Bausch & Lomb Biotrue ONEday for Presbyopia - Manual

IMPORTANT
This package insert and fitting guide has been developed to provide practitioners
with information covering characteristics of the Bausch + Lomb Biotrue™ ONEday
(nesofilcon A) Contact Lens and to illustrate fitting procedures. It is effective as
of March 2012 and supersedes all prior fitting guides for the product described.
Please read carefully and keep this information for future use.
This package insert and fitting guide is intended for the eye care professional, but
should be made available to patients upon request. The eye care professional
should provide the patient with the patient instructions that pertain to the patient’s
prescribed lens and the recommended wearing schedule
DESCRIPTION
The Bausch + Lomb Biotrue™ ONEday (nesofilcon A) Contact Lens is a soft
hydrophilic contact lens which is available as a spherical lens. The lens is made from
the nesofilcon A material, a hydrophilic copolymer of 2-hydroxyethyl methacrylate
and N-vinyl pyrrolidone, and is 78% water by weight when immersed in a sterile
saline solution. A UV-absorbing monomer is used to block UV radiation. The
transmittance characteristics are less than 5% in the UVB range of 280nm to
315nm and less than 50% in the UVA range of 316nm to 380nm. This lens is tinted
blue with Reactive Blue Dye 246.
The physical / optical properties of the lens are:
Specific Gravity:
1.039
Refractive Index: 1.3737
Light Transmittance: C.I.E. Y value - approximately 99%
Water Content: 78%
Oxygen Permeability (Dk): 42 x 10 –11 [cm 3 O
2
(STP) x cm]/(sec x cm 2 x mmHg) @
35° C (Polarographic Method)
The Bausch + Lomb Biotrue™ ONEday (nesofilcon A) Contact Lens is to be
prescribed for single-use disposable wear.
© Bausch & Lomb Incorporated. All rights reserved worldwide.
®/TM denote registered trademarks of Bausch & Lomb Incorporated.
Other product/brand names are trademarks of their respective owners.
Name and Address of Manufacturer:
Bausch & Lomb Incorporated
Rochester, New York, USA 14609
Printed in the U.S.A.
SyMbOl REfERENCE GuIDE
For labels and cartons:
Do Not Reuse
Temperature Limitation
Sterile Using Steam or Dry Heat
See Instruction Leaflet
Indicates the CE Conformity Marking and the
Notified Body Number
Authorized Representative in European Community
Caution: Federal law restricts this device to sale by or
on the order of a licensed practitioner.
Fee Paid for Waste Management
Use by Date (Expiration Date)
Batch Code
Diameter
Diopter (Lens Power)
Base Curve
TAblE Of CONTENTS
Important 2
Description 2
Lens Parameters Available
4
How the Lens Works (Actions) 4
Indications 4
Contraindications (Reasons Not to Use)
5
Warnings 5
Precautions 6
Adverse Reactions
8
Important Treatment Information for Adverse Reactions 8
Selection of Patients 9
Fitting Procedure 10
Pre-Fitting Examination 10
Initial Lens Power Selection 10
Initial Lens Evaluation 10
Criteria of a Well-Fitted Lens 10
Characteristics of a Tight (Steep) Lens 11
Characteristics of a Loose (Flat) Lens 11
Follow-up Care 11
Practitioner Fitting Sets 12
Wearing Schedule 12
Monovision Fitting Guidelines 12
Patient Selection 12
Eye Selection 13
Special Fitting Considerations 14
Near Add Determination 14
Trial Lens Fitting 14
Adaptation 15
Other Suggestions 15
Handling of Lenses 16
Care for a Sticking (Nonmoving) Lens 16
Emergencies 16
Reporting of Adverse Reactions
16
How Supplied 16
The typical transmittance profile of nesofilcon A lenses vs a Human Cornea and
Human Lens:
Nesofilcon A Lens —Nominal Center Thickness 0.1 mm (-1.25D).
Cornea—Human Cornea from a 24-year-old person as described in Lerman, S.,
Radiant Energy and the Eye, MacMillan, New York, 1980, p.58, fig. 2-21.
Lens—Human crystalline lens from a 25-year-old person as described in Waxler M.,
Hitchins V.M., Optical Radiation and Visual Health, CRC Press, Boca Raton, Florida,
1986, p. 19, fig. 5.
