mm
ParagonCRTRG4 ParagonHDS100 7.0-12.0(0.5mmsteps) 6.5-10.5mm
ParagonCRTSpecialty ParagonHDS,HDS100,MeniconZ 10.0-12.0(0.5mmsteps) 7.2-10.3mm
ParagonCRTStandard ParagonHDS,HDS100,MeniconZ 10.5-11.5(0.5mmsteps) 7.2-10.3mm
Vectre100 ParagonHDS100 10.8mm Madetoorder
35
Gas Permeable CL care
TradeName Manufacturer Preservative Other
BostonAdvance B+LDYMED,Chlorhexidine
gluconate,ED
Cleaner:Tri-quaternarycocoabasedphospholipid,Silicagel,Titaniumdioxide
Conditioners:PVA,PEG
BostonSimplus B+LDYMED,Chlorhexidine
gluconateHPMC,poloxamine
ClearCare Alcon NoneHydrogenperoxide
pluronic17R4
MenicareGP Menicon Benzylalcohol,EDLaurylSuldateSaltofImidazolineoctylphenoxypolyethoxyethanol
OptimumGP ContamacUS Benzylalcohol Sodiumbisulfite
OPTI-FREEGP Alcon PolyquadHPGuar
BoricAcidTetronic1304
Progent Menicon
SolutionA:NaCLO,sodiumcarbonate,sodiumhydroxide,purifiedwater
SolutionB:KBr,sodiumcarbonate,purifiedwater
UniquepH Menicon Polyquad/ED
HPGuar,Boricacid,
Tetronic1304,Poloxamine,PG,PEG
DYMED:PolyaminopropylBiguanide NaCLO:SodiumhypochloriteED:Edetatedisodium PEG:PolyethyleneglycolHPMC:Hydroxypropylmethylcellulose PG:PropyleneglycolKBr:Potassiumbromide PVA:Polyvinylalcohol
36
UsefulContactLenswebsites
Companies– www.abbconcise.com– www.abbott.com– www.acculens.com– www.alcon.com– www.artoptical.com– www.bausch.com– www.blanchardlab.com– www.cibavision.com– www.contamac.com– www.coopervision.com– www.essilorcontacts.com– www.jnjvisioncare.com– www.lensdynamics.com– www.meniconamerica.com– www.oculususa.com– www.paragonvision.com– www.specialeyesqc.com– www.synergeyes.com– www.valleycontax.com– www.walman.com
Organizations– www.aoa.org/x4783.xml(AOA-CL)– www.aaopt.org(AAO)– www.aocle.org(AOCLE)– www.bcla.org.uk(BCLA)– www.brienholdenvision.org(IERgradingscales)– www.clao.org(CLAO)– www.clsa.info(CLSA)– www.gpli.info(GPLI)– www.iacle.org(IACLE)– www.sclerallens.org– www.tearfilm.org(TFOS)
Patient info– www.aoa.org/contact-lenses.xml
(AOAconsumerpage)– www.contactlenses.org– www.mycontactlenses.org– www.nei.nih.gov/health/dryeye/index.asp(DryEye)– www.mayoclinic.com/health/dry-eyes/ds00463
(DryEye)– www.aoa.org/dry-eye.xml(DryEye)– www.nkcf.org(Keratoconus)– www.fda.gov/MedicalDevices/DeviceRegulationand-
Guidance/GuidanceDocuments/ucm077371.htm(ContactLenses)
Publications– www.claojournal.org(Eye&CL)– www.clspectrum.com– www.contactlensjournal.com(CL&AntEye)– www.contactlensupdate.com– http://journal.lww.com/corneajrnl(Cornea)– www.optvissci.com(OVS)– www.theocularsurface.com
References – www.bauscheducators.com– www.eyedock.com– www.opted.org/i4a/pages/index.cfm?pageid=3389
(ASCOresidencywebsite)– www.optometryresident.org(ORMS)– www.staininggrid.com– www.tearfilm.org/dewsreport(DEWSreport)– www.tearfilm.org/mgdworkshop(MGDreport)– www.truthaboutstaininggrid.com
Acknowledgements
We would like to acknowledge the efforts of the following people for the preparation of this guide;
Etty Bitton (Montreal), Project coordinatorClaudine Courey (Montreal) Jean-Sébastien Dufour (Montreal)My Tien Pham (Montreal) Vinita Henry (UMSL)Jan Jurkus (ICO)Susan Kovacich (IU)Bruce Morgan (MCO)Marjorie Rah (Boston)Christine Sindt (Iowa) Ron Watanabe (NECO)
Graphic Design: Denis Latendresse (Montreal)
2012-2014 AOCLE Officers
Chair: Bruce Morgan (MCO)Vice-Chair: Judy Perrigin (UH)Secretary: Susan Kovacich (IU)Treasurer: John Corzine (Berkeley)Past Chair: Vinita Henry (UMSL)
4th edition 2012Unit Value: $5.oo Cdn
would like to thank all of its sponsors for its support and commitment
towards contact lens education
sPonsors
Abbot Medical opticsAlcon Laboratories
Art optical Contact Lens Bausch + Lomb
Blanchard LaboratoriesContamac U.s.CooperVision
Essilor Contact LensesMenicon America
oculus Paragon Vision sciences
specialEyes synergEyes
The Vision Care Institute, LLCValley Contax
X-Cel Contacts