Piggy Backing

[Lia Williams]

Hi Ladyburd,

I am very pleased with vision I'm getting with my new lenses, especially the right lens which is giving me better vision than I have had in that eye for years.

But on day 17 the right lens became most uncomfortable. After cleaning it four times in four hours I gave up and reverted to my old Rose K lens. So I'm hoping that when I go back in January, and get the daily lenses for piggy backing, the new lenses will be both comfortable and give me good vision.

As I understand it piggy backing does reduce the amount of oxygen to the eye as it has to go through two lenses but modern lenses do let more oxygen through than the older ones. Ladyburd, if they say you shouldn't piggy back your current lens could you ask for a different lens that could be piggy backed? Or ask how many hours a day it is OK to piggy back for.
There are lots of different types of RGP lenses so there may be a different one that is more comfortable for you. It's just finding it! I've always found the Rose K lenses comfortable and so far they have been the best compromise for my right eye, its just that I've never felt that my vision has been optimised and now the optometrist doesn't like its fit which is why I'm hoping that piggy backing will work with the new lens.

Lia

[Ladyburd]

Hi Lia

I did try a Rose K on its own & was also too sore, but maybe an option if I can piggy back.

I agree with you, I only wear my lens to work, so I hope my Dr will agree to let me continue, as I'm not wearing it for a whole day. Also as you say the Tru Eye is great lens with good oxygen readings, so I'm hoping to continue

I think the optomo is just has her nose out of joint as I've done lots of reading & asking on the forum to arm myself with info. But als Tru Eye are not available on my NHS area

I'll let you know how I get on in 2 weeks

Thanks again

Claire

[rosemary johnson]

I've been piggybacking for a few years now - under scleral (23mm diameter) lenses rather than corneal (8mm diameter) ones, but the principle is the same.
To answer your questions:
THey are the same sclerals as I was wearing before I started piggybacking. Well, in the case of the first one, the idea was that this new lens might give better vision but less comfort, so the fitter suggested trying the new shape and piggybacking. At first I wasn't too keen, so suggested trying the new scleral lens. After trying it for a while, the vision was better (not brilliant, but better than bbefore) and the comfort very short-lived, so I decided to try the piggybacking. THat eye has now been grafted and won't tolerate lenses at all, and the other eye is complaining about the extra work and getting sore more easily, so I've started piggybacking under the old lens in that eye.
Tolerance times: initially, in the grafted eye, wearing time went from 4 hours, 6 hours if I really pushed it and then couldn't wear the lens for the next two days, to all day most days - that's 12-16 hours, 5 days a week.
By the end of the say, the soft lens was drying out and the vision too blurry to read with it, but the distant vision was still useful.
in the ungrafted eye now, maybe 12 hours a day, most days, rather than pretty variable and getting itchy easily.
Lately, though, I've been having more problems with sore eyes and lensintolerance - probably somethign to do with working outdoors in the snow and ice, looking after the horses, ponies etc at the farm where my pony lives, and I think the freezing cold isn't helping.
Power - my soft lenses are -0.25, which is the lowest power, closest to unpowered, they make. SO a negligible difference to the power of the scleral.
Type: mine are daily disposal, and that's what I've always used.
Advantages: no messing about with cleaning and storing a remove-and-reuse soft lens, and no two sets of solutions, cleaners, whatever, and no protein buildups from insufficient cleaning or tolerance problems either with protein buildups or allergies to the soft lens solutions.
Disadvantages: running out of soft lens, and having to get new supplies ordered (there was one time when the people at the hospital couldn't decide whether I should have had to pay or not and therefore couldn't order me any more. SO I couldn't use the lens for months till they sorted that out. I have two letters from the Chairman of the hospital trust apologising for that - both addressed to Harry COhen MP, but one can't have everything!) That seems to be sorted out now.
You do need to keep tabs on how stocks are going, of course, and make sure new supplies get ordered in good time. ANd take enough with you when you go on holiday. But at least you aren't packing loadsa bottles of solutions for the soft lenses and the hard ones.
I don't know if it would be possible to have power on both the hard lens and the piggybacking soft lenses. I don't see why you shouldn't, technically - though if you did, the soft lenses would could as a vision correction, so you'd be charged one NHS lens charge (52 quid or thereabouts) for each 3 months' supply of daily lens FOR EACH EYE - which starts to get a bit expensive if you're on a budget!
(Note: if you end up with this, see if they dialies aren't cheaper in ASDA - I found they would be.)
ANything else: it can be a fiddle getting the two in together, and sometimes out to gether. I just had to get the hang of getting them in, though sometimes still the soft one slips and I have to take both out and try again. Normally, when I take out the scleral, the soft one comes too - if it doesn't, it's mad panic time!
If you have a lot of problems with protein deposits, I suppose you could take the lens out mid day, throw away a dialy disposable and put a new one in. THough that could start getting a bit expensive if the hospital recon you are getting through them faster than your "ration".
I always clean my sclerals with ordinary washing up liquid, never have any problems with protein build-up or similar and was dreading having to wrestle with such things with soft lenses. FOr me, the dailies were a great relief!
Incidentally: if they say your eye is an odd shape leading to air bubbles under a corneal lens, and that is what they want piggybacking to sort out, I wonder if you might get a better result from sclerals? they look horrendous when you first see them - bt the aim is that they arch right over the cornea, with a big lake of first saline, then tears behind them, which allows for all sorts of irregularities in the cornea behind the lens - it just changes the shape of the tear lake slightly.
SOme people swear bby them - I've worn them for well over 30 years now - and others don't get on with them.
I'm wondering if they might be worth considering?
Rosemary