Warning
UV absorbing contact lenses are NOT substitutes for protective UV absorbing
eyewear such as UV absorbing goggles or sunglasses because they do not
completely cover the eye and surrounding area. You should continue to use UV
absorbing eyewear as directed.
Note
Long term exposure to UV radiation is one of the risk factors associated with
cataracts. Exposure is based on a number of factors such as environmental
conditions (altitude, geography, cloud cover) and personal factors (extent and
nature of outdoor activities). UV blocking contact lenses help provide protection
against harmful UV radiation.
Note
The effectiveness of wearing UV absorbing contact lenses in preventing or reducing
the incidence of ocular disorders associated with exposure to UV light has not been
established at this time. However, clinical studies have not been done to demonstrate
that wearing UV blocking contact lenses reduce the risk of developing cataracts or
other eye disorders. Consult your Eye Care Professional for more information.
lENS PARAMETERS AVAIlAblE
The Bausch + Lomb Biotrue™ ONEday (nesofilcon A) Contact Lens is a
hemispherical shell of the following dimensions:
Diameter: 14.2mm
Center Thickness: 0.05mm to 0.75mm (varies with power)
Base Curve: 8.6mm
Powers: +6.50D to -6.50D in 0.25D steps
-7.00D to -9.00D in 0.50D steps
HOW THE lENS WORKS (ACTIONS)
In its hydrated state, the Bausch + Lomb Biotrue™ ONEday (nesofilcon A) Contact
Lens when placed on the cornea acts as a refracting medium to focus light rays on
the retina.
The transmittance characteristics are less than 5% in the UVB range of 280nm to
315nm and less than 50% in the UVA range of 316nm to 380nm.
INDICATIONS
The Bausch + Lomb Biotrue™ ONEday (nesofilcon A) Contact Lens is indicated
for the daily wear correction of refractive ametropia (myopia, hyperopia and
astigmatism) in aphakic and/or non-aphakic persons with non-diseased eyes,
exhibiting astigmatism of 2.00 diopters or less, that does not interfere with visual
acuity. The lens may be prescribed in spherical powers ranging from +20.00D to
-20.00D.
The lens is to be prescribed for single-use disposable wear, and is to be discarded
after each removal.
CONTRAINDICATIONS
(REASONS NOT TO uSE)
DO NOT USE the Bausch + Lomb Biotrue™ ONEday (nesofilcon A) Contact
Lens when any of the following conditions exist:
• Acute and subacute inflammation or infection of the anterior chamber of
the eye
• Any eye disease, injury, or abnormality that affects the cornea, conjunctiva, or
eyelids
• Severe insufficiency of lacrimal secretion (dry eyes)
• Corneal hypoesthesia (reduced corneal sensitivity)
• Any systemic disease that may affect the eye or be exaggerated by wearing
contact lenses
• Allergic reactions of ocular surfaces or adnexa (surrounding tissue) that
may be induced or exaggerated by wearing contact lenses or use of contact
lens solutions
• Any active corneal infection (bacterial, fungal, or viral)
• If eyes become red or irritated
WARNINGS
After a thorough eye examination, including appropriate medical background,
patients should be fully apprised by the prescribing professional of all the risks
with contact lens wear. Patients should be advised of the following warnings
pertaining to contact lens wear:
• Problems with contact lenses and lens care products could result in serious
injury to the eye. It is essential that patients follow their eye care professional’s
direction and all labeling instructions for proper use of lenses and lens care
products, including the lens case. Eye problems, including corneal ulcers, can
develop rapidly and lead to loss of vision.
• Daily wear lenses are not indicated for overnight wear, and patients should be
instructed not to wear lenses while sleeping. Clinical studies have shown
that the risk of serious adverse reactions is increased when daily wear lenses are
worn overnight.
• Studies have shown that contact lens wearers who are smokers have a higher
incidence of adverse reactions than nonsmokers.
• If a patient experiences eye discomfort, excessive tearing, vision changes, or
redness of the eye, the patient should be instructed to immediately remove
lenses and promptly contact his or her eye care professional.
PRECAuTIONS
Special Precautions for Eye Care Professionals:
• Due to the small number of patients enrolled in clinical investigation of lenses, all
refractive powers, design configurations, or lens parameters available in the lens
material are not evaluated in significant numbers. Consequently, when selecting
an appropriate lens design and parameters, the eye care professional should
consider all characteristics of the lens that can affect lens performance and
ocular health, including oxygen permeability, wettability, central and peripheral
thickness, and optic zone diameter.
