Together we will break down the most common bad habits that I see everyday in practice that lead to future eye problems.
According to the Center of Disease Control and Prevention (CDC) there are over 30 million people in the U.S who wear contact lenses. Did you know that 1 in 500 or 60,000 of these contact lens wearers will suffer from a serious eye infection that could potentially lead to blindness this year? This article is designed to give you the tools to ensure you or your child do not fall into this group.
The 7 Habits Broken Down
1. Improper Lens Hygiene - If you clean your feet and arm pits everyday, I would also urge you to clean the object that is stuck to your eye for most of the day. You can do this in 4 easy steps.
- Always wash your hands before inserting and removal of your contact lenses.
- Fill your hand with a small amount of solution and rub the contact. Even if you have a "no rub" formula, this is misleading. The FDA recommends rubbing the lens so that the friction breaks up protein build up, make up, or other sticky debri that may be stuck to the contact lens.
- Rinse off the loose debris with more solution and insert into your clean contact lens case.
- Fill the case with Fresh solution. Do NOT "top off" old solution that remains in the case from the previous day or night. Replace your contact lens case every 3 months.
2. Sleeping In Contact Lenses - This by far is the #1 reason for serious eye infections! This is true for ALL contact lenses. Some are less dangerous than others, but even the contacts that are "FDA approved" to sleep in can wreak havoc on the eye. From my experience every contact lens wearer has heard at one time or another that they should not sleep in their contacts, but to my surprise only a small fraction of them know why they shouldn't do it. If you can only remember two words remember "oxygen" and "bacteria". All of the tissues in the body need an adequate oxygen supply and the cornea (tissue the contact lens sits on) is no different. However the cornea is different from those other tissues in that it does not receive its oxygen from a blood supply, but instead receives most of its oxygen from the atmosphere (air). So what happens when are eyes are closed? Great question, when our eyes are closed we get the oxygen from our tears and mostly from the small blood vessels (capillaries) in our eye lids. The oxygen must leave the blood vessel and then pass through our lid tissue and then reach our eye, which you can imagine is only a small fraction of the oxygen we receive when our eye is open. So the last we need, is another barrier (contact lens) for the oxygen to try to pass through.
Now lets talk about the second word I mentioned "bacteria". When we don't take our contact lenses out, we are unable to properly clean our contacts, which in turn allows micro-organisms to propagate and multiply, increasing our risk for a potential serious eye infection. Bacterial corneal ulcers are one of the most common and most significant reasons for long term vision loss secondary to contact lens wear. A centrally located ulcer can be visually devastating. An ulcer will leave a scar once it has healed and when that scar is located in the center of your pupil it is like forever looking through a dirty windshield, making the vision appear blurry, even when wearing glasses. Earlier this year one of my patients suffered a permanent reduction of vision in his right eye after obtaining a central corneal ulcer after sleeping in his daily disposable contact lenses. This patient went from best corrected vision of 20/20 in his right eye to 20/60 best corrected vision. So please learn from his mistake.
#3 Swimming With Contact Lenses. This one could potentially blind you. Although rare, believe it or not this is true. The same holds true for swimming in lakes, pools, oceans, or jacuzzi tubs. Even storing your contact lenses in tap water can cause a sight threatening condition known as Acanthamoeba Keratitis. Like the name suggests, Acanthamoeba is an amoeba (one-celled organism) that is commonly found in water sources. The tiny organism can embed itself into your contact lens and then progress to embed itself into your cornea. The organism, if it is caught early enough, is treated with a vigorous eye drop regimen around the clock. It is very resistant to treatment so often even when treated properly with topical medications the patient still may need a corneal transplant to repair vision. With summer approaching think about that before jumping into the lake or the pool wearing your contacts. So whats the solution? Use prescription goggles or if you must use contact lenses, use air tight goggles with daily disposable contacts and throw them away immediately afterward. Will this cost you a little more money per year? Of course, but ask yourself... how much is your vision worth to you?
