Yes, I can. Patients have the right to request their prescriptions from me and purchase lens elsewhere.
But I hope you'll purchase them from us. Here's why.
I can help patients much better if they have a problem after making purchase (which often happens). Sometimes it takes few different type of lenses and fittings to get the best fit and comfort. I can also supply spare emergency replacement lenses at no cost, or replace defective lenses from boxes.
What about cost? Our prices are competitive. Sometimes you will find lenses on the internet for less. And sometimes my prices will actually be cheaper.
My main concern is the health of my patients eyes, and feel I can offer you the best possible care when I can sell and adjust your contacts directly.
Last year a sales rep from a new lab told us about a new technology for digitally cutting progressive lenses with more accuracy and precision.
Both Julie and I personally tried these "high definition" lenses. We were impressed. Distance vision seemed exceptionally sharp with very good intermediate and near vision.
These digitally cut lenses have become our lens of choice for new progressive lens wearers. The feedback has been excellent.
Like all progressive lenses, they come with a 60 day warranty. If you don't like them, we'll help you choose a different style of progressive lens or bifocal, or exchange them for two pair of single vision lenses.
Mother Nature may well be a factor. Winter months are not only colder but drier (cold air doesn't hold moisture as well as warmer air). Contact lenses rely on a steady source of tears to stay moist. Dry air increases evaporation from both the skin and eyes -- that means less tears and less comfort for your contacts.
Here are some tips for countering excessive dryness, anytime of year:
1. Use more rewetting drops or artificial tears (Be sure to use the right drops for the type of contacts)
2. Use a humidifier - but don't overdo it. Too much humidity can promote growth of mold and dust mites.
3. Redirect air vents in your home or car away from your eyes -- moving air increases evaporation.
Of course, if your discomfort continues or increases, please make an appointment so we can examine your lenses and eyes further.
A study was published in the June 2008 issue of Ophthalmology reporting that individuals purchasing their contact lenses over the internet are 4.76 times more likely to develop contact lens-related bacterial infections. These infections could cause corneal scarring and loss of vision. Other factors that increase your chance of developing infections are: overnight wear, poor storage case hygiene, poor personal hygiene (not washing hands) and smoking. Please refer to my website to read my many blogs on how to prevent eye infections.
At your annual contact lens examination, I will update you on the most effective ways to take care of your contact lenses, as well as to inform you of any problems or defective products that may have been discovered.
Patients purchasing contact lens over the internet often try to avoid this important visit, and I believe that is a factor in why they are more likely to have problems with their contact lenses.
MULTIFOCAL CONTACT LENSES
Yes, multifocal contact lenses are available. When patients notice they can no longer comfortably read with their distance glasses, a new prescription is required for comfortable near vision. They either use traditional bifocals (2 prescriptions in one lens), trifocals (3 prescriptions in one lens), progressive lenses (a smooth transition from distance to near in one lens), or a separate pair of glasses for reading.
Until recently, contact lens wearers had only one option to avoid using reading glasses: Monovision (wearing a contact lens that corrects one eye for distance and a contact lens in the other eye that corrects for reading). Although some patients find this works for them, others find it disorienting. In addition, monovision wearers have decreased abilities to judge distances. Good depth perception is best achieved by both eyes contributing equally.
Contact lens companies (both in soft and gas permeable materials) have developed excellent designs that can correct vision at all distances, therefore negating the use of glasses. The most successful of these designs act like a progressive lens and also provide intermediate vision.
Most patients that try them are thrilled that they do not need reading glasses anymore. As they are somewhat new, they are not available for all prescriptions. Call our office to see if you are a candidate for multifocal contact lenses.
Hi everyone - Mitch Teplitsky here. I've been Dr. Tracy's client forever (well, nearly 20 years). And for the past 2 years, his web marketing consultant.
Usually Dr. Tracy writes his own blogs and newsletters. But this month I wanted to share my own story, about how Dr. Tracy helped my wife Doris wear contact lenses for the first time.
Doris is from Peru, and had never tried contacts before. Last summer we visited friends on Cape Cod, where Doris left her glasses on the beach. Lost at sea.
We hopped on our bikes to the nearby optometrist at Walmart, where Doris figured she'd try contacts.
The optometrist did a thorough exam and fitted her with a reputable trial brand. But Doris couldn't tolerate them. Her eyes got red and irritated.
