Proper care of contact lenses

contact pictureNext week, the Center for Disease Control and Prevention is sponsoring its first Contact Lens Health Week. Since more than 34 million Americans wear contact lenses, this topic is absolutely important and definitely a little late in coming.

While I would love to say that all of my patients have perfect hygiene habits, many of them do not. I have heard of patients sleeping in their contacts for months on end, using tap water to store them, and cleaning them in their mouths after falling out. Yes, the last one is true

So, after listening to my patients, here is my top ten list for caring for your contacts and your eyes:

  1. Wash your hands before handling your lenses.
  2. Keep your contact lens case clean and let it air dry.
  3. Change your case with every new bottle of solution.
  4. Use name brand solution and never top off your solution (always use new solution!).
  5. Throw your lenses out at the doctor prescribed interval.
  6. Even if your lenses are approved for overnight wear, it is a whole lot safer if you don’t.
  7. The solution may say no rub, rub anyway.
  8. Saline solution is not disinfecting, you need to use a proper solution.
  9. Contact lens solution is not a good rewetting drop. Ask your doctor for a good choice.
  10. Daily disposable contacts are the safest choice for those who swim. Open water and hot tubs are especially dangerous pathogens love these conditions.

The bottom line is that if you follow the rules, contacts can be a very safe and effective way to see better. Just remember to see your doctor every year to make sure that your contacts are still the best choice for your eyes. Your optometrist can be a great resource so make sure to ask questions during your exam and let them know if you are experiencing any difficulties with your lenses.

~ David C. Ardaya, O.D.
California Optometric Association

Decorative contact lenses & Halloween – fun or danger?

Photo courtesy of College of Medicine at Chicago

Photo courtesy of College of Medicine at Chicago

November 1 2012, a 19-year-old woman from the local college came into my office complaining of scratchy, painful, swollen eyes. As the story goes, she had purchased decorative contact lenses online to complement her Halloween costume. Although I’m sure she looked amazing, after a few hours of wearing the contact lenses, her eyes started hurting which progressed throughout the evening. By the next morning she was in my exam chair being treated for Iridocyclitis, a deep swelling of the eye tissues. Luckily, with treatment, she recovered without permanent damage.

Cases like this led the US government to establish regulation that define contact lenses, whether prescription or cosmetic, as medical devices with protections in place to safeguard the public. According to the FDA, “On November 9, 2005, section 520(n) was added to the Federal Food, Drug, and Cosmetic Act (the Act) by Public Law 109-96 to establish that all contact lenses are devices under section 201(h) of the Act.”  Click here for more info >>

“Without a valid prescription, fitting, supervision, or regular check-ups by a qualified eye care professional, decorative contact lenses, like all contact lenses, can cause a variety of serious injuries or conditions. For example, lens wear has been associated with corneal ulcer, which can lead rapidly to internal ocular infection if left untreated. Uncontrolled infection can cause corneal scarring, which can lead to vision impairment, and in extreme cases, blindness or the loss of an eye. Other risks include conjunctivitis; corneal edema (swelling); allergic reaction; abrasion from poor lens fit; reduction in visual acuity, contrast sensitivity, and other visual complications that can interfere with driving and other activities.

Because of these risks, contact lenses, including decorative contact lenses that are non-corrective, are not safe for use except under the supervision of a practitioner licensed by law to direct the use of such devices. The Agency believes that these risks cannot be sufficiently controlled unless the wearer does the following under professional supervision:

  • Obtains advice about using contact lenses;
  • Has a valid prescription;
  • Has the lenses fitted properly; and
  • Remains under appropriate professional care for contact lens use.”

Unfortunately, even though the United States government has set in place regulations to control the illegal sale of contact lenses, overseas companies are still selling contact lenses that are being shipped into the country.

~ Dr. Steven Sage Hider, OD
California Optometric Association

A contact lens exam, what’s different?

Photo courtesy of Valley Eyecare Center

Photo courtesy of Valley Eyecare Center

I often get this question from patients: “I can see fine. My contacts are fine. Why do I have to have a contact lens exam?” This is not an unusual conversation in my office. Now is a great opportunity to explain the different tests done in a Contact lens exam.

One important thing we need to understand is that contact lenses are FDA approved medical devices.  They are actually small, very thin, pieces of plastic that sit directly on the cornea. The cornea of the eye is a very small, yet complicated structure that needs to be examined regularly when a patient wears contacts. Misuse of contacts and/or poor fitting contacts can cause serious harm to the health of the cornea and ultimately your vision.

My vision is fine. Why do I need another exam?