• The potential impact of these factors on the patient’s ocular health should be
carefully weighed against the patient’s need for refractive correction; therefore,
the continuing ocular health of the patient and lens performance on eye should
be carefully monitored by the prescribing eye care professional.
• Patients who wear aspheric contact lenses, such as the Bausch + Lomb
Biotrue™ ONEday (nesofilcon A) Contact Lenses, to correct presbyopia may
not achieve the best corrected visual acuity for either far or near vision. Visual
requirements vary with the individual and should be considered when selecting
the most appropriate type of lens for each patient.
• Eye care professionals should instruct the patient to REMOVE A LENS
IMMEDIATELY if an eye becomes red or irritated.
• Fluorescein, a yellow dye, should not be used while the lenses are on the eyes.
The lenses absorb this dye and become discolored. Whenever fluorescein
is used in eyes, the eyes should be flushed with sterile saline solution that is
recommended for in-eye use.
• The patient should be instructed to always discard disposable lenses and lenses
worn on a frequent/planned replacement schedule after the recommended
wearing schedule prescribed by the eye care professional.
• As with any contact lens, follow-up visits are necessary to assure the
continuing health of the patient’s eyes. The patient should be instructed as to a
recommended follow-up schedule.
• Aphakic patients should not be fitted with Bausch + Lomb Biotrue™ ONEday
(nesofilcon A) Contact Lenses until the determination is made that the eye has
healed completely.
• The lenses are prescribed for disposable wear, and are to be disposed of
once they are removed from the patient’s eye. It is important that patients be
instructed to always have available a pair of replacement lenses. In the event that
a lens must be removed from the eye because of dust, a foreign body or other
contaminant gets on the lens or the lens becomes dehydrated, the lens should
be removed and replaced with a replacement lens.
• Eyecare professionals should carefully instruct patients about the following
safety precautions. It is strongly recommended that patients be provided with
a copy of the Bausch + Lomb Biotrue™ ONEday (nesofilcon A) Contact Lens
Patient Information Booklet available from Bausch + Lomb and understand its
contents prior to dispensing the lenses.
Handling Precautions:
• Always wash and rinse hands before handling lenses. Do not get cosmetics,
lotions, soaps, creams, deodorants, or sprays in the eyes or on the lenses.
It is best to put on lenses before putting on makeup. Water-base cosmetics are
less likely to damage lenses than oil-base products.
• Be sure that before leaving the eye care professional’s office, the patient
is able to remove lenses promptly or have someone else available to remove
them.
• Be certain that the fingers or hands are free of foreign materials before touching
lenses, as microscopic scratches of the lenses may occur, causing distorted
vision and/or injury to the eye.
• Always handle lenses carefully and avoid dropping them.
• Do not touch the lens with fingernails.
• Carefully follow the handling, insertion, removal, cleaning disinfecting, storing
and wearing instructions in the Patient Information Booklet for the Bausch +
Lomb Biotrue™ ONEday (nesofilcon A) Contact Lenses and those prescribed
by the eye care professional.
• Never use tweezers or other tools to remove lenses from the lens container
unless specifically indicated for that use. Pour the lens into the hand.
Topics to Discuss with the Patient:
• As with any contact lens, follow-up visits are necessary to assure the continuing
health of the eyes. The patient should be instructed as to a recommended
follow-up schedule.
• Patients should be advised about wearing lenses during sporting and water
related activities. Exposure to water while wearing contact lenses in activities
such as swimming, water skiing and hot tubs may increase the risk of ocular
infection including but not limited to Acanthamoeba keratitis.
• Always contact the eye care professional before using any medicine in the eyes.
Who Should Know That the Patient is Wearing Contact Lenses:
• Patients should inform their doctor (health care professional) about being a
contact lens wearer.
• Patients should always inform their employer of being a contact lens wearer.
Some jobs may require the use of eye protection equipment or may require that
you do not wear lenses.
ADVERSE REACTIONS
The patient should be informed that the following problems may occur:
• Eyes stinging, burning, itching (irritation), or other eye pain
• Comfort is less than when lens was first placed on eye
• Abnormal feeling of something in the eye (foreign body, scratched area
• Excessive watering (tearing) of the eyes
• Unusual eye secretions
• Redness of the eyes
• Reduced sharpness of vision (poor visual acuity)
• Blurred vision, rainbows, or halos around objects
• Sensitivity to light (photophobia)
• Dry eyes
If the patient notices any of the above, he or she should be instructed to:
• Immediately remove the lenses.
