Can Your Doctor Override Manufacturers' Suggestions For Bifocal Lens Wear?

Georgiaonmymind · #1 (**permalink**) 05-13-2008, 04:08 PM

If you have a bifocal contact lens that's supposed to last for two weeks, can your eye doctor tell you it's okay to wear for a month? I mean, legally?

DebiK · #2 (**permalink**) 04-23-2010, 10:03 AM

Quote:

Originally Posted by Georgiaonmymind

If you have a bifocal contact lens that's supposed to last for two weeks, can your eye doctor tell you it's okay to wear fro a month? I mean, legally?

I'm not an eye doctor, but I would think that if your doctor examines your eyes and decides that your eyes are so healthy that you can wear bi-weekly lenses for a month, who am I to argue?
I would be more inclined to believe that a dishonest practitioner would tell you to change your contacts more often The more you spend on contacts, the more money there is to be made. If your doctor tells you to change your contacts less often, then making more money is probably not their goal.

Georgiaonmymind · #3 (**permalink**) 07-30-2010, 04:13 PM

Quote:

Originally Posted by DebiK

I'm not an eye doctor, but I would think that if your doctor examines your eyes and decides that your eyes are so healthy that you can wear bi-weekly lenses for a month, who am I to argue?
I would be more inclined to believe that a dishonest practitioner would tell you to change your contacts more often The more you spend on contacts, the more money there is to be made. If your doctor tells you to change your contacts less often, then making more money is probably not their goal.

That makes sense DebiK. Thanks.

DebiK · #4 (**permalink**) 09-08-2010, 01:54 PM

Quote:

Originally Posted by Georgiaonmymind

That makes sense DebiK. Thanks.

Glad I could help you.

Who's next?

Georgiaonmymind · #5 (**permalink**) 09-28-2010, 04:26 PM

Quote:

Originally Posted by DebiK

Glad I could help you.

Who's next?

Shall I do what someone did on another post and show a picture of Ben Stein going "Beuller? "Beuller?"

Knotlob · #6 (**permalink**) 09-29-2010, 03:58 AM

Quote:

Originally Posted by Georgiaonmymind

If you have a bifocal contact lens that's supposed to last for two weeks, can your eye doctor tell you it's okay to wear fro a month? I mean, legally?

All contact lens manufacturers qualify their recommended wear regimes with a statement to the effect that you should follow your own eye care professional's (ECP) advice. So yes, if your ECP says one month, that should be OK.

knotlob

Anthanxan · #7 (**permalink**) 09-29-2010, 08:51 AM

Quote:

Originally Posted by Knotlob

All contact lens manufacturers qualify their recommended wear regimes with a statement to the effect that you should follow your own eye care professional's (ECP) advice. So yes, if your ECP says one month, that should be OK.

knotlob

Well, now we've heard from Knotlob, and that makes it Official.

lurker2010 · #8 (**permalink**) 09-29-2010, 09:15 AM

The question isn't if the doctor can legally suggest wearing your lenses for longer then 2 weeks. The question is if you safely wear your lenses for more then 2 weeks. Proper cleaning, particularly with a lens you plan to wear for more then a week (maybe 2) requires rubbing. Many 14 day lenses will rip if you rub hard enough to properly clean them.

The number of days you can wear your lens may depend on how much protein (and other "stuff") you "deposit" on your lenses.

You need to examine your lenses for deposits and rips. Some patients may not even get 14 days.

You need to talk to your doctor. He/she may recommend a different cleaning and disinfecting procedure if you're planning on using the lenses for more then 14 days. You may need to use enzymes for example. It may also depend on what brand of lenses you have. Some may hold up better then others.

Keep in mind a doctor that officially suggests wearing a 14 day lens for 30 days may want you to come in for additional visits. Make sure your eye and lenses are OK. Obviously those visits would be an additional charge. The money you save on lenses may be spent on extra cleaning products and office visits.

JMO but a doctor is more likely to allow/suggest extending the number of days if the patient previously wore vial (quarterly or annual) lenses. A patient who knows about cleaning lenses. A patient who knows what a lens looks like when it's time to replace a lens.

I doubt a doctor is going to want to take the time to educate a patient who's never worn such a lens.

