Brief History
In 1971, Bausch & Lomb introduced the first commercially available soft contact lens. For years, this conventional soft daily wear lens was the only type of soft contact lens available. This lens ideally was meant to last between 6 and 12 months and required daily cleaning and weekly enzymatic treatment.
In 1981 the FDA approved the first contact lenses approved for extended or overnight wear.
It wasn’t until 1991 that the first frequent-replacement contact lenses were sold. Frequent-replacement contacts are typically replaced every 1 to 3 months. The next year, 1992, disposable contacts (disposed every 2 weeks or less) were introduced.
In less than a decade, frequent-replacement and disposable lenses became the lenses of choice for the vast majority of eye care providers. Today approximately 75% of soft contact lens patients are wearing some sort of frequent-replacement or disposable lens. Frequent-replacement and disposable contacts are available as both daily and extended wear.
Soft Contact Lens Options
As implied, daily wear contacts are removed and cleaned daily, while extended wear lenses can typically be worn continuously for up to 7 days (or more as CibaVision’s Focus® Night & Day® contacts have been approved for up to 30 days continuous wear).
Disposable contacts are, as the name implies, disposed on a regular period, while the non-disposable contacts are cleaned and disinfected before reinserting the contacts.
Patients who choose extended wear should be aware of the added risk of eye infections and complications that come with sleeping in contacts. I typically discourage extended wear, but will fit contacts as extended wear only after the patient understands the added risk and agrees to be seen for more frequent follow-ups. I also will use a silicone hydrogel lens material for these patients.
Types of Soft Contact Lenses Available
Soft contact lenses are available for a variety of visual corrections.
For patients with significant astigmatism, I will often use a soft toric contact lens. Toric contacts have improved greatly over the last few years. Indeed, many patients who have never been able to wear contacts due to their astigmatic prescription are now able to successfully wear contact lenses.
Soft bifocal contacts are a relatively recent option for patients requiring a reading prescription or bifocal. Along these same lines, monovision continues to be a good option for these same patients. Monovision correction does not use a bifocal contact, but rather uses one contact for the distance vision (usually the dominant eye) and one contact for the near vision.
Soft contact lenses come as either clear or with a visibility (handling) tint. The visibility generally has no effect on eye color, but is there to help you see the lens while you’re handling it. These lenses are not the same as cosmetic soft contacts.
Cosmetic soft contacts have been popular sellers since their introduction. Now patients with or without a prescription can change the color of their eyes with colored or tinted contacts.
CibaVision’s Wild Eyes® contact lenses and CooperVision’s Crazy Lenses are novelty lenses that are fun to fit around Halloween.
Concluding Thoughts
Part of the reason for the success of soft contact lenses is the comfort these lenses offer over rigid gas permeable (RGP) contacts. As a result, they have a much shorter adaptation period. However, in some cases with soft contacts, vision may not be as sharp as with RGP contacts.
When prescribing a soft contact, my first lens of choice is CibaVision’s O2Optix™. This lens can be worn for up to one week extended wear or two weeks daily wear. For patients who may not want a disposable lens (this is very rare), I will recommend CibaVision’s Cibasoft® Visitint® standard daily wear.
For patients who experience drying with their contacts, I will often recommend contacts with newer, moisture-retaining materials. Such contact lenses include Proclear® Compatibles by CooperVision and Acuvue® Advance™ with Hydraclear by Vistakon (Johnson & Johnson). Indeed, Vistakon has recently launched the Acuvue® Oasys™ with Hydraclear, which is primarily targeted for patients who experience contact lens dryness.
Regardless of your own situation, chances are good that you will end up wearing a soft lens if you decide to try contacts Be sure to discuss with your eye care provider all the options you may have, given your prescription, age, needs, and expectations.
