Q: How Many Contacts Come in a Box?

A: Six*

This is one of the more common questions I hear when people are wondering how much their contacts are going to cost. The simple answer is six, but there is a better question to ask: “How much is a year supply of contacts?”

Some brands of contacts are meant to be replaced every two weeks and others are one month. So you have to buy twice as many boxes for a two week lens vs the one month kind. On average, the one month kind are almost twice as much as the two week lenses, but this varies from brand to brand.

In general, the cheaper contacts you see advertised to get you in the door are made from an older, plastic technology that in general is more dry and less breathable on your eyes. The newer contact lens materials cost a little more, but most people notice their eyes feel significantly less dry and red with the newer, breathable contacts.

If you want to find out how much contacts cost per box, check out 1800Contacts.com. If you buy a complete year supply, you can usually get a discount, and having a year supply tends to make it less likely that you will over-wear your contacts and get an eye infection.

*If you get the daily disposable contacts, they come in packs of 30 or 90.

Aqua Worx Health Fair Sponsors

Aqua Worx is sponsoring a health fair on Saturday July 9, 2011 from 10:00am to 3:00pm. I will be there to give simple screenings and answer general questions about eye health.

Planned events are:

• balance screening
• hearing screening
• blood pressure
• foot soaks
• massages
• skin cancer screening
• fitness, nutrition, and foot care education
• Door Prizes

So join me there at 209 W 300 N in Logan! Visit aquaworxhealthfair2011.blogspot.com for more information about the health fair.

Because the contact lens doesn’t completely cover your eyes, is it even important for your contacts to have UV blocking? This panel of expert eye doctors concludes that yes, it is. I think it’s especially true if your sunglasses do not have a wrap to stop UV coming in from the side. The UV light on a standard frame will sneak through the side and reflect off the back lens surface and onto/into your eyes. UV blocking contacts filter out these peripheral rays.

These graphs from Acuvue.com illustrate the difference in UV blocking ability between several popular brands of contacts:

UVA blocking ability of select soft contact lenses

UVB blocking ability of select soft contact lenses

Most contacts don’t block UV except Johnson & Johnson’s Acuvue brand of lenses. The reason is most soft contacts are created in a solid plastic and then hydrated at the end. Part of their process is to use UV light to cure the lens, so it would be impossible for these manufacturers to create a UV blocking lens. Acuvue, on the other hand, hydrates the lens from the onset, so they can build UV blocking into the material because they don’t need UV light curing for their polymer.

I know a guy who works for Acuvue who told me about a time his daughter went snow skiing and refused to put on sunglasses or goggles. At the end of the day, her eyes were completely red from UV light passing through the clouds, bouncing off the snow, and inflaming her eyes. When she took off the contacts that evening, she had a white ring where the contact lens overlaps from the cornea onto the conjunctiva. Her Acuvue lenses had spared her from getting a photokeratitis! (However, her photo-conjunctivitis was still pretty painful and required some eye drops to treat it.)

My message is, if all things are equal, contact lens wearers should consider getting contacts that block UV light. Also, everyone should wear sunglasses with a side wrap to decrease UV exposure to areas in and around your eyes. Your skin, conjunctiva, and lens will be healthier and look younger for longer. Start your kids out young with sunwear because this is the most important time to prevent UV exposure.

Sources for more information:

• Acuvue.com
• American Optometric Association
• Contact Lenses holding AOA Seal of Acceptance for UV blocking

(Note: not everyone can wear Acuvue lenses due to fit on their eye or prescription not available in their powers. Ask me during your eye exam if Acuvue lenses are a possibility for your eyes.)

• Replace your lenses on the approved schedule. (An old lens is a dry lens.)
• How many hours a day do you wear your lenses? Not all lenses are meant to be worn 14+ hours a day.
• Ask your eye doctor if he would recommend a certain kind of contact lens brand/material that could help decrease dryness and match your wear time lifestyle.
• What contact lens care system are you using? Ask your eye doctor for a recommendation considering your eye health and contact lens material.

The contact lens care system you buy is very important because not all contact lens materials are compatible with all contact lens solutions. This has been studied and the researchers publish a grid that helps us predict for most people what solutions they should use. Here is copy I grabbed from their website on January 26, 2011 (click to enlarge):

Match up your solution with your contacts. Is it usually compatible for most people?

My observations are that that Optifree and ClearCare are generally compatible with contact lens materials. (Please don’t just buy the Unisol Saline because it won’t disinfect your lenses.) In general, the Acuvue2, Acuvue Oasys, and Biofinity materials are compatible with most contact lens solutions.

So, in short, if you experience dryness, first start by replacing your contacts according to the recommended schedule which I mark on your prescription paper. If you already do this, then the next step I would take is try changing your contact lens care system.

