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Contact lens, hydrophilic, extended wear, per lens

HCPCS code

Name of the Procedure:

Contact Lens, Hydrophilic, Extended Wear per Lens (HCPCS V2523)

Summary

This procedure involves the provision and fitting of hydrophilic (soft) contact lenses designed for extended or continuous wear. These types of contact lenses can be worn for extended periods, including overnight, without the need for daily removal.

Purpose

Medical Conditions:

Extended wear hydrophilic contact lenses are primarily used to correct refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and presbyopia.

Goals:

The main goal is to provide clear and comfortable vision over extended periods without the inconvenience of daily lens removal and cleaning.

Indications

  • Refractive errors (myopia, hyperopia, astigmatism, presbyopia)
  • Patients seeking convenience and who are uncomfortable with daily lens removal
  • Individuals with an active lifestyle that makes daily lens maintenance challenging

Preparation

  • Comprehensive eye examination to determine vision needs and lens suitability
  • Ensure the patient’s eyes are free from infections and inflammation
  • Possible trial fitting to assess comfort and visual acuity

Procedure Description

  1. Eye Examination: An optometrist or ophthalmologist performs a thorough eye exam to determine the prescription, corneal curvature, and eye health.
  2. Lens Selection: The appropriate hydrophilic extended wear lens is selected based on the eye measurements and visual needs.
  3. Lens Fitting: The selected lenses are fitted to the patient’s eyes, and the fit is evaluated. Adjustments are made as necessary.
  4. Patient Education: The patient is educated on lens care, wear schedule, and signs of potential complications.
Tools/Equipment:
  • Slit lamp biomicroscope
  • Keratometer/Corneal topographer
  • Trial contact lenses and fitting sets
Anesthesia/Sedation:
  • Not required

Duration

The initial fitting session typically takes about 30 to 60 minutes. Follow-up appointments may be shorter.

Setting

  • Optometrist or ophthalmologist office
  • Specialized vision care clinics

Personnel

  • Optometrist or ophthalmologist
  • Optician or contact lens technician (for training and support)

Risks and Complications

  • Eye infections (e.g., microbial keratitis)
  • Corneal ulcers
  • Dry eye syndrome
  • Allergic reactions
  • Discomfort or lens intolerance
Management:

Promptly remove the lenses and seek medical attention if any signs of infection, discomfort, or vision changes occur.

Benefits

  • Improved visual acuity
  • Enhanced convenience and comfort
  • Suitable for extended and continuous wear, including overnight
Realization:

Benefits can be observed immediately upon proper fitting and continued use.

Recovery

  • Follow the recommended lens wear and care routine
  • Regular follow-up examinations to monitor eye health and lens fit
  • Avoid wearing lenses beyond the prescribed time
Restrictions:
  • Avoid swimming or showering with lenses unless specified
  • Adhere to the replacement schedule

Alternatives

  • Daily wear contact lenses
  • Rigid gas-permeable contact lenses
  • Glasses
  • Refractive surgery (e.g., LASIK)
Pros and Cons:

Daily wear lenses: Less risk of infections but require daily maintenance. Rigid gas-permeable lenses: Better oxygen permeability but may be less comfortable initially. Glasses: No risk of eye infections but may be less convenient. Refractive surgery: Permanent solution but involves surgical risks.

Patient Experience

  • Initial adaptation period for comfort
  • May experience temporary discomfort or blurred vision during the adaptation phase
  • Regular check-ups for comfort and correction
  • On-going lens care for optimum health
Pain Management and Comfort:
  • Use lubricant eye drops if needed (as recommended)
  • Follow proper hygiene routines to prevent infections

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