Do You Wear Contact Lenses? Your Eyes Could Be At Risk.

By HELEN BOND

Special Contributor

Published: 30 April 2012 02:23 PM

Spend a few minutes talking about the topic of eye infections with Dr. H. Dwight Cavanagh, clinical professor of ophthalmology at UT Southwestern Medical Center, and you will think twice before you dip a lens back into a case filled with the same solution from the night before, which you just topped off.
Green-gray pus, scar tissue and pain like a hot needle in your eye are just a few of the repercussions Cavanagh passionately describes.
“These infections are horrible,” says Cavanagh, a lauded professor and co-author of a recent study about contact lens care. “There is nothing about a corneal ulcer outside of the eye that is not severe. The pain is severe, you can’t work, you can lose your vision, you may need a corneal transplant — you just don’t want to go there.”
We know we should replace our cases regularly and use fresh, sterile solution, instead of the leftover stuff, on our contacts, but we just don’t.
Cavanagh and fellow UT Southwestern Medical Center vision scientist Dr. Danielle Robertson analyzed the lens care practices of 433 people and found that 85 percent of the contact wearers believed they were following safe practices. When scientists dug deeper, they found that the average lens wearer practiced just half of the recommended hygienic steps.
Only 2 percent of contact wearers earned a good rating for their lens care, and just one patient did everything right, according to the study, published in December’s issue of the journal Optometry and Vision Science.
The most common offenders: not cleaning contacts and cases properly; swimming, showering or sleeping in lenses; and wearing them longer than recommended.
“Patients like to get their money’s worth out of the lenses and will wear them longer than the company recommends,” notes Dr. Karen Bassichis Saland, an ophthalmologist with Texas Health Presbyterian of Dallas. “If it is a two-week lens, many will wear them past the two-week mark, stretching the pair until the contacts start to irritate the eyes.”
With 38 million contact wearers in the United States, serious eye infections related to wear and care are rare, but they can be excruciatingly painful.
Bacteria and fungal-infection-causing agents can bind to lenses and flourish in a dirty lens storage case, Cavanagh says.
Typically, common bacterial eye infections clear up with prompt use of prescription antibiotic eyedrops or ointments, but exposure to other organisms, such as amoebas in impure water, can take months to treat and lead to blindness.
Poor contact care can also result in less harmful but still irritating and uncomfortable eye problems caused by inflammation.
Saland commonly treats patients for giant papillary conjunctivitis (GPC), characterized by mucous discharge, eye irritation and dry-feeling lenses. The condition occurs when someone wears the same pair too long or sleeps in contact lenses and basically becomes allergic to the contacts.
As a teenager, Saland suffered years of eye inflammation from sleeping in extended-wear contacts. She advises her own patients not to sleep in lenses, even if approved for use.
Cavanagh would like to see proper contact lens hygiene become a public health issue, like hand washing.
“When a contact falls out of your eye at a cocktail party, don’t pick it up off the carpet, lick it and put it back in your eye,” Cavanagh begs. “And you have to clean the case — it’s like not cleaning your kitchen sink or your toilet bowl.”
Infections are analogous to car wrecks, he says. “You hope you are never in one, they are rare, but if it happens it can be catastrophic.”
Helen Bond is a Dallas freelance writer.
Proper lens care
Have you cleaned your contact lenses today? The best way to avoid contact-lens- related infections is to practice some tender, loving eye care.
That means following all, not just some, of the prescribed proper lens care directions. Do not reuse old solution or top off the solution in your lens case; avoid exposure to contaminants by using tap water for lens cleaning or wearing lenses while showering or swimming; and wear and replace contact lenses on time, recommends the American Academy of Ophthalmology.
OTHER TIPS:
Wash and dry your hands each time you handle lenses. Use a “rub and rinse” step in the lens cleaning process. Rub your contact lenses with your fingers, then rinse the lenses with solution before soaking them.
Do not use saline solution and rewetting drops to disinfect lenses. Neither is an effective or approved disinfectant. Never transfer contact lens solution into smaller travel-size containers.
Clean, rinse and air-dry your case each time lenses are removed. Studies show that leftover solution in a lens case is often already contaminated with bacteria. Replace the case regularly, at least every one to three months. (UT Southwestern’s Dr. H. Dwight Cavanagh would tell you to dump your case once a week).

