Saturday, December 1, 2012

Blinded by convenience

Life & Times
 November 27, 2012

Blinded by convenience

Don’t take the handling of contact lenses lightly, warns Nadia Badarudin. It may lead to irreversible damage to the eyes
NINA Ridzuan (not her real name) wore contact lenses simply because she felt spectacles made her look less attractive and restricted her freedom to enjoy outdoor activities.
However, she was ill-informed and did almost everything that a contact lens wearer shouldn’t do. She wore her contact lenses for more than the recommended eight hours. She put them on at 6am before she left for work and took them out only after she reached home at about 8pm (sometimes, she was so tired she even slept with the lenses on).
If she ran out of disinfecting solution, she would just clean the lenses with normal saline solution. The 25-year-old bought solutions that were cheaper or on sale without seeking the advice of her optometrist. Worst of all, she kept the contact lens casing on the toilet sink.
One day, she experienced excruciating pain in her left eye. It was red and watery. Within minutes, she suffered partial vision loss. Then she went blind in her left eye.
Nina did regain her vision after undergoing treatment but she still has a scarred cornea which takes time to heal.

Nina’s ordeal (and daily habits in the episode) is one of the many sorry stories which stem from the wearers’ ignorance or indifferent attitude towards the importance of proper wear and care of contact lenses.
“Wearing contact lenses is safe for all. It’s the way we handle the lenses that can be hazardous to the eyes and lead to such horrible stories,” says associate professor Dr Haliza Abdul Mutalib, an optometrist from the Faculty of Health Sciences, Universiti Kebangsaan Malaysia.
“Many first time wearers don’t realise that contact lenses can affect their vision if mishandled. Most wearers put the lenses not knowing that insertion or removal can cause various injuries such as corneal scratch,” she says.
And while some are clueless about proper disinfecting procedures, there are those who don’t know that the lenses must be used with disinfecting solution and kept in proper casing.
“Incorrect wearing technique and handling can bring infections, allergies, ulceration and eventually cause blindness,” says Dr Haliza, adding that incompliant wearers would usually get infections in less than a year of using the lenses.

Contact lenses can do more good than harm. Besides providing cosmetic benefits to almost everyone — from newborns to the elderly — it can help improve vision, particularly in those who are aphakics (people who lack the eyes’ natural lenses), or suffer from ocular conditions or diseases such as keratoconus (degeneration of the cornea structure) or recurrent cornea erosion syndrome.
“Contact lenses also benefit babies born with congenital cataract. They can also perform as ‘bandage lenses’ for therapeutic reason,” says Dr Haliza.
She says it is crucial to get the eyes checked by eye care practitioners before wearing contact lenses. The practitioner would run a series of tests to ascertain whether a person can wear contact lenses or not.
“If a person is deemed suitable to use the lenses, the practitioner will determine the lens type (either soft or rigid gas permeable contact lenses) and the right lens care products that suit the person’s lifestyle,” she says.
“If the wearer uses heavy make-up or is active in sports, the practitioner would normally recommend daily disposable lenses that can be used up to 10 hours.
“There are also contact lenses that can be worn for more than 14 hours (extended wear) or 30 days (continuous wear) without the need to take them off during the
period,” she adds.

Dr Haliza says individuals with severe dry eye syndrome or allergies are among those who cannot wear contact lenses. She says dry eye syndrome is where the tear glands produce fewer tears and is normal among those who take heavy medication.
Then there are those who can’t wear contact lenses because of the shape of their eyes.
“Individuals with severe nearsightedness may also find it hard to wear them because there aren’t many lenses with high enough power to correct their vision,” says Dr Haliza.
“There are also those allergic to disinfecting solution or the contact lenses and those with previous trauma, infection, ulceration are likely to get the painful episodes repeated if they wear contact lenses.”
She adds that some experts have suggested that diabetics don’t wear contact lenses because they are prone to infections.

Thinking of buying trendy contact lenses to imitate Lady Gaga’s Bad Romance video anime-look, or to appear childlike, doe-eyed like your favourite Korean Pop idol for your Facebook profile picture?
Think again.
The eye-enlarging circle lenses make the eyes look bigger (or most of the times, disturbing!) by covering the iris as well as part of the whites. Popular among female teenagers with mostly good vision, circle lenses are cheap and easily available at night markets or sold on the Internet.
Dr Haliza says youngsters should understand that contact lenses are not accessories, and be warned about the consequences of buying lenses from unqualified sources.
“Trendy, cheap contact lenses have low oxygen and water content and are meant for occasional wear. The lenses come in standard sizes and may not fit the wearer’s eyes. Ill-fitting lenses can deprive the eyes of oxygen, resulting in various complications,” she says.
It is also a risk to share contact lenses with friends. “There is a risk of getting HIV through shared contact lenses. With the right concentration, the virus can spread through tears,” she explains.
Dr Haliza continues: “Despite lack of care, the lenses will still look good and wearable, but when put under the microscope, it’s a different story. Dirty lenses are full of deposits, germs and whatnots that can cause discomfort and trigger giant papillary conjunctivitis where the inner surface of the eyelids becomes irritated and inflamed.”
She says that compromising on the efficacy of disinfecting solutions is also another common mistake. She recalls a patient who “treated” the solution like shampoo or body lotion and re-poured the solution into 30 small casings for the convenience of daily use.
Moreover, she says, many are ill-informed that different solution has different efficacies.
“Eye care practitioners will recommend products that best suit the wearer’s lens type and ocular health. So buying non-recommended mix-and-match products over the counter may not fulfil the need,” she says.
1. Wear the lenses for longer than the recommended period.
2. Sleep with lenses on.
3. Handle contact lenses with dirty hands and long nails.
4. Top-up or reuse disinfecting solution.
5. Transfer the disinfecting solution to other containers.
6. Leave contact lens casing without the lids on.
7. Expose your contact lenses to tap, bottled, distilled, lake or ocean water (tap and distilled water have been associated with Acanthamoeba keratitis, a corneal infection that is resistant to treatment and cure).

1. Get a thorough eye examination from a qualified optometrist or optician
    before deciding to wear contact lenses.
2. Rub and rinse the contact lenses as recommended by the eye care
    practitioners. Rub the lenses immediately after taking them off.
3. Rub the inner part of the casing while cleaning, and let it air-dry. Keep
    the casing in a clean, hygienic place.
4. Use daily disposable lenses when going for swimming, camping or other 
    outdoor activities as well as while travelling.
5. Replace the casing every three to six months.
6. Use disinfecting solution as advised by the eye care practitioners (what
    the manufacturer recommends on the product label might not be suitable 
    to the wearer’s need).
7. Use re-wetting drops, as prescribed by eye care practitioners, to moisten
    the eyes when the environment is dry.

Prof Madya Dr Haliza Abdul Mutalib
Pakar Optometris & Prof Madya
Program Optometri & Sains Penglihatan, FSK
Universiti Kebangsaan Malaysia