Petra · #9 (**permalink**) 09-29-2010, 10:10 AM

Quote:

Originally Posted by lurker2010

The question isn't if the doctor can legally suggest wearing your lenses for longer then 2 weeks. The question is if you safely wear your lenses for more then 2 weeks. Proper cleaning, particularly with a lens you plan to wear for more then a week (maybe 2) requires rubbing. Many 14 day lenses will rip if you rub hard enough to properly clean them.

The number of days you can wear your lens may depend on how much protein (and other "stuff") you "deposit" on your lenses.

You need to examine your lenses for deposits and rips. Some patients may not even get 14 days.

You need to talk to your doctor. He/she may recommend a different cleaning and disinfecting procedure if you're planning on using the lenses for more then 14 days. You may need to use enzymes for example. It may also depend on what brand of lenses you have. Some may hold up better then others.

Keep in mind a doctor that officially suggests wearing a 14 day lens for 30 days may want you to come in for additional visits. Make sure your eye and lenses are OK. Obviously those visits would be an additional charge. The money you save on lenses may be spent on extra cleaning products and office visits.

JMO but a doctor is more likely to allow/suggest extending the number of days if the patient previously wore vial (quarterly or annual) lenses. A patient who knows about cleaning lenses. A patient who knows what a lens looks like when it's time to replace a lens.

I doubt a doctor is going to want to take the time to educate a patient who's never worn such a lens.

You bring up some very good points, Lurker2010. Thank you. I wish I knew where I could get a Seal of Awesomeness for you, too.

Knotlob · #10 (**permalink**) 09-29-2010, 12:09 PM

Quote:

Originally Posted by Petra

You bring up some very good points, Lurker2010. Thank you. I wish I knew where I could get a Seal of Awesomeness for you, too.

That's a very valid point about previous vial/annual lens wearers and their attention to cleaning/disinfection regimes.

knotlob

Georgiaonmymind · #11 (**permalink**) 10-29-2010, 04:43 PM

Quote:

Originally Posted by lurker2010

The question isn't if the doctor can legally suggest wearing your lenses for longer then 2 weeks. The question is if you safely wear your lenses for more then 2 weeks. Proper cleaning, particularly with a lens you plan to wear for more then a week (maybe 2) requires rubbing. Many 14 day lenses will rip if you rub hard enough to properly clean them.

The number of days you can wear your lens may depend on how much protein (and other "stuff") you "deposit" on your lenses.

You need to examine your lenses for deposits and rips. Some patients may not even get 14 days.

You need to talk to your doctor. He/she may recommend a different cleaning and disinfecting procedure if you're planning on using the lenses for more then 14 days. You may need to use enzymes for example. It may also depend on what brand of lenses you have. Some may hold up better then others.

Keep in mind a doctor that officially suggests wearing a 14 day lens for 30 days may want you to come in for additional visits. Make sure your eye and lenses are OK. Obviously those visits would be an additional charge. The money you save on lenses may be spent on extra cleaning products and office visits.

JMO but a doctor is more likely to allow/suggest extending the number of days if the patient previously wore vial (quarterly or annual) lenses. A patient who knows about cleaning lenses. A patient who knows what a lens looks like when it's time to replace a lens.

I doubt a doctor is going to want to take the time to educate a patient who's never worn such a lens.

Actually, the question was "can your eye doctor tell you it's okay to wear [two week bifocal contacts] for a month? I mean, legally?" I did not ask "if you [can] safely wear your lenses for more then 2 weeks."
So yes, I want to know if your eye doctor can tell you to wear your contact lenses longer than they were designed to be worn. I know I can't on a forum such as this, because I'm far from an expert.
Let's put it this way. Will someone who is trained as a medical doctor and has experience in fitting contact lenses get in trouble with the law if she suggests to some of her patients that they can wear their contact lenses longer than their intended wear time?

lurker2010 · #12 (**permalink**) 11-06-2010, 03:25 PM

Quote:

Originally Posted by Georgiaonmymind

Actually, the question was "can your eye doctor tell you it's okay to wear [two week bifocal contacts] for a month? I mean, legally?" I did not ask "if you [can] safely wear your lenses for more then 2 weeks."
So yes, I want to know if your eye doctor can tell you to wear your contact lenses longer than they were designed to be worn. I know I can't on a forum such as this, because I'm far from an expert.
Let's put it this way. Will someone who is trained as a medical doctor and has experience in fitting contact lenses get in trouble with the law if she suggests to some of her patients that they can wear their contact lenses longer than their intended wear time?

