Intended for healthcare professionals

Rapid response to:

Practice Practice Pointer

Eye problems in contact lens wearers

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6337 (Published 27 November 2019) Cite this as: BMJ 2019;367:l6337

Rapid Response:

Eliminating Eye problems in contact lens wearers

Dear Editor

Regarding the BMJ article ‘Eye Problems in contact lens wear’ I wish to respond;

The main cause of eye problems associated with soft contact lens wear is the ‘modality’. There are three:
1. Over Night Wear (Extended Wear)
2. Daily wear with daily cleaning and repeated use (Reusable Wear) and
3. Daily-Wear with daily disposable (Daily-Disposable wear)

An added factor is whether the lens material contains Silicone or is simply a softer Hydrogel. There is now universal acknowledgement that the ‘lowest risk) modality is Daily-disposable. The incorporation of Silicone in such lenses, whilst increasing oxygen permeability (beyond what is needed for safe daily-disposable wear) has the negative effect of increasing ‘hardness’ of the material. This in turn, increases the incidence of corneal infiltrates as evidenced by increased appearance of mucin balls. They also carry a price premium.

In summary. By far the risk to be avoided is Loss of Vision eg due to Microbial Keratitis. I have attached three pages of independent research which demonstrate the eye-health benefits of Daily-Disposables. I am perturbed that Reusables and Extended-wear contact lens modalities are still being prescribed with, as far as I can see, no information for wearers as to the comparable risk factors, now so convincingly demonstrated.

I should declare an interest; I invented the daily-disposable lens and today make and sell millions annually via www.daysoft.com bringing the cost to a price-point comparable to Reusables. Daysoft’s extensive post market surveillance data covering sales of over 500 million lenses demonstrate the inherent safety of switching wearers to daily-disposable hydrogel lenses. The optical profession does not, in my opinion, sufficiently lay-out the relative risks due to commercial pressures. The section of the article in the BMJ “How patients were Involved” points to there being too little information in primary care about possible causes. I have copied Mr Hadley, Chairman of the General Optical Council. He is familiar with my views.

The comparable risk factors to which I refer are available from me by email (Ron.Hamilton@daysoft.com). They quantify the relative risks and should be given to ‘patients’ for informed consent.

Competing interests: No competing interests

19 February 2020
Ron Hamilton
Company Director & Founder. Inventor daily-disposable contact lenses. Graduate Engineer
Executive Chairman, Daysoft Limited, 5 Livingstone Boulevard, Blantyre, Scotland, G72 0BP