Contact Lens Care Goes Back to Basics

Revision of Standards Applying to Contact Lens Care Products LCPs) Likely

Following the issues that arose around the efficacy-in-use of several LCPs in the period 2006-2007 and the revisiting of the ‘No Rub’ issue that followed, advice was sought from interested parties by various regulatory authorities around the world on what might be done to reduce the likelihood of such events recurring. Foremost among authorities reviewing the episodes reported was the US Food and Drug Administration (FDA). Many practitioners, educators, and even some industry members have always regarded the concept of ‘No Rub’ contact lens care as being flawed. What perplexed this group of doubters was the realization that, with few exceptions, the legions of contact lens wearers around the world seemed to have ‘gotten away with it’ for so long (more than a decade). Yet others questioned ‘why it took so long’ for the predictable problems to surface. Some could even be heard to say “the low problem rate speaks well of the performance of modern LCPs, particularly Multi-purpose Solutions (MPSs) and later, One Bottle lens care Systems (OBSs)” when in truth, it is probable that what they should have been saying was “aren’t the eyes fantastic at looking after themselves” despite the use of regimens and products that are imperfect.

In 2008, the FDA received detailed submissions from the following at an open public hearing:
The FDA Ophthalmic Devices Panel Meeting (2008 June 10):

• Drs Ehlers & Tu representing:
– American Academy of Ophthalmology (2 submissions)
– Contact Lens Association of Ophthalmologists (2 submissions)
– The Cornea Society (2 submissions)
– American Society of Cataract & Refractive Surgery (2 submissions)These groups also tabled a set of joint recommendations for improving contact lens safety (visit:http://www.aao.org/newsroom/release/20080610.cfm)

• Dr Louise Sclafani & Prof. William Benjamin representing the American Optometric Association (visit:http://www.aoa.org/x10664.xml)

• CLI (Contact Lens Institute) representing:
– Alcon
– CIBA Vision
– AMO
– CooperVision
– Bausch & Lomb
– Johnson & Johnson

• Dr Simon Kilvington (scientist, widely-published UK author: micro-organisms & LCPs)
• Dr Arthur Epstein (practitioner, consultant, and columnist
• Dr James Thimons (educator and practitioner)
• Dr Mark Willcox (scientist, Institute for Eye Research, Sydney)
• Dr David Hansen (Professional Services, AMO)
• Dr Francis Mah (ophthalmologist, Uni. of Pittsburgh)
• Dr Charlotte Joslin (optometrist, post-graduate student, author)
• Prof. Dwight Cavanagh (ophthalmologist, author, editor)
• Dr James Saviola (optometrist, FDA)
• Dr Danica Marinac-Dabic (MD, FDA)
• Dr Jennifer Rabke Verani (MD, MPH, Centre for Disease Control [CDC])
• Dr SP Johnston et al. (Division of Parasitic Diseases, CDC)