Therapeutic contact lenses and their use in themanagement of anterior segment pathology

Therapeutic contact lenses have been advocated as an important component of anterior segment ophthalmic careregimes since the late 1960s. Despite favourable reviews in the ophthalmic literature, the perception remains, among contact lens and corneal specialists alike, that the benefits associated with this type of treatment should be considered only as a last resort. The results obtained in 46 consecutive cases fitted with either hydrogel or silicone therapeutic lenses, over an 18-month period are reviewed. Results indicate that successful therapeutic lens programmes can be achieved through a combination of appropriate patient and lens selection, and the initiation of a suitable management strategy. Approximately 25% of patients were fitted successfully with a conventional hydrogel low water content therapeutic lens. Twenty-five per cent of patients required alternative hydrogel lenses of differing parameters. Thirty per cent required silicone lenses to overcome ocular surface and lid abnormalities which had rendered hydrogel lens wear inappropriate. Almost 80% of patients fitted achieved some success with therapeutic lenses. Virtually all of those fitted on the basis of ocular pain achieved relief during the course of the treatment. Results highlight the need for a management protocol for the provision of therapeutic bandage contact lenses on a regional basis.