• If the discomfort or problem stops, then look closely at the lens. If the lens is
in any way damaged, do not put the lens back on the eye. Place the lens in
the storage case and contact the eye care professional. If the lens has dirt, an
eyelash, or other foreign body on it, or the problem stops and the lens appears
undamaged, the patient should thoroughly clean, rinse, and disinfect the lenses;
then reinsert them. After reinsertion, if the problem continues, the patient should
immediately remove the lenses and consult his or her eye care
professional.
• If the above symptoms continue after removal of the lens, or upon reinsertion
of a lens, or upon insertion of a new lens, the patient should immediately
remove the lenses and contact his or her eye care professional or
physician, who must determine the need for examination, treatment or referral
without delay. (See Important Treatment Information for Adverse Reactions.)
A serious condition such as infection, corneal ulcer, corneal vascularization, or
iritis may be present, and may progress rapidly. Less serious reactions such as
abrasions, epithelial staining or bacterial conjunctivitis must be managed and
treated carefully to avoid more serious complications.
Important Treatment Information for Adverse Reactions
Sight-threatening ocular complications associated with contact lens wear can
develop rapidly, and therefore early recognition and treatment of problems
are critical. Infectious corneal ulceration is one of the most serious potential
complications, and may be ambiguous in its early stage. Signs and symptoms of
infectious corneal ulceration include discomfort, pain, inflammation, purulent
discharge, sensitivity to light, cells and flare, and corneal infiltrates.
Initial symptoms of a minor abrasion and an early infected ulcer are sometimes
similar. Accordingly, such epithelial defect, if not treated properly, may develop
into an infected ulcer. In order to prevent serious progression of these conditions,
a patient presenting symptoms of abrasions or early ulcers should be evaluated as
a potential medical emergency, treated accordingly, and be referred to a corneal
specialist when appropriate. Standard therapy for corneal abrasions such as eye
patching or the use of steroids or steroid/antibiotic combinations may exacerbate
the condition. If the patient is wearing a contact lens on the affected eye when
examined, the lens should be removed immediately and the lens and lens care
products retained for analysis and culturing.
SElECTION Of PATIENTS
The eye care professional should not fit patients who cannot or will not adhere to a
recommended care or replacement regimen, or are unable to place and remove
the lenses. Failure to follow handling and cleaning instructions could lead to serious
eye infections which might result in corneal ulcers.
Patient communication is vital because it relates not only to patient selection but also
to ensure compliance. It is also necessary to discuss the information contained in the
Patient Information Booklet with the patient at the time of the initial examination.
Patients selected to wear Bausch + Lomb Biotrue™ ONEday (nesofilcon A)
Contact Lenses should be chosen for their motivation to wear contact lenses,
general health and cooperation. The eye care professional must take care in
selecting, examining and instructing contact lens patients. Patient hygiene and
willingness to follow practitioner instructions are essential to their success.
A detailed history is crucial to determining patient needs and expectations.
Your patient should be questioned regarding vocation, desired lens wearing time
(full or part time), and desired lens usage (reading, recreation or hobbies).
Initial evaluation of the trial lens should be preceded by a complete eye examination,
including visual acuity with and without correction at both distance and near,
keratometry and slit lamp examination.
It is normal for the patient to experience mild symptoms such as lens awareness,
variable vision, occasional tearing (watery eyes) and slight redness during the
adaptation period. Although the adaptation period varies for each individual,
generally within one week these symptoms will disappear.
If these symptoms persist, the patient should be instructed to contact his or her eye
care professional.
fITTING PROCEDuRE
1. Pre-Fitting Examination
A pre-fitting patient history and examination are necessary to:
• Determine whether a patient is a suitable candidate for contact lenses (consider
patient hygiene and mental and physical state),
• Make ocular measurements for initial contact lens parameter selection, and
• Collect and record baseline clinical information to which post-fitting
examination results can be compared.
A pre-fitting examination should include spherocylinder refraction and VA,
keratometry, and biomicroscopic examination.