Did this mean Doris couldn't wear contacts? Was it some pre-disposed condition? Maybe the type or brand of contacts wasn't right? The store didn't have other trial brands in stock to try.
Having edited several blogs about contacts with Dr. Tracy, I decided to place a call to The Man himself.
"Fitting contact lens is as much an art as a science," Dr. Tracy explained. "I have to really examine the health of Doris's eyes, her history, and then try to match her up with the right lenses -- and the right solution. It takes time. And some people just aren't meant for contacts at all, their eyes can't produce enough tears to support comfortable wear."
Doris saw Dr. Tracy upon returning to New York. In fact it took several exams and fittings to hone in on a system of lenses and solution that worked comfortably. We discovered that Doris's eyes were unusually sensitive, and worked best with a chemical-free solution.
It's one thing to edit and read Dr. Tracy's blogs about the art of fitting contacts, but another thing to witness it up close on one's wife! I was grateful. And it's nice to have a doctor who takes such pride in his craft.
"After many years of fitting contact lenses, I find it's very satisfying to fit someone successfully, who was unable to find a comfortable lens in the past, sometimes having tried many times."
Anything that comes into contact with your eye can potentially introduce micro-organisms (bacteria, virus, fungus) that can cause eye infections. Here's how to prevent that:
1. WASH YOUR HANDS
Always wash your hands before handling contacts. Use a soap that contains an antibiotic, but avoid brands with scents or moisturizers, which reduce contacts' ability to absorb tears and stay wet.
2.RUB THOSE LENS
Many cleaning solutions boast "No Rub" on the label. Ignore that. After hours of wear, lenses attract proteins, oils, mucous and external debris. Rubbing the surface does a much better job of cleaning than rinsing alone.
3. ALWAYS USE FRESH SOLUTION
Some patients leave old disinfecting solution in the case, and "top it off" with fresh solution. Bad idea. Older solution loses effectiveness and accumulates debris. A better tactic: throw out used solution each morning. Wipe cases with a clean tissue, and and let them air dry.
4. REPLACE YOUR CASE OFTEN -- as least every 2-3 months.
Think of your case as disposable. Yes, you should air dry and wipe them clean, but cases still get contaminated with coatings that harbor micro-organisms. (Ask us for a complimentary case).
5. DISINFECT YOUR CONTACT LENSES
I find many patients store their lenses overnight in saline, which has no disinfecting properties. Disinfecting only occurs in a Multi-Purpose solution -- basically a saline with a disinfecting and cleaning agent added -- or by soaking in a hydrogen peroxide-based system like Clear Care.
Exciting news for contact lens wearers: we've begun fitting patients with Biofinity (from CooperVision), a new brand that's been delighting users with their comfort and ease of use. I've been recommending them to anyone wearing contacts on a full-time and overnight basis.
Biofinity is a type of silicon hydrogel lens. They are far more oxygen permeable than other lenses -- yet easy to handle and very wettable. Silicon hydrogel lenses are available for astigmatism and in multi-focal (distance, near, and reading) designs.
The problems I've seen with contact lenses, including corneal swelling and clouding, have virtually disappeared when one changes to silicon lenses.
Please call the office if you would like more information.
Contact lenses have been in the news lately because of their association with eye infections. I will give you some practical ideas on how to minimize chances of developing an infection.
* Don't sleep overnight with your contact lenses. It has been proven that overnight wear greatly increases the chance of developing eye infections. If you do sleep overnight, make sure that you get your eyes examined more frequently and that you are wearing the proper contact lenses to minimize problems. Each additional night in a row that you do not remove your contact lenses increases the chances of developing problems.
* Wash your hands before inserting or removing your contact lenses. Anything you touch can harbor micro-organisms, which can be transmitted to your eyes, causing an infection
* Clean your lenses when you remove them. I have long been advising patients to ignore the "No Rub" written on the Multi-Purpose solution bottles. A good digital massage of the lens with a cleaning agent (and then rinsed) goes a long way to removing debris, coatings and "gunk" that build up on the surface each day, and allows the disinfecting step to follow to be even more effective.