In your contact lens exam I recommend and mark on your contact lens prescription paper specific contact lens care systems for your eyes based on the lens material, your previous experiences with solutions, and your eye health.

2011 Roadmap Planner with Daily Dats System™

More information is available at roadmapplanner.com, but in essence you can calendar, schedule, make goals, and track your goal progress/achievement all in one compact form factor that fits in your pocket. Just add a pen and get your life organized for just $10 (while supplies last).

The 2011 Roadmap Planner is available to buy from the website or pick one up at the office during doctor hours to avoid shipping fees.

By the way, I would be a contract provider with SelectHealth, but from Provo to Cache Valley they discriminate against optometrists and only allow ophthalmologists on their panel. I would suggest writing your Utah state senators and representatives and ask them to not allow the Utah state government to contract with insurance companies that do not allow any willing provider to be paneled.

This is a question that we get sometimes from people that happen to pass by the optical. The truth is, there is no way of knowing unless we do an actual paid exam. Why? Because red eyes can be caused from all sorts of different conditions. Not even your personal physician can really know without performing additional testing like flourescien drops and highly magnified ophthalmoscopic evaluation using a slit lamp. Such testing equipment isn’t commonly found in your regular doctor’s office, so whenever you or your child have a red and/or painful eye and/or decreased vision, come see me, your eye doctor.

Cases in point:

• Case #1:
  
  A distinguished gentlemen came in, miserable, because both eyes were painful, light sensitive, red, and very watery. His regular doctor told him that his eyes have a cold and to just wait it out. I saw him, evaluated his eyes with my equipment, and again concluded that his eyes did have a virus-caused condition, but rather than do nothing, he should try a prescription eye drop that will greatly enhance his comfort and decrease his redness.
  Diagnosis: epidemic keratoconjunctivitis
  Treatment is with a combination antibiotic and steroid eye drop. It doesn’t kill the viris causing the pink eye, but it helps your eyes be more comfortable and less watery and red. Patient tried it and was ecstatic.
• Case #2:
  
  This patient had a painful, light sensitive, watery, red eye. She is a contact lens wearer. On close examination with a slit lamp, I saw two cloudy circles on the cornea (which is supposed to be crystal clear). Using fluorescien dye and a blue light, the circles lit up green.
  Diagnosis: marginal corneal infiltrates.
  If your pediatrician gave your kid just an antibiotic drop, it wouldn’t help with this condition. It also requires a steroid eye drop.
• Case #3:
  
  Patient came in with painful, light sensitive, watery, red eye. Sound familiar? This time the cornea is clear (or there could have been white spots on the inside of the cornea), but the anterior chamber of the eye, viewable only under high magnification in a slit lamp, reveals small cells floating around.
  Diagnosis: iritis
  If your pediatrician treated this like a pink eye or even like a marginal corneal infiltrate, your poor child will unnecessarily suffer for a few days until you finally make it in to see me, your eye doctor. This condition requires a powerful steroid to calm the eye down. When these are recurrent, you need blood testing and possibly x-rays to determine the cause.
• Case #4:
  
  Patient came in with a painful, light sensitive, watery, red eye. Your pediatrician got burned the last two times, so let’s say they tried a steroid on this one. Ooops, it made it worse! When we look closer, the cornea has a characteristic pattern of grey/white lines with bulbs called dendrites. Your kid possibly has a history of cold soars and now she/he has one on the eye!
  Diagnosis: herpes simplex keratitis
  Anitibiotics are totally ineffective. Steroids make this condition MUCH worse. A frequently-installed and very expensive eye drop is the only way to treat this condition and minimize a permanent decrease in best possible vision.

Again, all these scenarios really require the expertise and equipment of me, your eye doctor, to help you quickly get relief and effectively handle your eye condition. And these are only a handful of possible problems your eye can have when it’s red. If your eye condition isn’t diagnosed promptly and treated effectively, you will be uncomfortable at best or have permanent vision loss in a worst case scenario.

I don’t have a beef with your primary care eye doctor or your pediatrician. They are great! But don’t put them in the position of having to deal with your red eye since most of them won’t have the equipment necessary nor the day-after-day experience to fully take care of your family’s eye conditions.

Also, you can see why you can’t just come up to me in in the optical and ask about what eye drop could help your redness because it totally depends on what is causing your redness! Your eyes are worth a paid exam.

A good study in Archives demonstrates that executive bifocals (+1.50) do retard myopia in fast-progressing myopes among children. After 2 years, axial length was .62 and myopia about -.50 more in the single vision compared to bifocal group- statistically significant, and if true over several years, very important to public health.

So set up an appointment to see if your child could benefit from bifocals to slow his/her nearsighted progression.

To offset your increased cost, I’ve changed one fee policy. From now on when dilation is needed as part of your eye exam, there is no extra charge for it.

Please review my new fees and keep updated on the new insurances that I can bill at the “Fee” page.