2. Initial Lens Power Selection
a. Lens power is determined from the patient’s spherical equivalent prescription
corrected to the corneal plane.
b. Select the appropriate lens and place on the eye. Allow the lens to remain on
the eye long enough (10 to 20 minutes) to achieve a state of equilibrium. Small
variations in the tonicity, pH of the lens solutions, and individual tear composition
may cause slight changes in fitting characteristics.
c. Allow any increase in tear flow to subside before evaluating the lens. The time
required will vary with the individual.
3. Initial Lens Evaluation
a. To determine proper lens parameters observe the lens relationship to the eye
using a slit lamp.
• Movement: The lens should provide discernible movement with:
— Primary gaze blink
— Upgaze blink
— Upgaze lag
• Centration: The lens should provide full corneal coverage.
b. Lens evaluation allows the contact lens fitter to evaluate the lens/cornea
relationship in the same manner as would be done with any soft lens.
4. Criteria of a Well-Fitted Lens
If the initial lens selection fully covers the cornea, provides discernible movement
after a blink, is comfortable for the patient and provides satisfactory visual
performance, it is a well fitted lens and can be dispensed.
5. Characteristics of a Tight (Steep) Lens
A lens which is much too steep may subjectively and objectively cause distortion
which will vary after a blink. However, if a lens is only marginally steep, the initial
subjective and objective vision and comfort findings may be quite good. A
marginally steep lens may be differentiated from a properly fitted lens by having
the patient gaze upward. A properly fitted lens will tend to slide downward
approximately 0.5mm while a steep lens will remain relatively stable in relationship
to the cornea, particularly with the blink.
6. Characteristics of a Loose (Flat) Lens
If the lens is too flat, it will:
• Decenter, especially on post-blink.
• Have a tendency to edge lift inferiorly and sit on the lower lid, rather than
positioning between the sclera and palpebral conjunctiva.
• Have a tendency to be uncomfortable and irritating with fluctuating vision.
• Have a tendency to drop or lag greater than 2.0mm on upgaze post-blink.
7. Follow-up Care
a. Follow-up examinations are necessary to ensure continued successful contact
lens wear. From the day of dispensing, the following schedule is a suggested
guideline for follow up.
• 3–4 days post-dispensing
• 10 days
• 1 month
• 3 months
• Every six months thereafter
At the initial follow-up evaluations the eye care professional should again
reassure the patient that any of the previously described adaptive symptoms
are normal, and that the adaptation period should be relatively brief.
b. Prior to a follow-up examination, the contact lenses should be worn for at least
4 continuous hours and the patient should be asked to identify any problems
which might be occurring related to contact lens wear.
c. With lenses in place on the eyes, evaluate fitting performance to assure that
CRITERIA OF A WELL FITTED LENS continue to be satisfied. Examine the
lenses closely for surface deposition and/or damage.
d. After the lens removal, instill sodium fluorescein [unless contraindicated] into
the eyes and conduct a thorough biomicroscopy examination.
1. The presence of vertical corneal striae in the posterior central cornea and/
or corneal neovascularization may be indicative of excessive
corneal edema.
2. The presence of corneal staining and/or limbal-conjunctival hyperemia
can be indicative of an unclean lens, a reaction to solution preservatives,
excessive lens wear, and/or a poorly fitting lens.
3. Papillary conjunctival changes may be indicative of an unclean and/or
damaged lens.
If any of the above observations are judged abnormal, various professional
judgments are necessary to alleviate the problem and restore the eye to
optimal conditions. If the CRITERIA OF A WELL FITTED LENS are not
satisfied during any follow-up examination, the patient should be re-fitted with a
more appropriate lens.
PRACTITIONER fITTING SETS
Lenses must be discarded after single use and must not be used from patient to
patient.
WEARING SCHEDulE
The wearing and replacement schedules should be determined by the eye care
professional. Regular checkups, as determined by the eye care professional, are
extremely important.
Daily Wear
There may be a tendency for the daily wear patient to over-wear the lenses initially.
Therefore, the importance of adhering to a proper, initial daily wearing schedule
should be stressed to these patients. The wearing schedule should be determined
by the eye care professional. The wearing schedule chosen by the eye care
professional should be provided to the patient. The lens is to be prescribed for
single-use disposable wear, and is to be discarded after each removal.
MONOVISION fITTING GuIDElINES
1. Patient Selection
a. Monovision Needs Assessment
For a good prognosis the patient should have adequately corrected distance
and near visual acuity in each eye. The amblyopic patient or the patient with
significant astigmatism (greater than one [1] diopter) in one eye may not be a
good candidate for monovision with the Bausch + Lomb Biotrue™ ONEday
(nesofilcon A) Contact Lenses.
