Thursday, July 1, 2010

‘Piggybacking’ and ‘Vaulting’ Contact Lenses for Keratoconus

The cornea of the eye is the ‘window’ that allows light to be reflected onto the retina to enable our sight. One of the irregularities that can afflict the cornea is the disease called keratoconus.

Keratoconus occurs most frequently during the teen years or early 20s. It causes the naturally rounded cornea to become more cone-shaped, resulting in nearsightedness, astigmatism, and light sensitivity. Changes in eyeglass prescriptions tend to be necessary upon each visit with the eye doctor and, for many years, patients were told they could not wear contact lenses. Fortunately, some excellent options have been developed and marketed. These options can provide keratoconus patients with a contact lens option in various lens materials and designs.

Initially, rigid gas permeable (RGP or GP) lenses were the only type of contact used because their firmness restored a symmetrical window, correcting the focus of light into the eye. However, there were cases where keratoconus made the eye so sensitive that GP lenses could not be worn due to pressure exerted on corneal tissue. A solution called ‘piggybacking’ was developed.

In ‘piggybacking’ eyes that cannot tolerate GP contact lenses are first fitted with a soft lens that is intended to act as a cushion. Then, a GP is fitted over the soft lens. This achieves both the comfort and correction needed to overcome the effects of keratoconus. The one concern with this method is the issue of oxygen permeability necessary to keep the eye healthy. Fortunately, the advance of hydrogel and silicone hydrogel lenses has greatly increased oxygen flow for their wearers; GPs have also improved in oxygen transmission by way of new materials development in that segment. Despite this advantage, ‘piggyback’ patients need to be monitored by their eye doctor to prevent any problems that might occur.

One other innovation is the hybrid lens, which combines features of GP and soft contacts. Unlike the ‘piggyback’ lens option where two different lenses are used, with the hybrid lens there exists a center portion, made of a non-pliable material, while the outer skirt is made of a soft hydrogel material. This type of contact lens performs a function in which the corrective window ‘vaults’ over the cornea, eliminating any uncomfortable pressure. This is closer to the fit wearers have come to expect from current lenses.

Being diagnosed with keratoconus is not an automatic sentence to eyeglasses. It may take some patience and close consultation and visits with your eye doctor, but the options available give lens users good opportunities to keep the freedom and comfort of contact lenses.

Friday, June 25, 2010

Water and Contact Lenses

Water is one of the most plentiful substances on Earth, and its relationship to man’s survival is vital. However, when it comes to contact lenses, water holds both risks and benefits depending on its source.

Water has always been thought of as a cleanser, and in most instances that is true, but not so in the case of contacts. Water should not be used to clean or store lenses because it contains bacteria and microorganisms that transfer first to the lenses and then to your eyes. The serious infections and eye damage that result can cause vision loss, and even blindness. It does not matter whether the water comes from a filtered tap or is bottled or distilled, those harmful organisms remain. Use nothing but approved contact solutions to clean and store your lenses.

If you are the type of person who enjoys water sports or leisure activities, care must be taken when wearing your contacts in lakes, pools, hot tubs, or the ocean. Water splashed in the eyes will leave your lenses vulnerable to the same type of pathogens found in tap water. It is recommended that you remove your contacts before going into the water, or protect them with swim goggles. If water does get in to your eyes while wearing your lenses, remove them immediately. Thoroughly rinse them in solution and store them overnight. Daily disposable lenses are very convenient in this regard as they can be removed and replaced with a fresh pair right away. This is handy in situations when you find yourself without contact solution, e.g. at a park, lake, or resort.

On the other hand, the water that forms our tears is essential for comfortable contact lens wear. Not only do tears keep the eye healthy by flushing out dust and debris, they also minimize the growth of naturally occurring microorganisms that can appear on the eye’s surface. Tears are also important in keeping the cornea supplied with oxygen while contacts are in place, and blinking allows the tears to be continually replenished.

In addition, a recent innovation in contact lens manufacture has allowed water to become a component in silicone hydrogels, a soft lens that can deliver more oxygen to the cornea because of the water content in the plastic that makes up the lens. As a result, these contacts have become some of the most popular types on the market.

