editor's perspective
Continuous Wear and the Contact Lens Event of 2003

In the past few months I've read numerous reports in the lay press and (even more troubling) in the professional and scientific literature that 30-day continuous wear is a new phenomenon that was just introduced in this century. It reminds me of young sportscasters who compare today's great athletes and say, "They are the greatest ever," when they never saw the ones who played decades ago. How would they know?

I'm not saying that the 30-day extended wear (we say continuous wear now) lenses that the FDA approved 20 years ago were great for that indication, but I am saying that this modality is not new. The currently approved extended wear hydrogels (for up to six nights of extended wear) and silicone elastomer lenses received approval in the early 1980s for up to 30 days of wear. (I just felt the need to set the record straight.)

Are current and future silicone hydrogel and hyper-Dk GP materials for 30-day continuous wear the answer for extended and continuous wear? Patients certainly are increasingly wearing them. Will practitioners proactively prescribe these lenses for this regimen? Certainly they will use them as a healthy alternative. More study and experience will tell us if they provide the safety we hope for.

Vistakon's introduction of its new silicone hydrogel lens is certainly a significant event in 2003-2004.

So what is the contact lens event of 2003? The US House of Representatives passed the plano contact lens bill, HR 2218, which amends the "Federal Food, Drug and Cosmetics Act" to recognize and regulate both corrective and non-corrective contact lenses as medical devices, regardless of their intended use. Representatives Henry Waxman (D-CA) and John Boozman (R-AR) introduced this bill in the House in May after reports of serious ocular injury resulting from unsupervised use of the lenses. Senators Mike DeWine (R-OH) and Ted Kennedy (D-MA) have introduced the Senate companion bill, S 1747.

But the "Fairness to Contact Lens Consumers Act" (HR 3140) was the most important event of 2003. The bill, which Representative Richard Burr (R-NC) introduced in May, mandates that eyecare providers give patients a contact lens prescription following their exam, fitting and healthy follow up, along with meeting certain prescription fulfillment needs of contact lens dispensers.