A friend recently contacted me with this sad story: an elite young gymnast, Deanne Soza, is at risk of permanent and severe vision loss due to an aggressive contact-lens associated infection. Reading the posts from her family it appears she had contracted a possible Acanthamoeba infection in both eyes from wearing contact lenses in a hot tub. Acanthamoeba is a protozoan parasite that is commonly found in water - swimming pools, lakes, and yes, hot tubs. As doctors work to treat the infection and save Deanne's eyesight, it highlights a new and disturbing trend in the eye care world. Corneal infections from contact lens wear are actually on the rise, and it is time for both contact lens wearers and eye doctors to rethink what we can do to prevent even just one more person from going blind or suffering vision loss from wearing contact lenses.
What Can You Do?
If you wear contact lenses, it is so easy to treat them with relative indifference. Every single day I have patients tell me that they sleep in lenses that aren't approved for it, wear lenses 2 or 3 times longer than the FDA and their doctor have prescribed, and disinfect their lenses with cleaning supplies that are not safe to use with contact lenses. Tap water, sterile saline, your saliva, or any home-made solutions are not safe for cleaning your lenses! If you follow these safety protocols, then contact lens wear should be safe for you:
1) Follow the Prescription
Do you have monthly lenses? Biweekly lenses? Lenses approved for overnight wear? Your doctor has prescribed lenses with specific wearing schedules, and make sure you know what you lens is made for. If you wear a 2 week lens for over a month, you are putting yourself at a really high risk of complications. Why risk blindness when just changing out your lens will keep your eyes safe? Make sure you tell your doctor how you want to wear your lenses, and they can help you find a lens material approved for that wear time.
2) If your eye is red or irritated, take your contact lenses out
When you are a contact lens wearer, it is often like telling someone they have to go to prom in a potato sack to get them to wear their glasses for a few days. But if your eye looks red or feels a little uncomfortable (yes, even just a little!), you should throw away your contact lens and wear glasses. If your eye isn't 100% back to normal later that day, call your doctor to be seen immediately! Do not wait until you have vision loss or discharge or severe pain. You need to stop contact lens wear the second your eyes don't feel right to prevent severe infections.
3) If your eye is exposed to water, take your contact lenses out
Any water-related activities are extremely dangerous when combined with contact lenses. Rare but severely aggressive pathogens like Acanthomoeba live in water and soil. Swimming in lakes or pools or hot tubs and getting that water in your eyes just coats your contact lens with loads of pathogens. If your eye gets even a small scratch or dry spot under your contact lens, then the infection can break through the corneal epithelium and penetrate deep into your eye. That's why removing lenses to clean them right after exposure is so important, and removing lenses if your eye feels even just a little uncomfortable is crucial. You need to have a 100% normal corneal surface to safely wear contact lenses -- no scratched areas, and no dry areas.
What Can Your Doctor Do?
I am a huge proponent of talking about daily disposable contact lenses with my patients. I know dailies aren't as popular in the US because they are seen as price prohibitive, but they are far and away the safest way to wear contact lenses. When you throw away your lens every day, there is no chance to seal bacteria or any infectious entity against your eye. As contact lens risks come under increasing scrutiny from the FDA , I expect that we will see growing numbers of patients switching to dailies for all the perks of both safety, comfort, and incredibly clear vision since there is no build up or lens deterioration to combat. I ask all of my fellow eye care specialists to advocate for daily disposable lens wear, and even if your patient isn't interested in dailies this year, if we continue to talk about the benefits and safety, we can help prevent the number of infections and the number of people being blinded by their contact lenses forever!
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| I don't show a lot of graphic pictures on the blog, but this is what an advanced Acanthamoeba infection looks like. When it gets to this point, vision is likely permanently damaged and your doctor is battling to save your eye at all. via |
What Can You Do?
If you wear contact lenses, it is so easy to treat them with relative indifference. Every single day I have patients tell me that they sleep in lenses that aren't approved for it, wear lenses 2 or 3 times longer than the FDA and their doctor have prescribed, and disinfect their lenses with cleaning supplies that are not safe to use with contact lenses. Tap water, sterile saline, your saliva, or any home-made solutions are not safe for cleaning your lenses! If you follow these safety protocols, then contact lens wear should be safe for you:
1) Follow the Prescription
Do you have monthly lenses? Biweekly lenses? Lenses approved for overnight wear? Your doctor has prescribed lenses with specific wearing schedules, and make sure you know what you lens is made for. If you wear a 2 week lens for over a month, you are putting yourself at a really high risk of complications. Why risk blindness when just changing out your lens will keep your eyes safe? Make sure you tell your doctor how you want to wear your lenses, and they can help you find a lens material approved for that wear time.
2) If your eye is red or irritated, take your contact lenses out
When you are a contact lens wearer, it is often like telling someone they have to go to prom in a potato sack to get them to wear their glasses for a few days. But if your eye looks red or feels a little uncomfortable (yes, even just a little!), you should throw away your contact lens and wear glasses. If your eye isn't 100% back to normal later that day, call your doctor to be seen immediately! Do not wait until you have vision loss or discharge or severe pain. You need to stop contact lens wear the second your eyes don't feel right to prevent severe infections.
 |
| Does your eye look or feel just a little irritated. If you notice even mild redness like above, take your contact lenses out and wear your glasses that day! If your eye is irritated, it needs a chance to fully recover without exposure to bacteria or other microbial pathogens that your contact lens may have on it! via |
3) If your eye is exposed to water, take your contact lenses out
Any water-related activities are extremely dangerous when combined with contact lenses. Rare but severely aggressive pathogens like Acanthomoeba live in water and soil. Swimming in lakes or pools or hot tubs and getting that water in your eyes just coats your contact lens with loads of pathogens. If your eye gets even a small scratch or dry spot under your contact lens, then the infection can break through the corneal epithelium and penetrate deep into your eye. That's why removing lenses to clean them right after exposure is so important, and removing lenses if your eye feels even just a little uncomfortable is crucial. You need to have a 100% normal corneal surface to safely wear contact lenses -- no scratched areas, and no dry areas.
What Can Your Doctor Do?
I am a huge proponent of talking about daily disposable contact lenses with my patients. I know dailies aren't as popular in the US because they are seen as price prohibitive, but they are far and away the safest way to wear contact lenses. When you throw away your lens every day, there is no chance to seal bacteria or any infectious entity against your eye. As contact lens risks come under increasing scrutiny from the FDA , I expect that we will see growing numbers of patients switching to dailies for all the perks of both safety, comfort, and incredibly clear vision since there is no build up or lens deterioration to combat. I ask all of my fellow eye care specialists to advocate for daily disposable lens wear, and even if your patient isn't interested in dailies this year, if we continue to talk about the benefits and safety, we can help prevent the number of infections and the number of people being blinded by their contact lenses forever!