You're still not asking the right question. Go to the FDA website. One of the most popular lenses marketed as a 14 day lens is filed with the FDA with the following indications for use:

Eye care practitioners may prescribe the lens for either single-use disposable wear or for frequent/planned replacement wear, with cleaning, disinfection and scheduled replacement. When prescribed for frequent/planned replacement wear, the lens may be disinfected with a chemical disinfection system only.

Some patients can wear the lens for more then 14 days, others less.

I checked a couple of other lenses marketed for planned replacement. None list the number of days. All leave it up to the practitioner.

I think you have your question reversed. I don't think it's legal for a lens manufacturer to tell the practitioner how many days a lens, filed for planned replacement,, can be worn.

petern · #13 (**permalink**) 11-07-2010, 10:07 AM

The manufacturer after developing the lens and with extensive research then recommends to the Doctor the anticipated life of the lens. This is not written in stone nor are you going to jail if you wear the lens longer. It is just a recommendation. Now if the Patient has a bad outcome, then in a court of law I would think that the Doctor and the Patient would be held responsible for not following the manufacturers instructions. Your Doctor has your Eye Health in mind when he/ she recommends lens changes. You pay for the advice and if it seems reasonable I would follow it. Just my opinion for what it is worth.

lurker2010 · #14 (**permalink**) 11-07-2010, 08:23 PM

Quote:

Originally Posted by petern

The manufacturer after developing the lens and with extensive research then recommends to the Doctor the anticipated life of the lens. This is not written in stone nor are you going to jail if you wear the lens longer. It is just a recommendation. Now if the Patient has a bad outcome, then in a court of law I would think that the Doctor and the Patient would be held responsible for not following the manufacturers instructions. Your Doctor has your eye health in mind when he/ she recommends lens changes. You pay for the advice and if it seems reasonable I would follow it. Just my opinion for what it is worth.

Not really true. Major lens manufacturers sometimes market the identical lens under different brand names with dramatically different prices. The different brand names are marketed with different replacement periods.

Read my prior post in this thread. Direct quote from the FDA site.

edited to add--The mfg is never going to suggest a replacement schedule that extends beyond the anticipated life of a lens. There are a variety of reasons why a mfg will sometimes market a lens for a time period far less then the anticipated life of the lens.

One reason is so the lens can be marketed with different cleaning/disinfecting procedures.

Eyeofharmony · #15 (**permalink**) 11-08-2010, 10:11 AM

Quote:

Originally Posted by lurker2010

You're still not asking the right question.

How can you say that Georgiaonmymond is not asking the right question? He or she is asking what he or she wants to know, and so is asking exactly the right question. How can you come on this site and tell someone that they're not asking about what they want to know?

I'd also like to address another statement you made. You quoted the FDA as saying that "eye care practitioners may prescribe the lens for either single-use disposable wear or for frequent/planned replacement wear, with cleaning, disinfection and scheduled replacement."
You made it sound like your eye doctor could be honest and tell you to replace your contact lenses once a week, or he can lie to you and tell you that you have to replace them every day. I don't think that's the case. (Not always, anyway.) I think some people can wear Brand A contact lenses for a week because their eyes are very healthy, but someone else whose eyes may not be so healthy may only be able to wear Brand A contacts for one day before they need to be replaced. That's not any kind of trickery or deceit, that's adapting your instructions to fit a particular patient's needs.

I'm just guessing here. Do we have anyone who can confirm my theory--or shoot it down?

lurker2010 · #16 (**permalink**) 11-08-2010, 10:12 AM

Quote:

Originally Posted by Eyeofharmony

How can you say that Georgiaonmymond is not asking the right question? He or she is asking what he or she wants to know, and so is asking exactly the right question.

Did you read my followup post.