So, water has a two-fold relationship with contact lenses—one harmful, the other beneficial. Being mindful of the differences will keep your experience with lens wear a pleasant, comfortable, and healthy one.

Friday, June 18, 2010

Coming to Terms with Contact Lenses’ Prescriptions and Their Expiration

Despite all the information available about contact lenses, there is still one area where misconceptions crop up concerning the nature of contacts and their use: prescriptions and their expirations.

Eye doctors and contact lens sellers remain surprised that a good number of people continue to ask why they need a prescription to wear contact lenses. In cases like these, the prevailing notion seems to be that contacts are somehow just a fashion accessory and not the controlled medical devices that they are. It is true that patients have been given greater freedom to shop around for their lenses since the federal government required that contact wearers have a copy of their prescription. However, this freedom may have fostered assumptions that contacts have become less controlled. No one would think of taking a medication to treat a serious illness without benefit of a doctor’s prescription because that medication must be monitored so it will do no harm. The same holds true for contacts. A lens that fits poorly, is not perfectly matched to your vision power, or is made from material not best suited for your eyes will cause problems. Not only is discomfort a most likely result, but inflammation, infection, and permanent damage to eye tissue are also risks.

Once you have the proper prescription it is important to remember that it is subject to expiration, in most cases after one year. Your eyes may continue to feel good and lens wear remains comfortable, but there could be microscopic changes in your eye health that are not noticeable. An annual exam with your eye doctor assures that any potential problems with your eyes are caught and corrected before they become serious. These regular exams also keep up with how your lenses are performing and allows for any required updates in regards to power, size, material, or design.

In addition to prescription expiration, soft contact lenses themselves have a time limit placed on them. Despite the airtight packaging used on most brands of soft contacts, the passage of time may weaken or compromise the seal. This leads to contamination of the sterile saline solution and the lens inside. Expiration dates can be found on the box and on the lens’ foil wrapper. Dates are printed in a year-month format, meaning the contacts within can be used until the last day of the month in the calendar year indicated (e.g. 2014/12 means you can use the lenses until December 31, 2014). Once an expiration date has been reached, discard the lenses immediately and obtain fresh ones.

Contact lenses provide great convenience and comfort regarding vision correction, but it is important to remember that they also impact a most sensitive part of our bodies, the eyes. Regular and timely visits with your eye doctor are necessary to maintain eye health and to make sure they are enhanced--not harmed--by the contacts we choose.

Friday, June 11, 2010

Ending Discomfort Associated with Contact Lenses

The ongoing advance of contact lens technology in recent years has made the wearing and enjoyment of contacts more widespread. Nevertheless, there may be instances where discomfort may occur in some people’s use of lenses. In most situations where this is an issue, there are relatively simple solutions.

Eyes that burn when contacts are inserted are many times due to substances that get on the lenses through handling. Skin lotions, cosmetics, food oils, and soaps with additives (e.g. moisturizers and perfumes) can easily find their way onto your contact lenses. Search out ‘basic’ or ‘all natural’ soaps for use and make sure your hands are thoroughly dried with a lint-free towel before handling your contacts. Daily disposable lenses go a long way to cut down on contamination because you use them once and then throw them away.

Foreign body sensation (the feeling that something is in the eye) when wearing contacts could be a sign that your lens fit may not be just right. This cause may be as simple as inverted lenses, a nick at the edge of the lens, a torn lens or an incorrect base curve or diameter. Lipids and natural deposits left on lenses due to tear production is another factor, and can be removed with the proper cleaning solution. Your eye doctor can help you with the correct fitting and care regimen necessary.

Dry eyes while using contact lenses can possibly be solved by having your current lens fitting reevaluated by your eye doctor. A switch to contacts better suited for dry eye symptoms (silicone hydrogels are one type) may be recommended. Certain eye drops used for dryness in conjunction with lenses are available. High intakes of caffeine and alcohol contribute to the problem, so a moderation in their consumption may help.

Silicone hydrogels have also come to the rescue of those who find they cannot wear their lenses as long as they would like each day. These soft lenses have increased wear time due to their high rate of oxygen flow to the cornea, which also promotes good eye health in addition to comfort.

