Part I Clinical overview of the management and fitting of the extended wear patient.

With the advent of extended wear contact lenses, new potential benefits, risk and responsibilities have come into existence for contact lens patients and practitioners alike. Without a careful, thorough and systematic clinical approach, the practitioner will find himself experiencing only the pitfalls without enjoying the possible benefits. This paper will attempt to present such a clinical approach, emphasizing a deductive and holistic approach to extended wear lens fitting. Previous clinical and laboratory work will be reviewed as it pertains to this presentation. Through the use of a thorough case history and diagnostic evaluation, patients can be effectively screened and counseled as to their acceptability and selection into an extended wear lens program. Mutual patient and a doctor goals must be established and be compatible. Subsequent contact lens selection and patient management will be discussed as they relate to the fulfillment of these goals. Commonly found complications with extended wear of contact lenses will be reviewed as they pertain to both the lenses and the ocular structures. Methods of management of these complications will be discussed.