The filings with the FDA generally leave the exact replacement schedule to the eye practitioner. 14 days is on the marketing material not in the instructions to the eye docto. The question is wrong because it assumes the eye practitioner is told to recommend replacing the lens after 14 days.

That said wearing a lens for more then 14 days probably (at least for many patients) requires a different cleaning routine. "No Rub" isn't enough. Enzyme cleaning might be required. One of the leading companies suggests doctor recommend replacing the lenses every 14 days to reduce the chances of GPC. Proper cleaning and use of enzymes also reduces the risk.

People who've worn annual (or even quarterly) lenses understand. I'm not sure how many doctors want to take the time to review this with a patient who's only worn daily or 14 day lenses.

Knotlob · #17 (**permalink**) 11-08-2010, 11:55 AM

Quote:

Originally Posted by Eyeofharmony

How can you say that Georgiaonmymond is not asking the right question? He or she is asking what he or she wants to know, and so is asking exactly the right question. How can you come on this site and tell someone that they're not asking about what they want to know?

I'd also like to address another statement you made. You quoted the FDA as saying that "eye care practitioners may prescribe the lens for either single-use disposable wear or for frequent/planned replacement wear, with cleaning, disinfection and scheduled replacement."
You made it sound like your eye doctor could be honest and tell you to replace your contact lenses once a week, or he can lie to you and tell you that you have to replace them every day. I don't think that's the case. (Not always, anyway.) I think some people can wear Brand A contact lenses for a week because their eyes are very healthy, but someone else whose eyes may not be so healthy may only be able to wear Brand A contacts for one day before they need to be replaced. That's not any kind of trickery or deceit, that's adapting your instructions to fit a particular patient's needs.

I'm just guessing here. Do we have anyone who can confirm my theory--or shoot it down?

If you have read the posts by Lurker2010 you will see that he repeatedly stresses that everybody's eyes are different. Some people would be perfectly OK medically with monthly (or even annual vial lenses). Others would have to use a Daily Disposable lens because the composition of their tear chemistry led to severe protein/lipid deposits.

Their eye care specialist can then select the lens mode which best suits them - be it Daily Disposable or Monthly, Annual, etc. We know that some manufacturers have in the past (if not at present) sold the same lenses packaged as different products. The eye care specialist can specify which lens is best for their patient. There is no trickery or fraud in this.

knotlob

mayibfrank · #18 (**permalink**) 11-08-2010, 12:01 PM

Quote:

Originally Posted by lurker2010

You're still not asking the right question.

Georgiaonmymind wanted to know if an eye doctor can legally tell you to wear a given contact lens differently from what the manufacturer suggests. How can that not be "the right question"?

Knotlob · #19 (**permalink**) 11-08-2010, 12:58 PM

Quote:

Originally Posted by mayibfrank

Georgiaonmymind wanted to know if an eye doctor can legally tell you to wear a given contact lens differently from what the manufacturer suggests. How can that not be "the right question"?

Go to any of the lens manufacturer's sites and read the documentation there.

They almost always include a phase to the effect that your eye care practitioner has the final say on how you should wear your lenses. The manufacturers don't take responsibility for determining the wear mode - how can they? They haven't seen the wearer's eyes. It is the eye care professional's decision/professional opinion that determines how you should wear your lenses.

That is another reason for annual eye health checks - to make sure your eyes are not reacting adversely over the longer term to your lenses (e.g. neovascularisation).

knotlob

Columbia · #20 (**permalink**) 11-08-2010, 03:43 PM

Quote:

Originally Posted by Knotlob

Go to any of the lens manufacturer's sites and read the documentation there.

They almost always include a phase to the effect that your eye care practitioner has the final say on how you should wear your lenses. The manufacturers don't take responsibility for determining the wear mode - how can they? They haven't seen the wearer's eyes. It is the eye care professional's decision/professional opinion that determines how you should wear your lenses.

That is another reason for annual eye health checks - to make sure your eyes are not reacting adversely over the longer term to your lenses (e.g. neovascularisation).

knotlob

I think you finally answered Georgiaonmymond's question, knotlob.

lurker2010 · #21 (**permalink**) 11-08-2010, 05:21 PM

Quote:

Originally Posted by Columbia

I think you finally answered Georgiaonmymond's question, knotlob.

