About Disposable Contact Lenses

The U.S. Food and Drug Administration defines a disposable contact lens as any lens that is thrown away and never worn again after it’s been worn in the eye only once. Some contact lens vendors have used the term to mean any contact lens intended to be worn a few times, but that claim is deceptive and potentially unsafe. If your “disposable” lens company advises you to clean a lens and wear it again, then it’s acting in an unscrupulous manner and has in fact sold you what the FDA calls a planned replacement lens. A planned replacement lens should, by definition, come with a cleaning and replacement schedule designed by the manufacturer, and this schedule should be followed carefully to protect your health.

Disposable lenses are better than hard or planned replacement lenses in two closely related ways. First, studies have shown that patients who wear disposable lenses report fewer tolerance problems than those who wear hard contact lenses. Second, the more frequent a replacement schedule, the fewer reported contact lens complications, with disposable lens wearer reporting the fewest problems of all. The average person in these studies replaced his or her lenses every two weeks.

A Brief History

The first disposable lens was produced in 1982. The DanaLens was made of a polymer of hydroxyethyl methylacrylate and hydroxyethyl acrylate, molded into a lens shape while still in its liquid form. The lenses earned surprisingly high scores in subsequent testing. According to the National Library of Medicine, scanning electron microscopy detected superficial mucous deposits on the front surfaces of the lenses after more than a month, but no bacteria or fungi were detected. The mucous deposit was easily removed.

The birth of disposable contact lenses is sometimes inaccurately dated to the release of Spofa soft contact lenses in 1987. The lenses were sold in white plastic single-lens containers filled with sterile fluid. It wasn’t until 1995 that the first daily-wear disposable lenses hit the market; Ron Hamilton, an inventor in Scotland, produced the Premier Award lens and sold his product to Bausch & Lomb. The company renamed it SOFLENS 1 Day. Hamilton went on to launch a company called Provis Lenses. The world at large was introduced to daily disposable lenses with the international release of the 1-Day Acuvue in 1995. In 1997, a “monthly-use” lens called the Zodiac 73 was released, but it was only produced for a short while.

A year later, Bausch & Lomb released Occasions, the first brand of multifocal disposable soft lenses. The first truly disposable toric lens (i.e., a lens curved to help correct astigmatism) was CIBA-Vision’s Focus, which debuted in 2000. That monthly lens gave way to Focus Dailies in 2002.

Today disposable lenses are the most popular contact lenses in the Western world.

Safety and Comfort Issues

Daily disposable lenses offer the advantages of minimal lens aging. The longer your lenses stay in, the more they accrue surface deposits. This in turn can lead to blurred vision, reduced comfort, and even papillary conjunctivitis. The less you’re asked to clean your lenses, the less you need to know about cleaning them, and the fewer mistakes you can make. Doctors have found that “misuse of care systems”—that’s Ph.D.-speak for “the patient made a mistake”—is responsible for a high number of complaints. Disposable lenses are an excellent choice for patients who wear contact lenses only intermittently, as otherwise those patients might be tempted to leave their lenses in cleaning solution for extended periods of time.

A clinical study in 1996 tracked over two hundred daily disposable lens wearers for three years. The doctors, Soloman et al., found that these patients enjoyed reduced symptoms, better vision, lower deposition, and higher overall satisfaction than a control group of hard lens wearers. Hamano et al. studied over twenty-three thousand patients and found a complication rate of less than five percent, the lowest of all lens types studied. The only concern eye doctors have about daily disposables is the risk of severe keratitis (infection of the cornea), a risk shared by all contact lens wearers. The major studies in this area were conducted before the advent of daily disposables, and the main cause of keratitis is pathogens conducted onto the ocular surface by the inserter’s fingertip. Obviously, people who wear daily disposables are required to insert new contact lenses everyday. As of July 2004, optometrists in the UK were still calling for an expanded study that would test these concerns.

Wearers of daily disposables go through over seven hundred lenses a year. Obviously, then, the quality of manufacturing and reproducibility of lens shape become absolutely critical. Eliron et al. studied four hundred and fifty lenses from a variety of commercial batches in 1999. They checked total diameter, back optic zone radii, center thickness, water content, and back vertex power. They also measured accuracy by evaluating the difference between mean measured value and the labeled parameter. Then they tested standard deviations of the measured values to see how well these manufacturers were able to maintain product specifications. The study found high degrees of both accuracy and reproducibility when compared to tolerances mandated by ISO, the International Organization for Standardization.

In April 2004, a study called “Daily Disposable Contact Lens Wear in Myopic Children” (in Optometry and Vision Science) found that children as young as eight years old “are able to independently care for daily disposable contact lenses and wear them successfully.” That’s good news for parents whose kids might be reluctant to wear glasses, or who seem likely to lose or damage corrective eyewear.

An informal survey of contact lens wearers in the UK rated 1-Day Acuvue from Johnson & Johnson the highest among daily disposables with regard to comfort and quality. However, this was also the most expensive lens on the market. Focus Dailies from CIBA-Vision were almost as good but cost considerably less. Bausch & Lomb’s 1-Day Soflens wearers complained about ease of handling; packaging design problems may have been the culprit. Daysoft UV lenses from Provis were the least expensive model tested, but results were poor with regard to lens quality, reproducibility, and ease of handling.

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