Safe use of contact lenses
I have seen a number of patients over the years with infections of their cornea. The cornea is the clear window over the front of the eye. Unlike conjunctivitis, a corneal ulcer or keratitis can often cause permanent vision loss. This vision loss can sometimes be treated with a corneal transplant. Rarely, the keratitis can be bad enough that a patient can lose their eye completely. One of the most common causes of these corneal infections is actually contact lens wear. With perfect use, the rate of contact lens related corneal ulcers is only around one in two thousand per year. However, this can go up dramatically, and with certain behaviors, the infection rate can approach 100%. When you are wearing contacts, you have to be cognizant of what the wearer is actually doing. There is a "foreign" object that is in close proximity to your eye for hours during the day. This is done daily for many years. During the course of the day, bacteria, and occasionally fungus or amoeba are exposed to this contact lens and may form a biofilm. Basically, a layer of the bacteria that stick to the contact. Normally, your tears are constantly recycled and these bacteria are flushed away from the eye, but the contact keeps them on the ocular surface. If you wear your contacts overnight, your eyes also dry out, and there is not as much circulation of the tear film. This can result in decreased air to the cornea which can also increase the risk of infection. It is well known that overnight use of contacts increases your risk of infection significantly. Furthermore, you are not cleaning the lens at regular intervals. This results in more pathogens developing in that "biofilm." So what can we do to prevent infections and maintain safe use of contact lenses? The following are some of the rules that I recommend for safe contact lens wear. 1) Do not sleep in the lenses overnight. 2) Take your lenses out if your eyes start to bother you, and if your eyes do not feel better, see an ophthalmologist or eye doctor. 3) Follow all of the manufacturer recommendations for your lenses. If your lenses are 2 week lenses, do not keep them for 4 weeks to save money. If they are dailies, do not wear them for a week. Clean them with an appropriate regiment. 4) It is extremely important as mentioned earlier to clean your lenses ever day. 5) Do not "top off" the solution. Your case should be dried and cleaned daily and fresh solution should be used for your lenses. 6) Do not use tap water or ever swim in your lenses. There is a protozoa called acanthamoeba that is found in these sources and can cause a devastating eye infection. I have several patients who suffer with this infection; it not only puts your eye at risk, but it is extremely painful and takes months to resolve. 7) Replace your contact lens cases at the period recommended by the manufacturer. Usually at least every 3 months. 8) Have a back-up pair of glasses. If you do not have a pair of glasses to use, you will wear your lenses when you know you should not. 9) If you are not sure if you took your lens out, you may need to see an eye care professional to verify that fact. See the attached image. This has been in the news recently, but I have had patients with corneal ulcers related to retained contact lenses. These rules are not all inclusive, and you should always speak to your eye care professional. If you would like an appointment and you live in Central Texas, Austin, Georgetown, Cedar Park, Round Rock, or Temple, Texas. Please call our office at 512-686-1224.