#4. Improper Make up Habits - Guys you can skip to #5 (unless your wife or daughter wears contacts). Make up effects contact lenses in two major ways. #1 it is a source for bacterial infections, because most women do not dispose of their make up as often as they should. Make up that we apply close to our eyes, such as eyeliner and mascara, should be thrown away every 3 months. Bacteria builds up on the edge of the brush from the brush making contact with our normal bacteria flora that are located on our lashes and lids. When these bacteria lay dormant in our old brushes they are able to proliferate and multiply leading to potential future problems. #2 Drying out our eyes and causing an increase in contact lens discomfort at the end of the day. Powdered based eye shadow is more likely to make its way into your eye, but creams can wreak more havoc and more irritation. So the further you stay away from your eye the better off you will be.
#5. Putting To Many Miles On Your Contacts - One of the most common reasons for dryness and contact lens discomfort is due to wearing the contact lenses to many hours of the day and for to many days without disposing of them. The more hours of the day you wear your contacts the more likely you will eventually have irritation. Go to your glasses earlier in the night to give your eyes a breather and protect yourself from future problems. Even more importantly if your contacts are 30 day disposable lenses , wear them 30 days and throw them away! Do not try to extend them 50 , 60, or 70 days. Many studies show that patients who wear 2 week lenses will wear them 4 weeks and 4 week lens wearers will stretch them to 8 weeks. Whatever lens modality you are in, stick to the schedule. There really are no good excuses for not following this one. If its a financial reason for stretching out your contacts you can always wear glasses untill your financial position improves. Or you can pick up an extra shift at work or cut out certain other expenses. If its pure laziness or forgetfulness, you can set an alarm in your phone the first of every month or you can use any one of a number of free mobile apps such as "contact lenses", "lens timer", or "contact lens timer lite" that will remind you to change your lenses.
#6. Buying Generic Solutions and Thinking All Contact Lens Solutions Are Created Equally. I always say there are two things that contact lens solution reps agree on, one is that their product is always better than the competitors product and the second is to watch out for the patient who is always looking for the deal when buying contact lens solutions. One of the most common, incorrect perceptions I run into every day is the perception that generics are just as good or the same as the name brand solutions. With most products this is often true, from toilet paper to our generic medications. After a medication hits the market it has 15 years before its patent expires. What does that mean? It means they are the only company for that time period that can sell that particular drug, which also means they can drive up the price because there is no other competitor that is allowed to produce the same formula during that time period. Once that 15 year window expires, it is fair game for any company to reproduce the same formula and are able to offer it at a much lower cost. So the generic 1% tobramycin ointment priced at $4 made by M-Pharmaceuticals is the same formula as J-Pharmaceuticals name brand version of their 1% tobramycin ointment with a price tag of $50 . It's apples to apples comparison, both ointments are 1% tobramycin they are just made by two different companies. Contact lens solutions are different because the contact lens materials have changed over the past 20 years and those older solutions were tested on those older contact lens materials when they were brought to market. The materials of the lenses in 1998-1999 switched from a hydrogel material to a more breathable silicone based hydrogel material. These older brand name and generic solutions are more likely to dry out the modern-day contact lenses and do not clean them as effectively.
#7. Ignoring Symptoms - All to often contact lens wearers will wait a few days after feeling pain or discomfort before they will schedule their appointment. Don't ignore your symptoms. Schedule an eye exam with your eye doctor immediately if you feel any discomfort. Most common symptoms include :itching, burning, tearing, pain, sensitivity to light, sandy gritty feeling, foreign body sensation and most importantly any sudden change in vision requires immediate attention. It is much easier to treat most conditions if we are able to catch it early.
When it comes to your eyes and your vision live by the motto "when in doubt, check it out". Theres no better day than the present to start changing your habits. I spent some time specializing in low vision and trust me there is nothing sadder than a patient who has the sudden realization that they will no longer be able to see like they once had. Stop taking your vision for granted and start taking care of your eyes.
Today is a new day. Your slate is clean. In the words of H.G. Wells "if you fell down yesterday stand up today" and start taking care of your vision.