Discounts For Our Patients!

Everybody likes to save a little bit of money, right? Let us help you get what want and save a little money in the process. We have some great deals for you on glasses...

If you wear contact lenses, it is always a good idea to have a current "backup" pair of glasses. 

Some people like to have multiple pairs of glasses for different activities.

We also want to help you take advantage of the benefits of wearing contact lenses, by providing a discount on a pair of sunglasses!

We also have gift cards available to anyone who wants to give that unique gift to a friend or loved one.

VISION VS EYESIGHT: WHAT's THE DIFFERENCE?

Ashley Reddell, an optometrist who specializes in vision therapy and children's vision, discusses the difference between vision and eyesight. For school-aged children, this is a big deal. Dr. Reddell graduated from Southern College of Optometry in 2009, and completed a residency in pediatrics and vision therapy at Southern College of Optometry.


When it comes to children’s vision, optometrist Ashley Reddell says, it’s not all about those two numbers separated by a slash.
Even if a child’s eyesight is 20/20, his or her performance in school might be hampered by vision problems, Reddell said at a Basehor Chamber of Commerce meeting Thursday.
Children’s vision, not eyesight, is the specialty of Reddell, who works for the Vision Development Center in Leavenworth.
What’s the difference? Vision has less to do with a person’s eyeballs and more to do with their connection with the brain, she said.
“Vision is what the brain is doing with the information once it goes in,” said Reddell, who also gives presentations in schools, including in Basehor-Linwood.
Children with vision problems might have difficulty with keeping both eyes working together, changing focus from one object to another, following moving objects with their eyes or distinguishing between different letters with similar shapes, she said.
Such problems can make typical classroom tasks — reading a book or copying words from a board at the front of the class — seem excruciating, Reddell said.
“They think, why would my friend want to read ‘Harry Potter’? That sounds like torture to me,” Reddell said.
Vision difficulties often go unnoticed during regular eye screenings, and they can be tough for kids to recognize or describe, Reddell said.
For instance, a child having problems with eye teaming — or the ability to use both eyes together — might experience double vision while reading. But a child may not understand what “seeing double” looks like. If an optometrist shows a child an animation of words on a page splitting into two, though, the child might be able to say that’s what it looks like when he tries to read, Reddell said.
That difficulty in identifying the problem can sometimes cause parents to experience “mom guilt,” she said.
“They’ll say, ‘Oh my gosh, I had no idea! They didn’t complain about it,’ ” Reddell said.
Parents or teachers can sometimes see evidence of vision difficulties in children’s behavior, she said. A child struggling with eye teaming might often cover one eye while reading, and one having difficulty with eye focus might report that her vision is blurry even if she has 20/20 eyesight.
A survey, often given to both parents and teachers, is the best way to determine if a child has vision difficulties that are interfering with learning, Reddell said. She handed out to chamber members a sample survey that asks how often certain behaviors occur, ranging from reading below grade level or taking too long with homework to experiencing headaches or itchy and watery eyes.

These signs and symptoms could go unrecognized and untreated in many children. It's up to the parents to pay attention and to have regular eye exams done by an eye doctor to uncover some of these problems. If you have any questions, please feel free to contact us. 

MACULAR DEGENERATION AWARENESS

This blog was created in part as an effort to educate our patients and the general public about eye disease, and how they can affect you and your vision. 

Many eye diseases can be devastating to your vision. With most of them, vision loss or visual disturbances are not noticed by the patient. It is only when the disease process has progressed quite far and become much more difficult to treat, that patients begin to notice changes in their vision, and come see their optometrist. Sadly, by this point, irreversible damage has already been done, and all we can do is try to save what remaining vision a patient has left.


February is Age-Related Macular Degeneration Awareness Month. Macular degeneration is a devastating disease that is the leading cause of vision loss, affecting over 2 million Americans age 50 and over.

The disease is called Age-related macular degeneration (AMD), but signs and symptoms can appear in patients at a much earlier time. There is also a genetic predilection for AMD, so if a parent or grandparent has been diagnosed with AMD, it is wise to have annual eye exams that screen for AMD, so that any changes can be caught in the early stages.

As the name implies, macular degeneration affects the macula. The macula is a small, but very important area of the retina. It is responsible for all of your sharp, detailed vision. When you look at an object, you are using the macula. The rest of the retina could be described as supplying your peripheral vision.

