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Dropping out due to contact lens discomfort? ‘Nesofilcon A’ might be a solution.

by | Aug 1, 2020 | Manuscripts | 5 comments

Sucheta Mitra, M.Optom

Amity University, Haryana

 

INTRODUCTION

 ‘Nesofilcon A’ is one of the highly recommended choice for those people who dropout due to contact lens discomfort. This case description shows how a patient, who is reluctant to use contact lens, successfully converted into a daily disposable lens. The most common reason for contact lens dropout is the discomfort caused by dryness which often leads to visual disturbance and blurred vision1. ‘Nesofilcon A’ is high water content (78%) material and copolymer of HEMA and N-vinyl pyrrolidone. In the first 15 minutes of wear, this lens maintains all its initial water, which results in a stable tear film maintaining a low level of dehydration and a high level of visual quality. This lens retains 98% of the water over the next 16 hours of wear2, 3

CASE REPORT

A 29-year female visited for a routine eye checkup with complain of vision blurriness at distance. She had a history of using glasses for over 15 years and silicone hydrogel contact lens (biweekly disposable) for a month, which she later discontinued using due to eye irritation and discomfort at the end of the day. By profession, she was an IT professional, therefore due to lack of interest and time she always preferred glasses over contact lenses.

Upon presentation, the aided visual acuity was –8.25 DS (6/9) and near visual acuity for both eyes were N6 (at 30cm). Anterior and posterior evaluations were within normal limits. Following to a counselling session, the trial was done with ‘Nesofilcon A’. Patients visual acuity improved to 6/6 and she was comfortable with the trial lenses in her first visit. The daily disposable lens was prescribed with BC 8.6, TD 14.2 and BVP –7.50. In the follow-up visit, the patient had no complaints and was comfortable with the lens.

Some of the common complaints a patient report while wearing lenses are irritation, blurred vision after prolonged use. These complaints are reported due to lens drying out as the day progresses4. This case represents a very similar outline. When the patient visited the clinic, she with complained of blurry vision even with her eyeglasses and revealed that her vision never improved. She briefly used a biweekly SiHy contact lens and then discontinued due to discomfort. The root cause of her discomfort was unidentified. For these set of patients, daily disposable lenses are the best choice and ‘Nesofilcon A’ material lenses are suitable as these types of lenses are made up of 78% of water, which retains the moisture in the lens for longer durations.

Contact lenses are not only able to provide the best quality vision but also able to maintain comfort. Patients usually dropout from contact lens wear due to irritation, dryness after prolonged use, but these issues can easily be resolve by considering the nature of the profession, care and maintenance, modality, and material of the lenses.

REFERENCES

  1. Lubis, R. R., & Gultom, M. T. H. (2018). The correlation between daily lens wear duration and dry eye syndrome. Open Access Macedonian Journal of Medical Sciences, 6(5), 829–834. https://doi.org/10.3889/oamjms.2018.215
  2. Saxon, J., Rah, M. J., & Reindel, W. T. (2019). Satisfaction of astigmatic patients with toric nesofilcon A contact lenses. Clinical Optometry, Volume 11, 1–10. https://doi.org/10.2147/OPTO.S191835
  3. Hydrogel contact lens materials: Dead and buried or about to rise again? | Contact Lens Update. (n.d.). Retrieved June 7, 2020, from https://contactlensupdate.com/2013/10/07/hydrogel-contact-lens-materials-dead-and-buried-or-about-to-rise-again/
  4. Dumbleton, K., Woods, C. A., Jones, L. W., & Fonn, D. (2013). The impact of contemporary contact lenses on contact lens discontinuation. Eye and Contact Lens. https://doi.org/10.1097/ICL.0b013e318271caf4

 

  1. Somayeh on at

    could please mention which company provide the contact lens with NasofilconA material ?

  2. Suraj on at

    1. What did anterior and posterior evatualtions means?- I mean to say that, was there any papillary changes in the UTC or LTC or corneal aberations or dry spot on the cornea, due to that the patient was not comfortable with her Si-Hy lenses. And in the posterior evaluation you should clearly mentioned about the status of retina as the patient was high myopic.
    2. What was the patient k- reading?-Its not mentioned in the report
    3. You could have mentioned about the status of meibomitis as the meibomitis is the most common cause of dryness in a patients who are wearing since long time.

    • Sucheta on at

      Anterior and posterior evaluations mean all. The patient was highly myopic and hence posterior examination was done and the retina was normal. The reason why I mentioned within normal limit is that there was no sign of dry eye/ meibomitis. As it is a case of soft CL hence K reading was not mentioned.
      Thank you so much for your comment. It will really help me with further work.

  3. Jasper on at

    I know Silicone Hydrogels are the most popular lenses right now, but they are actually less comfortable than improved “traditional” Hydrogels. For example, I find the Si-Hy lenses from all manufacturers less comfortable than hydrogels from the same manufacturer. As an example, Acuvue Moist is more comfortable than Oasys. B+L Biotrue is far more comfortable than B+L Ultra. And the same goes for all products I’ve tried. Oxygen permeability shouldn’t be the only factor when fitting a lens, comfort should be first. I think docs have went too far into pushing the industry line, Si-Hy lenses are what manufacturers push the most, so that is what docs feel like selling. It should always be about comfort, IMO. Good article!

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