Occupational and environmental visual demands should be considered.
If the patient requires critical vision (visual acuity and stereopsis) it should
be determined by trial whether this patient can function adequately with
monovision. Monovision contact lens wear may not be optimal for such
activities as:
1. Visually demanding situations such as operating potentially dangerous
machinery or performing other potentially hazardous activities; and
2. Driving automobiles (e.g., driving at night). Patients who cannot pass their
state drivers license requirements with monovision correction should be
advised to not drive with this correction, OR may require that additional
over-correction be prescribed.
b. Patient Education
All patients do not function equally well with monovision correction. Patients
may not perform as well for certain tasks with this correction as they have with
bifocal reading glasses. Each patient should understand that monovision can
create a vision compromise that may reduce visual acuity and depth perception
for distance and near tasks. During the fitting process it is necessary for the
patient to realize the disadvantages as well as the advantages of clear near
vision in straight ahead and upward gaze that monovision contact lenses
provide.
2. Eye Selection
Generally, the non-dominant eye is corrected for near vision. The following test for
eye dominance can be used.
a. Ocular Preference Determination Methods
• Method 1—Determine which eye is the “sighting dominant eye.” Have
the patient point to an object at the far end of the room. Cover one eye. If
the patient is still pointing directly at the object, the eye being used is the
dominant (sighting) eye.
• Method 2—Determine which eye will accept the added power with the
least reduction in vision. Place a trial spectacle near add lens in front of one
eye and then the other while the distance refractive error correction is in
place for both eyes. Determine whether the patient functions best with the
near add lens over the right or left eye.
b. Refractive Error Method
For anisometropic corrections, it is generally best to fit the more hyperopic (less
myopic) eye for distance and the more myopic (less hyperopic) eye for near.
c. Visual Demands Method
Consider the patient’s occupation during the eye selection process to
determine the critical vision requirements. If a patient’s gaze for near tasks is
usually in one direction correct the eye on that side for near.
Example:
A secretary who places copy to the left side of the desk will usually function best
with the near lens on the left eye.
3. Special Fitting Considerations
Unilateral Lens Correction
There are circumstances where only one contact lens is required. As an example,
an emmetropic patient would only require a near lens while a bilateral myope may
require only a distance lens.
Example:
A presbyopic emmetropic patient who requires a +1.75 diopter add would have a
+1.75 lens on the near eye and the other eye left without a lens.
A presbyopic patient requiring a +1.50 diopter add who is –2.50 diopters myopic
in the right eye and –1.50 diopters myopic in the left eye may have the right eye
corrected for distance and the left uncorrected for near.
4. Near Add Determination
Always prescribe the lens power for the near eye that provides optimal near acuity
at the midpoint of the patient’s habitual reading distance. However, when more than
one power provides optimal reading performance, prescribe the least plus (most
minus) of the powers.
5. Trial Lens Fitting
A trial fitting is performed in the office to allow the patient to experience monovision
correction. Lenses are fit according to the directions in the general fitting guidelines.
Case history and standard clinical evaluation procedure should be used to
determine the prognosis. Determine which eye is to be corrected for distance and
which eye is to be corrected for near. Next determine the near add.
With trial lenses of the proper power in place observe the reaction to this mode of
correction.
Immediately after the correct power lenses are in place, walk across the room and
have the patient look at you. Assess the patient’s reaction to distance vision under
these circumstances. Then have the patient look at familiar near objects such as a
watch face or fingernails. Again assess the reaction. As the patient continues to look
around the room at both near and distant objects, observe the reactions. Only after
these vision tasks are completed should the patient be asked to read print. Evaluate
the patient’s reaction to large print (e.g. typewritten copy) at first and then graduate
to newsprint and finally smaller type sizes.
After the patient’s performance under the above conditions are completed, tests
of visual acuity and reading ability under conditions of moderately dim illumination
should be attempted.
An initial unfavorable response in the office, while indicative of a guarded prognosis,
should not immediately rule out a more extensive trial under the usual conditions in
which a patient functions.
PACKAGE INSERT / FITTING GUIDE
SL-6887
8101900 2
6
10
14
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3
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CAUTION: Federal law restricts this device to
sale by or on the order of a licensed practitioner.
ONEday (nesofilcon A)
Contact Lenses