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).