* Properly disinfect your contact lenses. Contact lenses need to be disinfected when they are removed for the day or evening. Some soft lens solutions have been removed from the market (B&L ReNu with Moisturelock and AMO Complete) because of their failure to effectively disinfect certain micro-organisms. I have been recommending Alcon's Opti-Free Express Replenish because of its superior disinfecting ability. The two hydrogen peroxide systems (CIBA's Clear Care and AMO's Ultracare) are excellent disinfectants. Whichever system you use, be sure to follow the instructions for minimal soaking times.
* Change disinfecting solution daily. Dispose the previous night's solution when you put your lenses in, and use fresh solution for the next disinfecting. Don't "top off" the solution simply add fresh solution to the old, stale solution in the bottom of the case.
* Change your contact lens case on a regular basis. Cases tend to develop a film that can harbor bacteria, so consider your case as disposable as your contact lenses. I would recommend to replace your case each time you start your next bottle of solution (many companies include a new case with the purchase of their solution) If they don't, we will be glad to give you a complimentary case.
What happens when you grab a contact lens package or solution from your medicine cabinet - and see that the expiration date has passed?
Just what does "expiration date" mean anyway? It's actually the last date that the manufacturer can guarantee the full potency and safety of the drug - it doesn't mean that the drug will suddenly be ineffective or unsafe. (Enter "drug expiration date" on health sites like Medscape and Mercola and you'll find plenty of information).
As for contact lenses and solution: I'm not aware of any research on how long they can be used before they risk becoming contaminated.
So my advice, for now:
Respect the expiration dates of your lenses and solution, and obtain "fresh" products. Chances are you'll be fine with the older products, but why take the chance? As my long-time patients know, when it comes to your eye's health, I prefer to to be cautious.
Hello Dr. Tracy,
I just wanted to tell you before our next appointment that I love the new Acuvue lenses. I didn't intend to be brand-loyal, but these are much better than the first pair I tried. I am not having the issues with focusing either for distances or close up. Plus they are very comfortable.
Thank you so much for seeing me so quickly on Friday. I appreciate your follow-up time and care.
- Best, Sophia F.
The longer I fit contact lenses, the more I realize that it is more of an art than a science. What works best for one person, can be the worst lens for the next patient, for no logical reason.
Many optical "chain" stores make deals with one company to promote and sell their lens, with patient symptoms and complaints basically ignored.
Here we go again. Another alert about an eye infection associated with the use of a contact lens solution. The CDC (Center of Disease Control) reports an outbreak of a serious eye infection, and found an association with Complete Moisture Plus TM Multi-Purpose Solution.
If you use this solution you should:
1. Stop using it immediately and discard the bottle, including any unopened ones.
2. Discard your current pair of soft lenses AND storage container
3. Stop by our office for an Opti-Free Replenish care kit (the most effective multi-purpose solution on the market)
If you've been using CompleteR and are experiencing any sign of an eye infection - eye pain, eye redness, blurred vision, sensitivity to light, sensation of something in the eye, or excessive tearing - please make an appointment with an eye doctor immediately.
This infection is caused by a micro-organism called Acanthomeba, and although extremely rare, can have devastating consequences if not treated early.
Daily disposable contact lenses can't be beat for convenience. Yet many patients have found daily disposables less comfortable than other lenses. But two new disposable brands on the market may change that.
I've been testing two brands of daily disposables -- Definition 1 Days (Optical Connection) and 2 Clear Dailies (Cooper Vision). The initial findings have been excellent: more comfortable, easier to handle, and less drying than the three current brands on the market (Vistacon's Acuvue Daily, CIBA's Focus Daily, and Bausch & Lomb's B&L Daily).
Based on these findings, I'm encouraging current daily disposable wearers to try these new brands. Please call us to make an appointment for a fitting.
Even if you're comfortable and happy with regular lenses, you may want to consider daily disposables for special occasions - say, for swimming, traveling, a bike ride or late night social event.
With Quick Care off the market since last year, there are three main options:
1. Multipurpose Solutions like Opti-Free, Re-Nu, Complete and Aquify.
2. Hydrogen peroxide solutions like Ultra Care and Clear Care.
3. Using separate products for cleaning and rinsing/storing - e.g. CIBA's Pliagel cleaner with CIBA Softwear Saline.
A closer look at each below:
Option #1: Multipurposes Solutions - (Opti-Free, Re-Nu, Complete, Aquify)
Cleaning agents and disinfecting agents are all in the solution. They are being promoted as No-Rub, but are much more effective when used to rub the lenses. I think Opti-Free is the best of these, because of superior disinfecting properties and fewer problems with toxicity or allergic reactions to the chemicals. Opti-Free has been proven to work well with the new silicone based lenses. As of now Bausch & Lomb Re-Nu w/ MoistureLock is off the market because of an association with fungal infections.