I gave the same answer in post 12 of this thread.

Ordersixtysix · #22 (**permalink**) 11-09-2010, 10:47 AM

Quote:

Originally Posted by lurker2010

I gave the same answer in post 12 of this thread.

Yeah, you did, more or less. I guess both Knotlob and Columbia didn't scroll up to post 12.

lurker2010 · #23 (**permalink**) 11-09-2010, 11:45 AM

Quote:

Originally Posted by Ordersixtysix

Yeah, you did, more or less. I guess both Knotlob and Columbia didn't scroll up to post 12.

I guess my post wasn't clear. Knotlob worded his reply differently.

Metsman · #24 (**permalink**) 11-09-2010, 12:55 PM

Quote:

Originally Posted by Knotlob

Go to any of the lens manufacturer's sites and read the documentation there.

They almost always include a phase to the effect that your eye care practitioner has the final say on how you should wear your lenses. The manufacturers don't take responsibility for determining the wear mode - how can they? They haven't seen the wearer's eyes. It is the eye care professional's decision/professional opinion that determines how you should wear your lenses.

That is another reason for annual eye health checks - to make sure your eyes are not reacting adversely over the longer term to your lenses (e.g. neovascularisation).

knotlob

Thanks for your help Knotlob--and to lurker2010 as well for providing pretty much the same answer earlier. When it comes to contact lens wear time, I'd rather hear it from someone who knows me and my eyes than some generic website that gives the same advice to everyone.

mayibfrank · #25 (**permalink**) 12-21-2010, 03:55 PM

Quote:

Originally Posted by DebiK

I'm not an eye doctor, but I would think that if your doctor examines your eyes and decides that your eyes are so healthy that you can wear bi-weekly lenses for a month, who am I to argue?
I would be more inclined to believe that a dishonest practitioner would tell you to change your contacts more often The more you spend on contacts, the more money there is to be made. If your doctor tells you to change your contacts less often, then making more money is probably not their goal.

Instead of telling you to wear your two week lenses for a month, don't you think the eye doc would prescribe monthly lenses?

Georgiaonmymind · #26 (**permalink**) 12-23-2010, 01:11 PM

Quote:

Originally Posted by lurker2010

You're still not asking the right question. Go to the FDA website. One of the most popular lenses marketed as a 14 day lens is filed with the FDA with the following indications for use:

Eye care practitioners may prescribe the lens for either single-use disposable wear or for frequent/planned replacement wear, with cleaning, disinfection and scheduled replacement. When prescribed for frequent/planned replacement wear, the lens may be disinfected with a chemical disinfection system only.

Some patients can wear the lens for more then 14 days, others less.

I checked a couple of other lenses marketed for planned replacement. None list the number of days. All leave it up to the practitioner.

I think you have your question reversed. I don't think it's legal for a lens manufacturer to tell the practitioner how many days a lens, filed for planned replacement,, can be worn.

My question is exactly the way it should be. I asked what I wanted to know, so I did ask the "right question."
Somehow you were able to answer my question though, and I thank you. So even though you have a lens that's marketed as monthly, a doctor can prescribe it to be changed more often or less often, depending on the situation.

DebiK · #27 (**permalink**) 01-12-2011, 04:59 PM

Quote:

Originally Posted by mayibfrank

Instead of telling you to wear your two week lenses for a month, don't you think the eye doc would prescribe monthly lenses?

That may be true, unless you tell him or her that you don't want to sit through another fitting. Would an eye doctor just let you wear your contacts longer, or would they always prescribe contact lenses with a longer wear time, just to be on the safe side?

Columbia · #28 (**permalink**) 01-20-2011, 04:58 PM

Quote:

Originally Posted by DebiK

That may be true, unless you tell him or her that you don't want to sit through another fitting. Would an eye doctor just let you wear your contacts longer, or would they always prescribe contact lenses with a longer wear time, just to be on the safe side?

I think lurker2010 answered your question when he/she said "I checked a couple of other lenses marketed for planned replacement. None list the number of days. All leave it up to the practitioner."