There are several tests your optometrist will do to determine that contacts are safe, healthy on your eyes and that the prescription is correct. We measure the curvature of the surface of the cornea – using a Keratometer or a Topographer – to determine the right size of contact to put on. Taking this measurement every year will help ensure that the contacts are not causing any subtle damage to the surface of the cornea. There is also a highly specialized microscope that some doctors are beginning to use that is able to count the number of corneal cells to make sure that they are staying stable while using contact lenses. These tests are early detectors of corneal changes due to the use of contacts that may not initially affect the vision or comfort of your lenses.

The contact lens exam also includes a detailed tear analysis to determine if you have dry eyes or allergy eyes. These common conditions can affect the comfort of your lenses and your vision. There are many different types of materials that contacts are made of and some are not compatible with certain eye surface conditions. For example, someone might need a contact with more water in it, others might need one that transmits more oxygen to the cornea. All of these factor are determined in the contact lens exam.

Next, the contact lens prescription needs to be determined. Due to the fact that that contact lens sits on the eye, not in front of the eye like glasses do, there is actually a different determination of the contact lens prescription that needs to be done in some cases. So, no … the contact lens prescription is not the same as the glasses prescription.

Once all of the parameters of the contact lens is chosen – size, material and optical prescription – the lens needs to be evaluated on the eye. We look at how the lens moves on the eye and how it sits to determine if it is going to be a healthy lens for you. Sometimes, differences in eyelids, blinking and tears can affect how a lens sits on the eye and adjustments might need to be made.

Finally, when your optometrist is happy with the fit and the vision through the contacts, then your contact lens examination is complete. Depending on the difficulty of your prescription, any eye surface disease, such as dry eyes or allergies, and if you are an experienced wearer or not, this process can take from one visit to several. Work with your optometrist during the process so that your can safely wear contact lenses for many years to come.

~ Lisa M. Weiss, O.D.
California Optometric Association


How old is old enough for contacts?

Photo courtesy of Valley Eyecare Center

Photo courtesy of Valley Eyecare Center

In our last blog, Dr. Melissa Barnett shared some great ways to help children wear their glasses. These excellent points are sure to help increase glasses wear, but there is a good chance that the day will come when your child will decide to hit you up for contacts.

At what age is it appropriate to consider contacts?

Well, in our practice, age is nothing but a number. What really counts is the maturity of the child (i.e. personal hygiene), the willingness of the parent to play a supporting role and the child’s needs. As such, your optometrist might ask you and your child a few questions to help make that determination. For example, we might ask if the kid is mature enough to brush their teeth without being asked. Or, if he or she is good about keeping their room clean without being asked. Hey, I know what you are thinking, this probably rules out 95 percent of kids (and adults) but we have to start somewhere.

Why might my child need contacts?

New studies show that measures of self-esteem increase significantly in contact lens wearing teens and children. Additionally, a number of contacts lens brands offer ultraviolet (UV) protection. While I always encourage children to wear sunglasses, any form of UV protection is welcome, as UV exposure is known to cause certain eye diseases like cataracts and macular degeneration. We also have to consider if the child plays sports. Contacts are great at improving peripheral vision and image stability and one can imagine what a difference contacts can make on an athlete’s performance.

Okay. What else do I need to know?

Once you have succumbed to your child’s incessant begging, you have to determine the safest and most fool-proof way to achieve a happy and safe experience with contacts. I can say firsthand, daily disposable contacts are almost always my first choice. My little brother started wearing contacts at 14 year old, and to be honest, I wasn’t sure he was ready so I started him with daily disposable lenses. As the name suggests, you chuck them on a daily basis. Thus, no solutions, no cleaning and fewer worries. The main concern we have is keeping our children from accidentally falling asleep in their lenses. Certainly, some children have prescriptions that are not available as daily disposables, but it is rare to find a young person who cannot be a contact lens wearer with a little work. In the end, contact lenses can be a safe and useful method for vision correction in children, provided that they follow the rules explained by their optometrists.

~ David C. Ardaya, O.D.
California Optometric Association

“What if 1 and 2 look the same?!”

Courtesy of riekhavoc (caughtup?) on Flickr

Courtesy of riekhavoc (caughtup?) on Flickr

A common concern for some of my patients is if they don’t tell me the correct choice of lens, then their prescription for that year will be off and not work properly. This is not true. When an optometrist is switching between lenses (which we in “the business” call a refraction), we are fine-tuning a prescription using the patient’s input to find the lenses that are the most clear and comfortable.

Optometrists are trained to filter out incorrect answers from our patients as we double and sometimes triple check on your responses to make sure we have the right powers. Many optometrists do this by bracketing the lens choices presented to patients. Bracketing means we pick two lenses with a noticeable difference in powers and move towards the most clear of the two. By doing so, the lenses in 1 and 2 may end up being the same lens or lenses in choices 7 and 8, etc.

