Warning for contact lens users

Some warnings for those who wear contact lenses, from bottomlinesecrets.com.


"For the 34 million Americans who wear contact lenses, disposable soft lenses have offered advantages in comfort and ease of use. However, soft-lens wearers have had problems recently from rare but dangerous infections associated with multipurpose lens cleaning solutions. You might remember that Bausch & Lomb recalled and discontinued all of its ReNu with MoistureLoc products in 2006 after fungal infections were associated with their use. A few months later it happened again -- another scattered but alarming breakout of an ameba corneal infection (keratitis) in soft lens wearers using Complete MoisturePlus Multi-Purpose Solution from Advanced Medical Optics, Inc. The offending agent was a parasite, called Acanthamoeba, present in the water supply.

The infection it caused created eye pain, redness, blurry vision, excessive tearing, sensitivity to light and a foreign-body-in-the-eye sensation. More than 130 people were affected and experts were worried, since it was possible for damage to be so severe it could cause blindness or could necessitate a corneal transplant. Early detection is critical for effective treatment, and the keratitis frequently mimics other infections caused by fungus or herpes simplex virus.

EYE INFECTION DANGERS

To learn what soft-lens wearers should do to avoid these and other infections, I called ophthalmologist Thomas Steinemann, MD, associate professor at Case Western Reserve University School of Medicine in Cleveland, Ohio, and spokesperson for the American Academy of Ophthalmology. He explains that while such parasite and fungal infections are rare, the presence of Acanthamoeba in our water supply is not. They are pretty much everywhere in nature, including in our soil as well as water. There has been speculation that the more relaxed water-purification restrictions enacted by the Environmental Protection Agency (EPA) in 2003 may have played a role. The EPA vigorously denies those charges and claims that the problem is an issue of contact lens hygiene, not drinking water.

Dr. Steinemann points out that widely used multipurpose lens cleaning solutions do not protect against microbes such as Acanthamoeba as well as hydrogen peroxide two-step solutions do. While consumers should definitely avoid using the products associated with the recent outbreaks of infection -- tossing away any unused solution -- it is equally important to keep in mind that the advantages of being able to correct your vision with contact lenses do not come without responsibility. The lenses are so easy to use that people forget that they are first and foremost medical devices and there are good reasons for the rules promoting safe lens wear. Excellent hygiene will go far in helping protect contact lens wearers from such infections, regardless of their source.

HOW TO STAY SAFE

For example, many people are in the habit of wearing their disposable lenses longer than they should. Lenses are designed to be worn for a day, a week, two weeks or a month -- whatever the time frame for yours, Dr. Steinemann says to respect it and dispose of them accordingly. He advises against sleeping in them. Sleeping in lenses translates to a five times greater likelihood of developing a blinding infection, so it is imperative to avoid the practice.

As for lens disinfecting and proper cleansing techniques, Dr. Steinemann has a number of tips. Noting that multipurpose solutions which clean, disinfect, rinse and store lenses in one fell swoop are convenient for patients, he has concerns about them because many people don't follow the manufacturer's guidelines for using the products, which increases risk. Though more time consuming, he says it might be better to use a two-step cleaner. Always follow guidelines for use of cleansers. Be sure to always empty your lens case of the old disinfecting solution, so you are putting them into fresh solution every single day -- people tend to top off yesterday's supply, says Dr. Steinemann, which means they are putting their lenses into a solution that may be filled with bacteria and ameba since these lose disinfecting efficacy after a day or two. The FDA recommends always washing hands with soap and water and letting them dry completely so water won't infiltrate your lenses. For the same reason, it is also important to let your lens case air-dry after you have dumped the used solution.

Infection protection while wearing your lenses is largely a matter of keeping water out of your lenses. For this reason Dr. Steinemann does not recommend wearing lenses while swimming or using hot tubs. Just wearing goggles isn't good enough... even the best-fitting ones allow some water from the pool or lake to seep in, he says. Showering with lenses is also a bad idea. He acknowledges this advice might seem over-the-top, but on the other hand, it is a way to make sure water-borne ameba do not get into your lenses. Look for prescription goggles from companies such as Hilco and Sports Optix.

Dr. Steinemann adds that occasionally people have difficulty wearing their lenses. Generally this manifests as dry eyes, particularly in women. He recommends using an artificial tear solution, which his patients have found helpful. Note: Choose a tear product that can be used with contacts. Another potential problem is blepharitis, an irritation of the eyelid and eye caused by the oil gland. Prevent this by taking supplements of flaxseed (available in grocery stores or in the eye care section of the drugstore) and omega-3-rich fish oil. These will help enhance the secretion of the oil glands."

Source: Thomas Steinemann, MD, associate professor of ophthalmology, Case Western Reserve University School of Medicine, Cleveland.