Option #2: Hydrogen peroxide Solutions (Ultra Care, Clear Care, which replaced AoSept)
I would have normally recommended one of these systems as the first alternative to Quick Care, except that they have eliminated the daily cleaner from their kits. They both claim the cleaning agents they have added to the hydrogen peroxide solution do an adequate job of cleaning. I can't recommend to rub with the solution, as any slight residue on the fingers will severly sting and burn if transmitted to the eye. Each kit has a different way to neutralize the hydogen peroxide into water and oxygen, to render the solution essentially chemical free.
For extra cleaning power you could add a soft lens daily cleaner and saline rinsing to this system - using the Clear Care or the Ultra Care for disinfecting.
Option #3
The closest option to Quick Care is purchasing Pliagel (CIBA) daily cleaner separately and using CIBA Softwear Saline (the exact same product as Quick Care Finishing Solution) for rinsing and storing. Quick Care Starting Solution evolved from Pliagel, with a slightly increased alcohol content allowing it to pass FDA standards as a disinfectent. I cannot recommend this option because Pliagel hasn't been approved by the FDA as a disinfectant.
Recommendation:
At this time I am leaving it to each patient which option to select, depending on how much care you choose to take. If simplicity is the priority, try the Multipurpose (all-in-one) option, making sure to rub and rinse. If you choose not to rub the lens, make sure you rinse the lens as directed on the bottle, and be prepared to replace your lenses sooner. Most patients are using Multipurpose Solutions, with few problems. If one is willing to put more time into the care of their contact lenses, the most effective method is using separate daily cleaner, rinsing with saline, and then using a hydrogen peroxide system for disinfection purposes only.
The best care system for you depends on how willing you are to put extra time into caring for your lenses and on how often you would like to replace your lenses.
Bausch & Lomb's ReNu Multipurpose Softlens Solution (the top selling brand) has been in the news lately because of its link with a recent outbreak of fungal corneal ulcers - and today the company announced that it has suspended shipments.
It's not clear yet from the stories I've read whether the suspected problem has to do with contaminated solutions, or ReNu's inability to properly kill this fungus.
In any case, fungal infections (characterized by a constant scratchy to painful feeling, extra redness, and excessive sticky secretions) are extremely rare, and usually stem from accidental scratches on the cornea.
Follow recommended hygiene and you shouldn't have a problem:
- Wash hands
- soak overnight in a proper disinfecting solution
- replace your case at regular intervals
- replace your contact lenses in a timely manner
Which product should you use instead?
We're recommending Alcon Opti-Free, a multi-purpose one step soft lens solution. Stop by our office for a free Opti-Free starter kit.
Other good products include Complete and CIBA Aquify. By the way, CIBA's Quick Care - a two-step kit I've recommended for years because of its strong cleaning and disinfecting qualities - has also been discontinued. It seems the public greatly prefers simplicity over effectiveness.
As many types of contact lens care systems are becoming harder to find, wearers are turning to All-in-One Multipurpose Solutions. "No rub" is usually written prominently on the bottle. But when it comes to cleaning your contacts thoroughly, there's still no substitute for rubbing.
No matter what the bottle says, here's what to do: Take your lens, add a couple of drops of the solution, and rub the surface for a few seconds — either between thumb and forefinger, or by placing on your palm and rubbing with forefinger. Be sure to rub both sides before rinsing well with your multipurpose solution or saline.
How often should you change your case? A good rule of thumb is at least every three months. Over time, cases can develop a film and dirt that harbor hard-to-remove bacteria.
Drop by the office and pick up a free case in a variety of cool styles and colors (while supplies last).
More about contact lens...
Contact lens keep getting better, with new materials that stay comfortable longer and offer more options, like correcting astigmatism, multi-focal disposables and progressive lenses.
But there's a trend in the industry that I don't much care for -- the push towards all-in-one solutions that clean, rinse and disinfect.
Yes, all-in-ones are convenient, and certainly good for occasional use (like travel). The problem is, they don't do any one job nearly well as products formulated for each task. And that may lead to more contact lens irritation and infection.
