Along with the anonymous writer of ‘Eye drop concerns’ last week, I too have for some time been perturbed at the ongoing use of Benzalkonium chloride as an eye drop preservative – in part because I have a family member with glaucoma who has been forced by BAK sensitivity to revert to the less effective Timoptol from Xalatan. Timoptol apparently is the only glaucoma medication available in unpreserved unit dose form.
I have raised this with more than one ophthalmologist, gaining the impression that the ophthalmological world does not consider BAK sensitivity to be a significant problem. It was also pointed out that any change in preservative would have to be validated by the drug firms with extensive and expensive trials – and if it (mostly) works, why spend megabucks to fix it for the minority where it doesn’t?
One would have thought that long-standing contact lens solution experience with newer preservatives would mean that alternatives to BAK have now been effectively trialled, so it is difficult to see why they are not used.
I take the point about the cost of testing new preservatives with old drugs, but new drugs would have to have their own trials regardless of preservative type, so why not break out of the pharmacological bronze age?
I look forward to seeing a response from the drug and CL solution makers.
Alan Donnelly
Thetford, Norfolk
I answered the phone today to a voice saying ‘This is going to be an extremely strange conversation’. At the other end was a gentleman from Manchester Airport who deals with lost luggage, stating that they had a suitcase containing lenses supplied by David Thomas. The only information he had to go on was a name. After ascertaining that the lenses were still in a mailer and contained one of our unique batch codes I was able to provide the gentleman with the optician’s name and phone number. The caller was very appreciative of our efficiency and co-operation and hopefully the lost case will be reunited with its owner.
Doreen Browne
Director, David Thomas Contact Lenses
My mother, Winifrid (Winnie) Taylor, was one of the first women to qualify in optics. She always eschewed the ‘self-luminous’ retinoscope as being a bit of a toy, preferring the Thorington reflector retinoscope for doing the job. The Thorington is essentially a plane mirror with a hole in the middle, which reflects light from a lamp behind a small aperture placed level with the patient.
By the age of 10, I was proficient in retinoscopy having received a practice eye for Christmas and the full co-operation of the cat thereafter. (I reckoned he was –1.5 R&L).
Years later, I was suddenly sent to ‘The Practice That Time Forgot’ as a locum, arriving without any equipment of my own. Everything was provided except a retinoscope; so I went to the chemist and bought a small mirror. I scratched a small hole in the silvering. Then I made a mask to cover the anglepoise lamp out of aluminium foil and cut a one inch aperture in it. Of course, it worked perfectly well, although I nearly burnt the place down towards the end of the day.
Nicholas Taylor
London NW5