Extended-wear contact lenses: a philosophy for fitting and management

The fitting and management of extended-wear contact lenses requires a conservative philosophy of patient selection and a structured program of care. Because of the increased risk of serious complications, informed consent must be obtained before fitting patients with lenses. Fitting philosophies favor hydrogel lenses of medium thickness and water content that provide adequate movement. Initial lens care is best provided by peroxide care systems. Patients are usually fitted in the morning, reevaluated in the afternoon, and allowed to wear lenses overnight if there are no contraindications. After reexamination the next morning, planned follow-up is usually provided at 3 days, 1 week, 1 month, and 3 months. If no adverse findings are encountered, patients are seen at 3- to 6-month intervals thereafter.