Ron Hamilton (June 8) in response to an extended wear contact lens manufacturer’s suggestion – ‘when possible, remove even extended wear contacts before sleeping’ –comments: ‘It does not say under what circumstances removal might not be possible?’

Ron Hamilton is, perhaps, no clinician and I wish to proffer an example of circumstances when it may be inappropriate to remove extended wear lenses prior to sleep.

A number of years ago, when SiH extended wear lenses were being introduced, a patient attended my practice and announced that she was entering the Chay Blyth Round the World Yacht Race and that she would like to be fitted with One Day disposable contact lenses for use during this event. After two seconds thought, or less, I replied ‘Ah, you wish to poke your finger in your eye whilst being thrown around in an Atlantic storm’. ‘You don’t think contact lenses are a good idea for this do you?’ she replied. ‘Not so,’ I stated. ‘A couple of companies have launched a new product, Silicone Hydrogel Extended Wear contact lenses, which may be retained on the eye for up to 30 days at a time, and these products show great promise’.

I suggested she contact Bausch & Lomb and suggest they might like to offer her some lenses free of charge by way of sponsorship.

This she did. I then received a telephone call from B+L informing me that they were very pleased that I was sponsoring this patient’s visual correction during the yacht race and were more than happy to provide lenses since I would not be charging any fitting fees (this was news to me, but I thought ‘Why not, let’s give it a go’).

B+L kindly provided six pairs of PureVision lenses at no charge. I then rang B+L to inform them that this yacht race sails the wrong way round the world (the Chay Blyth way) and it takes 10 months. B&L immediately furnished her with another six pairs.

Her boat came sixth out of the 12 vessels that commenced the race – a good result. At the post race eye assessment I found that the product had been well tolerated and she had not poked herself in the eye during the many storms that she had endured. However, being an early presbyopic myope, she had on occasions worn just one lens for the mono vision effect in order to read the charts when it was her turn of duty.

So there is a circumstance when it would be unwise for extended wear lenses to be removed prior to sleep. One case study is insufficient to comment on the efficacy of any product, but in the case of this patient I was able to demonstrate that the B+L PureVision product had been safe, albeit only at sea level!