Additionally, when we bracket the lens choices our goal (or “end point”) is when the two choices look just about the same. So if your optometrist is checking your eyes and the two choices look about the same, tell them- that’s what we want to know.

Another thing that we as optometrists don’t want is to give you a glasses prescription that are too strong for you. That is why it is important for you to relax and try not to squint when your optometrist is checking your prescription. If you are constantly squinting when we try to refract you, then you are more likely to end up with glasses that only work well when you squint, but are too strong for you when you don’t.

Courtesy of Lyn Kelley Author on Flickr

Courtesy of Lyn Kelley Author on Flickr

Something I have found to help patients give better responses is remembering to blink often. Occasionally, a patient will get so fixated on telling me which lens looks better that they don’t blink as often as they normally would. This can cause your tear film on the surface of your eyes to start to break up and affect your ability to tell which lens looks better. Blinking often lets your eyelids put a smooth layer of tears over the front of your eyes. It is similar to polishing a lens, and a polished lens is always easier to see out of than a scratched lens.

Your optometrist can check on the health and structures of your eyes as well as check the function of your two eyes working together when you go in for your annual eye exam. The art of determining a person’s prescription is not easy, but an optometrist is trained to work with the responses of their patients. Don’t worry about getting it wrong! If you just remember some of the tips mentioned above, you can be sure your optometrist find your proper prescription.

~Ranjeet S. Bajwa OD
California Optometric Association

The SCARY… and fun truth about colored contact lenses

Colored contact lenses are a popular topic this time of year as many people prepare their Halloween costumes. How fun is it to have a cool accessory like tiger eyes, cat eyes or red or white eyes to complement the most creative of costume? Colored contacts are a great fun option.  There are also many people who like to wear colored contact lenses daily to make their eyes more blue, more green, more brown or a different color all together!

Courtesy of therefromhere on Flickr

Courtesy of therefromhere on Flickr

However, most people do not realize that even contacts worn for cosmetic purposes still pose a potential health risk for the eye if not properly fitted. This is true even if there is no prescription on the lens.  Contact lenses are classified as “medical devices” with the FDA.  Regardless of a corrective prescription, contacts are plastic on the surface of the eye and need to be fit properly and be taken care of properly to lessen the chance of vision threatening infections such as corneal ulcers.

Doctors of optometry perform additional tests above and beyond the glasses and eye health examinations when fitting contacts. We evaluate the size and shape of the cornea, the health of the tear layer and the fitting relationship between the cornea (the outer surface of the eye where the lens sits) and the contacts lens to insure the safest most appropriate lens for each individual patient.  We also educate patients on the best cleaning and wearing regimen for the them.  This greatly reduces any complications associated with contact lens use.

Buying contact lenses without a doctor’s prescription is something that happens with colored contacts often.  This practice leads to rise in vision threatening conditions that could be prevented with a proper contact lens examination. So, buy a different kind Halloween contact lens for each Halloween party this season, but get a prescription first!

~Lisa Weiss, OD, MEd, FCOVDCalifornia Optometric Association

Are contact lenses dangerous?

Courtesy of wader on Flickr

Courtesy of wader on Flickr

The Benefits

Contact lenses are medical devices that millions of people wear safely every single day. Many people enjoy the freedom from glasses that contact lenses allow.

Contact lenses are also great options for:

  • Sports
  • Changing eye color
  • People who have irregularities to the front of the eye, cornea, or are not able to see with glasses.

Contact lenses make it possible to see and function in everyday life.

The Dangers

Contact lenses can be dangerous if they are abused.

Contact lenses are medical devices and can only be prescribed and dispensed by a licensed eye doctor. If they are sold without being evaluated on the eye by a doctor it can lead to:

  • Eye infections
  • Eye inflammation
  • Eye injuries

Proper care is key

Proper contact lens care and handling are important components of the contact lens fitting process. Contact lens solution used incorrectly or “topping off contact lens solution” (adding more without disposing of the current solution) can lead to multiple complications. It is important to use sterile contact lens solution and not tap water due to bacteria in water. Never, ever put contact lenses in your mouth or spit on them to try to clean them.

Courtesy of listentothemountains on Flickr

Courtesy of listentothemountains on Flickr

It is also important to replace contact lenses at the recommended frequency. For example, daily disposable contact lenses should be replaced each day. Contact lenses that are overused and abused can lead to serious problems.

Certain contact lenses are approved for sleeping or extended wear. However, if your contact lenses are not approved for extended wear, this can lead to complications on the cornea, or front of the eye.

If you are interested in contact lenses, schedule an appointment with a doctor of optometry today.

~Melissa Barnett, OD, FAAO