The picture below is an example of a normal retina and normal macula circled in black. The white marks are just a sheen, or reflection off of healthy nerve fibers.

When an optometrist dilates your eyes and looks into them with their bright lights, this is the view they see. At Family Vision Care of Bountiful, we also have an instrument called OCT. OCT is described as an MRI for the eye. It allows the doctor to view a cross section of retina, as opposed to an areal view like in the previous picture. It allows an optometrist to see what's going on in the layers beneath the surface, that may not have been visible just by looking into the eye. Below is an OCT of a "normal" retina. The macula is circled in white, and corresponds to a cut-away-view of the area circled in black in the previous photo.

As you can see, the retina looks healthy, and all of the layers are regular an defined. Especially the bright white band towards the bottom of the OCT. That bright white band is called the retinal pigment epithelium or RPE. It is responsible for maintaining the retina, and keeping it functioning properly.

In AMD, this RPE layer is the first place that signs will occur. At this stage, AMD is called "dry AMD". Instead of being a crisp, regular line like the previous photos show, it becomes lumpy, and irregular because it is holding onto cellular debris, and beginning to atrophy and die. Below is a picture of a retina with dry AMD.

In the above photo, areas of pigmentation and and small white spots called drusen are visible within the macula. These are the first sign of irreversible degeneration in the macula. At this stage, the patient would notice very minor, if any visual changes.

Below is an OCT of a retina, also with dry AMD. The crisp, regular layer of the RPE is gone, replaced by an irregular, lumpy appearing RPE layer.

At this stage, the standard of care, and only treatment available, would be heavy doses of eye-specific vitamins with things like leuteine, antioxidants, omega-3, taurine, and zinc. These would serve to protect the RPE from continued damage, and help it function to maintain the retina. Cessation of smoking would be highly recommended, strict UV protection, and regular eye exams in order to monitor change.

As AMD progresses, patients may begin to see visual changes. At first they may experience a slight decrease in clarity, with some straight lines appearing wavy, or distorted.

AMD progresses into what is called "wet AMD". At this stage, blood and fluid from below the RPE, begin to break through that compromised RPE layer, and leak into the retinal layers, causing widespread damage, scarring, and death to the retina. Below is an OCT of wet AMD. The large areas of fluid buildup are visible as black spaces, and scarring is visible as well. The retinal layers are no longer regular and defined, and have separated in may areas.

At this stage, the only options available as treatment are intraocular injections of a drug that helps to stop the formation of the vascular nets that form and leak blood and fluid into the retina and cause the widespread scarring. The patient may see a slight improvement in vision, but not much. At this point, almost all central vision is gone. A simulated view of what a patient may see is shown below.

At this point, no cure for AMD exists. Efforts are being made, and research is being done to find a cure. That is why it is so important to have your eyes examined regularly by an optometrist, so that we can help to slow the progression of AMD from the very earliest stages. If a patient has progressed to the point of significant vision loss, a referral can be made to a low vision professional, who can help with devices and training to utilize what retinal tissue is left for vision.

Keep in mind, that AMD does not exclusively affect older patients, however it is much more prevalent in that population. Additional risk factors include fair skin, light colored eyes, and positive family history.

If you have any questions regarding AMD or other topics related to the eyes, please feel free to give us a call.

Technology in Our Contact Lenses!

Experimental Contacts May Ease Pain After Laser Eye Surgery

Study Suggests That Lenses Laced With Pain Meds Could One Day Replace Regular Eye Drops

By Brenda Goodman, MA
WebMD Health News

Reviewed by Laura J. Martin, MD

Jan. 20, 2012 -- Researchers are developing contact lenses that may one day deliver painkilling drugs directly to the cornea after laser eye surgery.
The contact lenses rely on nanotechnology to slow the delivery of anesthetic medications.
Researchers say that if the technique works, it could eliminate the need for patients to repeatedly apply numbing eye drops after their photorefractive keratectomy (PRK) procedures.
“This would represent a version of time-release which would reduce the number of drops that a patient would need,” says Robert F. Steinert, MD, an eye surgeon who is professor and chair of the department of ophthalmology at the University of California at Irvine.
Steinert, who is also a spokesman for the American Society of Cataract and Refractive Surgery, reviewed a study of the new technology but was not involved in the research.
“I think it would add convenience, but it probably isn’t a game changer,” he says, noting that most patients are currently able to control their pain after PRK by using eye drops every couple of hours for the first three days or so, and they already have to wear bandage contact lenses while their eyes heal.

