Now that Acuvue recently introduced the first silicone hydrogel daily disposable contact lens approved by the FDA, wearers likely will want to know if benefits merit the extra cost of the lens material.

If you are on a budget, you may need to consider costs versus benefits of Acuvue's 1-Day TruEye daily disposable contact lenses.

Acuvue’s 1-Day TruEye daily disposables are made of what the company describes as a “breathable” type of silicone hydrogel contact lens material known as narafilcon B.

Before Acuvue offered silicone hydrogel dailies, these types of contact lenses were replaced only at intervals ranging from weekly to monthly.

But despite benefits such as extra comfort, some eye care practitioners say daily disposable silicone hydrogel contact lenses are roughly twice as expensive as other types.

And because the lenses are disposed of daily, the comfort aspect may not be as much of a factor as it is with lenses that have longer replacement schedules.

“Silicone hydrogel lenses may be overkill for daily disposables,” said Brian Chou, OD, a partner at Carmel Mountain Vision Care — a group optometric practice in San Diego.

But Larry K. Wan, OD, of Family EyeCare Center in Campbell, Calif., disagrees.

“The TruEyes silicone hydrogel contact lens provides five times more oxygen to the eye than other one-day, single-use lenses, and has the highest level of UV protection,” Wan told Contact Lens Headlines. “It may be the most comfortable and trouble-free lens option available.”

But Chou said he is inclined to wait and see if the new silicone hydrogel daily genuinely is cost effective for his patients.

“If there are two lenses that perform equivalently well but one lens is half the cost, I will prescribe the lower cost lens to serve the patient’s best interests,” Chou said.

Depending on the geographic market, Wan said TruEyes contact lenses cost about $15 to $17 more per 90-lens box than other products on the market. He said this expenditure amounts to about $1.80 per day for wearers.

“This is about the same as what a pair of high-quality eyeglasses would cost you,” Wan said. “For many patients, this is a tremendous value for the quality.”

Since disposable contacts were introduced in 1987, there has been plenty of controversy about how frequently you should replace your contacts to keep the lenses comfortable and your eyes healthy.

A consensus opinion doesn’t seem to exist among optometrists, as evidenced by a point-counterpoint discussion of the topic published in the June 2010 issue of Contact Lens Spectrum.

Colleen M. Riley, OD, vice president of professional development at Vistakon / Johnson & Johnson Vision Care, says disposable contact lenses should be replaced every two weeks for better vision, less contact lens discomfort and fewer complications.

Offering a different opinion, Peter D. Bergenske, OD, director of professional support at Ciba Vision North America, says popular and highly oxygen-permeable silicone hydrogel contact lenses make monthly replacement sufficient, and replacing contacts on a monthly basis is easier for contact lens wearers to remember than a two-week replacement schedule.

Other eye doctors prefer weekly replacement of disposable contacts. Weekly replacement is more likely to keep the lenses clear and comfortable, and a one-week replacement schedule is very easy for lens wearers to remember and comply with, they say.

Still other eye care practitioners say daily disposable contact lenses are the best choice. With daily disposables, there is no need to remember when to replace your contacts since they are discarded after a single use. Though daily disposable contacts may be the most costly option, many contact lens wearers prefer the convenience of not having to clean and disinfect their contacts at the end of the day, and there is no need to purchase lens care products.

So which contact lens replacement schedule is best for you? That may depend on your eyes as much as your personal preferences.

To determine the type of disposable contacts and the lens replacement schedule that are best for your needs, budget and lifestyle, it’s wise to discuss all options with your optometrist or ophthalmologist.

High-index lenses aren’t just for eyeglasses anymore. New high-index gas permeable (GP) contact lens materials now make GP contacts thinner and lighter, especially for people with high prescription powers.

Like high-index eyeglass lenses, high-index gas permeable contacts bend (refract) light more efficiently, so less lens material is needed for a given prescription power.

In the June 2010 issue of Contact Lens Spectrum, Ronald K. Watanabe, OD, associate professor of optometry at New England College of Optometry, outlines the benefits of high-index GP contacts. These include:

• Because high-index lenses are thinner than regular GP lenses, they fit more easily under the upper eyelid, which can improve comfort, especially in cases of high myopia.

• High-index GP lenses also are lighter, which can improve the upper eyelid’s ability to hold them properly in place on the eye.

• High-index materials also can increase the effective “add” power of aspheric GP multifocal contacts, potentially providing a better correction of presbyopia for contact lens wearers over age 40.

On the downside, high-index gas permeable contacts may not stay as moist as conventional GP lenses, possibly making them less comfortable for someone with dry eyes.

Also, high-index lenses have a lower oxygen permeability than some other GP lenses, which may be a problem for wearers whose corneas cannot tolerate a reduced oxygen supply, according to Dr. Watanabe.

Dry eye disease is widespread among contact lens wearers and is a significant reason people stop wearing contacts, according to Gary N. Foulks, MD.

Dr. Foulks is professor of ophthalmology at the University of Louisville (Louisville, Ky.) and a recognized expert in dry eyes. He discussed the condition at the annual meeting of the American Academy of Ophthalmology.

Dry eye symptoms are reported by 50 to 80 percent of people wearing contact lenses and may be the limiting factor in at least one-third of cases of contact lens wear failure, Dr. Foulks said.

An underlying cause of dry eye problems suffered by contact lens wearers is a condition called meibomian gland dysfunction (MGD), which is characterized by reduced secretions from oil glands located at the eyelid margins.

Oil secreted by meibomian glands becomes part of the tear film that coats the surface of the eye. If the meibomian glands become plugged or fail to secrete adequate oil for other reasons, the tear film quickly evaporates, leading to dry eye problems.

According to Dr. Foulks, MGD is present in 40 to 50 percent of patients in a typical optometric or contact lens practice.

Symptoms of meibomian gland dysfunction and dry eye are similar, and include:

• fluctuating vision (especially when reading or using a computer)
• eye irritiation
• a feeling something is “in” the eye (foreign body sensation)
• an eye itching or burning sensation

Treatment for MGD includes lid hygiene with hot compresses, followed by lid massage to open plugged meibomian glands. In more severe cases, topical antibiotic and anti-inflammatory medications may be needed.

Artificial tears and lubricating eye drops are the primary treatment for dry eye disease. Anti-inflammatory treatment with cyclosporine A (Restasis prescription eye drops) also has been shown to successfully manage dry eyes. Use of punctal plugs to slow the drainage of tears from the surface of the eye also can be helpful.

Recent research shows that dietary supplementation with flaxseed oil also may help reduce signs and symptoms of MGD and dry eye.

If your contact lenses are becoming uncomfortable and you suspect you have dry eyes, see your optometrist or ophthalmologist immediately. Early recognition and treatment of dry eye and MGD can control and prevent progression of these conditions and make your contact lens wear more comfortable.