[Andrew MacLean]

I never managed to cope with a piggy backed lens, but my scleral was my all time favourite. Rosemary is right; they do look a bit scary, but with a little practice they become easy to insert and remove and the one I had sat comfortably on my eye.

Andrew

[Ladyburd]

Hi Rosemary

Thanks for all the info

What NHS trust are you in? Glasgow have said that I can't have dailies, so I was going to complain to the Trust & my MP. However, after some reading on the web, I've found out that most dailies are the same specification as weekly lenses, so if you are careful & very clean, you can get several days of of them -of course your optom won't agree with this as they don't want to risk a law suit if you get an infection. But as I said the spec is the same!

I haven't even been offered sacerals -how old are you guys who are using them or piggybacking? As I've been told I'm too young to use it as a long term option - I'm 36, so not that young!

Thanks again for all the info

Cx

[GrandPaClanger]

I am now 47 (had KC since I was 17). Its only this year that I have been having issues that resulted in me trying to piggback before going on the waiting list for a graft. Must admit I thought I had got away with it

Ian

[Lia Williams]

Hi Rosemary,

Thank you for your detailed account of piggy backing. This will help me ask sensible questions at my next appointment in the New Year.

Hi Ladyburd,

I'm 53 and I've been wearing contact lenses since I was 17.

I originally wore the old PMMA corneal lenses and for the last 21 years corneal RGPs. Everything was going well until April last year when I went for an annual check-up and was told that my five year old lenses were in a terrible state due to the amount of protein deposits on them. Since then I've tried several lenses and the compromise solution has yet to be found. The new right lens has fantastic vision so I'm hoping that piggy backing it will be the solution as the Rose K lens, although comfortable, does give me 'smudgy' rather than crisp vision.

Scleral lenses have been mentioned but only as a future possibility if piggy backing doesn't work.

Lia

[rosemary johnson]

Hi.
I'm 24-yet-again.... errm, 49. Been wearing sclerals since I was in the fourth form of grammar school, 14 I think.
Whent straight into sclerals from nothing. Never knew why, but at the time had the idea that for KC it would be sclerals or nothing.
Which trust? - the infamous M**rf**lds.
No doubt inthis (dailies) respect influenced by the famous and renowned Ken.
Rosemary

[Ladyburd]

Thanks all

Don't worry I won't share your true ages with anyone

The reason I was told piggybacking was not a good option was due to lack of oxygen. Has this been an issue for any of you long term piggybackers or saceral users?

Thanks again

Cx