Slideshow: What Eye Problems Look Like

Could Better Pain Relief Give PRK an Edge Over Lasik?

In PRK, surgeons remove the surface of the cornea and reshape the deeper layers underneath. The outer layer eventually grows back.
That’s a bit different than Lasik, where doctors make a flap out of the outer layers of the cornea and use a laser to reshape the tissue underneath. The flap is then replaced. But it can be dislodged or dislocated if the eye is injured.
For that reason, PRK is considered to be more stable than Lasik. And it may be the only option for people who have thin corneas, dry eyes, or a condition called anterior basement membrane dystrophy. It also tends to be the preferred method for athletes and people in the military, who may be more likely to take a blow to the head.
But PRK has some drawbacks, too. Notably, it causes more pain and requires a longer healing time.
For those reasons, more people currently opt for Lasik over PRK.
But researchers say that could change if the new contacts make recovery more bearable and convenient.
“There are two big benefits,” says researcher Anuj Chauhan, PhD, a chemical engineer at the University of Florida in Gainesville. “Patients don’t have to remember to use the eye drops, so it increases compliance. And secondly, you don’t have to use as much of the drug because most of the drug is going directly into the cornea.”

Delivering Drugs Through Contact Lenses

For his experiment, Chauhan soaked water-permeable contact lenses in a solution that contained the anesthetic drug lidocaine.
In some batches, the contacts were soaked in the drug alone, and in others, the lenses were also soaked in solutions that contained various concentrations of vitamin E.
The lenses absorbed the drug and the nanoparticles of vitamin E, but they stayed clear, suggesting that the added ingredients wouldn’t interfere with vision.
The modified lenses were then blotted and dried and then placed back into a saline solution to test how long it might take them to release their medication.
Those that contained lidocaine alone released 90% of the drug within about two hours, meaning that they lasted about as long as conventional eye drops.
But the lenses that also contained nanoparticles of vitamin E lasted much longer, releasing nearly all their medication within six to 11 hours.
Chauhan explains that the vitamin E, which doesn’t dissolve in water, creates physical barriers in the lens that slow the delivery of the drug.
“The drug molecules have to weave around these vitamin E barriers,” he says. “Vitamin E essentially acts as bricks inside a contact lens to slow down the drug release.”
Chauhan and his team are currently testing the technology in animals. If all goes well, he says they hope to have the lenses on the market in about eight years.
The study was published in the American Chemical Society journal Langmuir.

My Arms Aren't Long Enough!

If you are around 40 years old (give or take a few years) you may have already experienced having to push reading material away from your face in order to see it clearly. Eventually your arms won't be long enough for you to see it clearly, and you will need to result to reading glasses or bifocal glasses.


If you have experienced this, don't fear. It's a natural part of getting up in years. Luckily, we can help you see clearly at all distances using our knowledge of optics, and the eye. This post will explain what is going on that causes you to need some help to see clearly up close. even though you have always been fine before.

To understand this, we need to consider how light enters the eye and is focused onto the retina to form a clear image. It is easiest to think of an individual who requires no glasses prescription, and has perfect vision (I know you glasses and/or contact wearers already dislike this person!) Light from a distant object (20 feet or farther) enters the eye, and forms a nice point focus on the retina, and the person sees a nice clear image without the eye needing to do any work at all.

As that object is brought closer to the person though, that point focus that fell so nicely onto the retina before, is now being pushed back "behind" the retina. In order for this person to see clearly now, the eye needs to use it's muscles and focus the light back onto the retina.

In our younger years, we typically have the power to focus this light onto the retina. As we age however, the focusing muscles start to diminish in their ability to focus this light for us. As a result, we need a little help to see clearly at near. That is where reading glasses or bifocals come in. They do the rest of the focusing that our eyes can no longer do for us.

The good part about this story, is that there are many different choices out there for you. You can hide the fact that you need some help with reading that great novel. We can help you find a solution that will work perfectly for you. Keep an eye out for our next post, in which some of the different options will be laid out for you.