Other factors that affect contact lens comfort are the presence of allergies, medical problems, and the use of some prescription medications. Smoking raises a whole host of health complications associated with vision.

The most important thing to remember is that discomfort in most cases does not mean having to give up your contact lenses. Meetings with your eye doctor will very likely result in greater satisfaction and enhanced visual freedom.

Friday, June 4, 2010

Answering Some Common Questions About Contacts

As long as contact lenses have been a common and widely available means of vision correction, there also have been some basic questions that people ask—especially if they do not wear them and/or are contemplating a switch from eyeglasses.

For the ‘sophisticated’ contact wearer, the following questions may seem silly or unnecessary, but they are of great concern to those who are thinking of purchasing lenses or those who are new wearers. In this regard, they should not be dismissed, as any exchange of information that is useful to someone is certainly not a waste of time.

Are contacts bad for your eyes? Do they make your eyes worse? The success rate among contact lenses over their decades of use is indisputable. However, ‘bad’ depends on how conscientious users are in following the wear and care regimen that is vital to eye health. Since contacts are placed directly on the eye, the natural oxygen flow to the eye is immediately reduced by a factor related to the lens material itself. Industry developments over the past 5-7 years have greatly improved oxygen transmission through the lens material. Nevertheless, careless habits employed by the wearer will increase the potential for infections and other problems. The best defense is to heed all of your eye doctor’s instructions on lenses’ wear time and cleaning. As far as making eyes worse, this is a misconception borne out of contact use among children who often experience a progression of myopia (nearsightedness) during their growing years. Studies* have shown that children who wear eyeglasses under the same circumstances have a nearly identical rate of progression. It is simply that myopic changes are greatest during childhood.

Are contact lenses difficult to insert? After your eye doctor has assisted you in achieving a good fit with the right type of contact, they will also demonstrate the proper way to insert and remove the lenses. There may be those who struggle at first with insertion, but patience and practice leads to success rather quickly. It has been proven that children as young as eight are able to successfully handle contact lenses; if they can do it so can you!

Can contacts get lost in your eyes? They certainly cannot find their way to the back of the eyeball, as some fear, due to the nature of the membrane of the inner eyelid (conjuctiva). This membrane continues up the inside lid to become the covering of your eye’s outer white surface; nothing can get behind the eye. However, lenses can move into the upper eyelid, usually due to rubbing or sudden jostle. When this happens, use re-wetting drops in your eye and gently massage the lid with your eye closed to move the lens to a position where it can be removed. Another method is to carefully turn up your eyelid so that it is inside out (employ a cotton swab on the outside of the lid to fold onto), tilt your head back, and use the inverted eyelid to move the contact onto the eye’s surface so it can be removed. If the above methods prove unsuccessful, ask someone for assistance or immediately see your eye doctor.

Where can contacts be bought without a prescription? Contact lenses are classified as medical devices by the FDA and cannot be purchased without a valid prescription from an eye doctor. However, since you have a legal right to obtain your prescription from your eye doctor, you have the freedom to shop and select the seller who best fills your needs.

These are only some of the questions asked about contact lenses. Your eye doctor is the best source for answers when it comes to the wearing and care of lenses. They are willing partners and the dialogue between you can only improve your satisfaction with contacts.


*The Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) is an example.

Friday, May 28, 2010

Contacts Match Active Lifestyles at All Ages

In recent decades, Americans have become more active as they try to live a healthy lifestyle. Whether it is competitive sports or leisurely pastimes such as jogging, walking, or swimming, we are going and doing in greater numbers than our grandparents. However, if you are among the millions who require vision correction you have another concern: finding the type of lenses that won’t inhibit your activity level or enjoyment.

Although tolerated for years, eyeglasses remain pretty much a non-starter as far as being the best means for seeing well while exerting yourself. There are many disadvantages: restricted peripheral vision, slipping or falling frames, putting up with spectacle headbands, accommodating goggles, etc. Oftentimes glasses are the main reason people opt not to take up a sport.