I strongly recommend using a separate daily cleaner -- followed by a good saline rinsing.
As to which brands: you have to try them for yourself. I don't think any one brand is superior to the others, but some patients do find certain brands more effective. Here are the brands on the market today:
1. Miraflow Extra Strength Daily Cleaner (CIBA)
2. Lens Plus Daily Cleaner
3. Pliagel
4. B&L Sensitive Eyes Daily Cleaner
5. Opti-Free Daily Cleaner (Alcon)
Did you know that even a tiny amount of oil on a contact lens can be impossible to remove, and even ruin the lens?
It's not hard to understand why. Oil repels water -- and contact lens need stay wet to be comfortable.
Here are six tips to eliminate or greatly reduce oils and keep your contacts in great shape:
1. Avoid soaps with moisturizers, aloe, perfumes, or fragrances. Good old Ivory has always been a mainstay for contact lens wearers. Better yet -- use an antibacterial soap that's oil or moisturizer-free.
2. RInse your hands thoroughly with water -- epecially after applying creams and lotions to other parts of your body.
3. Use water-based makeup. Oil-based will be just-about impossible to remove.
4. Close your eyes when using any sprays -- hairsprays, deodorants, etc.
5. Use a separate daily cleaner after contact lens use. These cleaners are formulated to remove oils and prevent build-up.
Daily disposable contact lenses can't be beat for convenience. Yet many patients have found daily disposables less comfortable than other lenses. But two new disposable brands on the market may change that.
I've been testing two brands of daily disposables -- Definition 1 Days (Optical Connection) and 2 Clear Dailies (Cooper Vision). The initial findings have been excellent: more comfortable, easier to handle, and less drying than the three current brands on the market (Vistacon's Acuvue Daily, CIBA's Focus Daily, and Bausch & Lomb's B&L Daily).
Based on these findings, I'm encouraging current daily disposable wearers to try these new brands. Please call us to make an appointment for a fitting.
Even if you're comfortable and happy with regular lenses, you may want to consider daily disposables for special occasions - say, for swimming, traveling, a bike ride or late night social event.
Ever since the Bausch & Lomb Moistureloc scare several months ago, the Optometric and Contact Lens journals have published articles about the importance of proper care to avoid infections. I feel the solution industry itself is somewhat to blame, as I think they are going too far in simplifying the care.
For many years, the solution makers have instructed professional contact lens fitters to stress the importance of using a separate cleaner to disinfect and throroughly remove deposits and buildup.
Since the arrival of disposable lenses, the industry has downplayed the cleaning step, assuming that the contact lens would be discarded before a problem could develop. They now include a very mild cleaner in the multi-purpose solution and promote it as a NO RUB solution. The FDA, when granting approval for these solutions, requires a thorough rinsing of both surfaces with the solution, as a substitute for rubbing, but the multi-purpose solutions do not emphasize this in their packaging.
THE BASICS - to reduce chances of getting an eye infection:
1. Wash your hands before handling your contact lenses.
2. Replace your contact lens case on a regular basis - Over time, cases can develop a "biofilm" that may harbor micro-organisms. Even if you wash your hands, you can pick up a micro-organism at the last minute while handling the case. Think of the case as disposable.
3. Remove your lenses at night before going to sleep. Despite the availability of "super oxygen" transmitting lenses that are much safer than previous lenses, overnight wear significantly increases the chance of an infection.
4. Make sure you are disinfecting your lenses before they are re-inserted the next day. I find there are some patients who do not understand the disinfecting procedure, and are storing their lenses overnight in saline solution, which has no disinfecting power. If you are not using a daily cleaner to clean your lenses, the chances increase even more. (I am convinced the daily cleaner not only cleaned the lenses, but also was responsible for removing micro-organisms that may have been hanging out in the secretions on the lens)
5. Add a daily contact lens cleaner to whatever system you are currently using (Multi-purpose or Hydrogen Peroxide). Reminder - the cleaner must be thoroughly rinsed off the lens, or it will burn and sting when inserted.
6. Replace your contact lenses as directed - The older the lens gets, the more chance it will irritate your eye and cause an infection. Whatever type of lens you are wearing or whatever schedule you are on - replace your lenses before they become uncomfortable.
7. Don't wear your contact lenses if you don't feel well, or if your eyes are red and/o the lenses are uncomfortable.
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