Contact lenses have certainly made it easier to participate in physical activities, with their convenience and range of choices. Also, because of recent studies showing that responsible children can be successfully fitted for contacts, the entry age for kids who need vision correction and wish to start playing sports now begins at approximately eight years old. At the other end of the scale, older or ‘more mature’ individuals are able to continue enjoying healthful exercise with contacts that have come a long way in addressing eye conditions related with age, primarily presbyopia and dry eye.

Between the two types of contacts favored today, soft and gas permeable (GP), soft contacts get the nod as the better choice when it comes to active wear. Besides being more comfortable and quicker to get used to, their gel-like make-up allows them to adhere to the eye in such a way that they do not fall out during exercise or strenuous activity. Gas permeable contact lenses, because of their rigid and smaller-diameter design, tend to move or dislodge as the body exhibits vigorous motion. A recent development, hybrid lenses, may make it easier for those who are bound to a GP contact. Hybrids blend the corrective qualities of GPs with the comfort of soft lenses.

Disposable lenses have been a boon to sports enthusiasts who find themselves in situations where a strict contact-cleaning regimen is unwieldy, i.e. camping, sailing, or hunting excursions that can last for days. Beginning with a fresh pair every day and discarding them before retiring for the night, disposables are seemingly made for those constantly on the go.

Nowadays there are eye care practitioners who can specifically fit for participants in competitive or professional sports. Adapting general fitting techniques to the more precise need of a particular activity accomplishes this, whether it is softball or soccer for school-age children or golf and tennis that appeal to an older crowd.

Be mindful that any change in eyewear you plan to make is done in close consultation with your eye doctor. This is necessary to arrive at the proper lens for comfort and ease that will allow an enhanced enjoyment of your activities.

Friday, May 21, 2010

Contact Lenses and Solutions

Conscientious contact wearers are fully aware that taking proper care of their lenses is important and vital to continued eye health. The cleaning and storing regimen is a major part of this care.

There are various types of solutions made to accomplish safe cleaning and storage and it is easy to become confused about which does what. The following breakdown may be helpful.
· Cleaning solutions remove bacteria and debris, including dirt and mucous.
· Disinfecting solutions are used when storing your lenses, killing bacteria when you are not wearing your contacts.
· Multi-purpose solutions combine cleansers with disinfectants and can be used to remove proteins on lenses that come from tears.
· Peroxide solutions are also disinfectants, but most importantly come with a neutralizing agent that must be employed to convert the peroxide to saline before contacts can be placed on the eye. Peroxide in the eye will cause serious injury.
· Enzyme cleaners and protein removers target tear deposits that may irritate eyes.
· Rewetting solutions moisten lenses during the course of the day as they become dry; also called comfort drops, they can extend lens wear.
· Rinsing solutions basically wash across lenses to ready them for use, but do not kill bacteria.

Solutions should not be kept beyond their expiration dates; neither should they be mixed unless okayed by a doctor.

With all the above information, not to mention expense, an obvious question would be why not use tap water as a cleanser? Because despite the best filtration systems, tap water carries microorganisms and bacteria that can cause serious eye infections such as Acanthamoeba keratitis, a parasite-triggered condition that is sometimes difficult to diagnose and leads to permanent vision loss if allowed to advance. Bottled and distilled water are also off limits as impromptu solutions for the same reason.

It is also important to remember that swimming pools, hot tubs, and other recreational waters pose the same potential health risks if water is splashed in the eyes while wearing contacts. If this happens, remove the lenses as soon as possible, rinse and store them overnight to a proper disinfecting solution. A way to avoid this problem, especially if you are a ‘water-loving’ person who has no solution handy, is to carry disposable contacts. Disposables can be discarded and replaced once you leave the pool, lake or tub.

As for selecting the right solution for reusable lens care, your eye doctor is the person to go to for the information you need to navigate the various types and brands available. In fact, consultation is vital for first-time contact wearers and those wishing to switch from an established care regimen.

You enjoy the comfort and convenience provided by contacts. By approaching the cleaning and care aspects in an informed and responsible manner, you will ensure your healthy enjoyment of lenses for years to come.