Contact lens wearers are all idiots!

There, he said it!

A series of recent encounters with contact lens wearers coming to us for the first time has led our optometrist, Dr. Euan McGinty, to this conclusion, shall we find out why?

Dr. McGinty writes:-

The eye is perhaps the most exquisitely sensitive organ in the body, one which provides information that we are highly dependent upon.  Lets take some cold hard facts - 40% of all nerve fibres connected to the brain are linked to the retina.  More of our neurons are dedicated to vision than the four other senses combined.  When our eyes are open, vision accounts for two thirds of the electrical activity in our brain.

There's no denying it, we like to see!

Contact lenses can be a great way to correct our vision and we now have options available to cover most prescriptions and eye-curvatures.

Over the years I have been practicing as an optometrist, perhaps the best single factor in contact lens development has been the move disposable contact lenses.  Compared to years ago, the frequent disposal of contact lenses has dramatically reduced the number of complications I see day-to-day related to the wear of contact lenses.

Disposable lenses are much safer

Studies have shown the compliance with proper contact lens care improves dramatically with the use of disposable lenses and, by a long margin, the best regime is single-use daily disposable lenses.

I was recently discussing this with a contact lens patient who we were refitting with new lenses.  This person had been running in to problems with discomfort, red eyes and variable vision with his regular contact lens regime.

As we discussed all of the options, two things became apparent - firstly, that the idea of single-use daily disposable lenses was something this patient was very keen on and; secondly, that although the current lenses being used were monthly disposable lenses, these had routinely been used for in excess of a month.

Let's make one thing clear, daily lenses are to be used for one day, two-weekly lenses for two weeks and monthly lenses for one month.  That's from when you open the packet until you throw them away, it is not two-weeks' or a month of "wears".

There was no doubt that a lot of issues had arisen for this patient due to the poor contact lens regime and that sorting out the routine, in terms of lens renewal, hygiene and cleaning and also ensuring a good contact lens fit would resolve a lot of the issues.

We really were tempted to switch out to a single-use daily disposable lens, for him the fresh-lens comfort every day was great and for me the excellent safety profile was highly desirable.

The stumbling point? 

Price.

This then caused quite a moment of humour as we realised that purchasing daily disposable lenses would be a third less in cost compared to the cup of coffee that he had come in with and that he picks up every day.  The difference is that you don't buy a year's worth of coffee all in one transaction.

He'd never thought about it in those terms, however, with a bit of perspective it became apparent that great vision and healthy eyes were at least as important as his daily cup of Joe.

If you hear hooves, don't think of zebras

The second encounter which really led me to the conclusion that all contact lens wearers are idiots was a lady who was scheduled for an eye examination.  She contacted us on the day of the eye examination to cancel and reschedule, she had a red-eye.  We suggested that this would be an ideal time to see her optometrist, however, for whatever reason, she didn't want to do so.

I then saw her two weeks later.  We were chatting about her eyes and her recent red eye, she was quite frustrated by it.  She was sure that there must have been a faulty contact lens, or an issue with her solutions.  She had just opened up a new set of lenses and put them in, so they must be to blame.  She stopped wearing them, used some over the counter antibiotic eye drops and it had eventually resolved.  So, in her mind, it was definitely the contact lens's fault.

I examined her eyes and noticed a corneal scar in her eye that had been the affected one.  In my assessment this had been a recent corneal ulcer and she was fortunate that it had resolved, as they have the potential to be quite damaging, especially when associated with contact lens wear.

I discussed my findings and again we went through the lead up to the red-eye to see if we could tease out what had gone wrong.  It was only at this point that it turned out that this patient had slept in the contact lenses and worn them for almost 48 hours straight - something they were never intended for!

We like to have cause and effect, and somewhere to lay the blame.  In this patient's opinion it was the new contact lens which had caused the issue.

This was a contact lens which, until it was opened, had been in sterile packaging.

This was a contact lens which then had been used inappropriately.

I politely suggested that this may not have been the contact lens which had caused the issue, however, it was much more likely to have been caused through "user-error"!

Okay, maybe not all contact lens wearers

These are just two stories of recent encounters which reminded me again how much we take our eyes and vision for granted ... until something goes wrong.  There is no doubt that there are many successful contact lens wearers who run in to no problems whatsoever.

I'll admit it, of course not all contact lens wearers are idiots, but there are some things we should think about.

It doesn't really matter if you believe in all-powerful being, in evolution, or in some other explanation of how we got here, if we were meant to have contact lenses in our eyes, we would have.  We don't!  Contact lenses are a foreign body, to our eyes, they're not meant to be there.

Therefore, when we wear contact lenses, we have to accept we are increasing the risks of having something adverse happen to our eyes.  We need to ensure that we follow simple care steps to make it as safe as possible.

Preferably we should look at single -use daily disposable lenses.

Even with all of these steps, things can go wrong, a recent news story on the BBC website highlighted this: http://www.bbc.com/news/uk-england-nottinghamshire-32797394

More information about our contact lenses can be found on our website here: http://www.oceanoptometry.ca/index.php/the-collections/the-contacts-collections

Dry Eye - an interview with our optometrists

Dry eye complaints are something both our optometrists, Dr. John Wilson and Dr. Euan McGinty are seeing more and more of in their day to day consultations.

With people spending more time doing visually intensive tasks, working on computer screens for extended periods and working in environments with controlled atmospheres which are often dry, it is perhaps not surprising that it is becoming an increasingly common complaint.

Therefore, we decided to quiz our doctors a little further about dry eyes.

"While the symptoms of dry eyes can be very frustrating", John says, "the clinical issues associated with it can be equally significant.  A dry eye can often be a compromised eye and therefore more vulnerable to infections or even scar tissue formation.  These both can further complicate the picture and early intervention to provide long term management really is key."

"If you suffer from dry eyes, which can often be recognised through its signs and symptoms, then it is important to have it properly assessed so that we can give you the correct advice specific to your condition."

"This is important", Euan adds, "not all dry eyes are the same.  From that point of view we often have people whose symptoms can range from a burning/gritty sensation, an itchy sensation, to just some discomfort.  What is surprising is we also have patients whose eyes are watering, they can find it strange when we start to talk about 'dry eyes'."

"Looking at the eyes, patients can present with red eyes or inflammation of the tissues of the eye and eyelids, at other times the eye looks quiet and healthy, but the symptoms are all there.  From this point of view dry eyes can be an incorrect label, really we are talking about the tear film not functioning properly."

"When we are performing a dry eye assessment we will be looking at all of these factors, taking into account the symptoms, the appearance of the eye and the tear film and the quality and quantity of tears present.  This will help us to arrive at a care plan which is individual and appropriate for each patient."

"I can't agree more", adds John.  "This really isn't a one-size-fits-all type condition.  With an appropriate manage plan, the condition can often be turned completely around.  It does take effort and commitment from both the patient and ourselves, especially in the early days and weeks.  When we review patients and compare their initial metrics to those after appropriate management, the improvements can be marked."

"This can translate into real world differences, not just in their comfort, but also in their quality of vision."

We asked, is there any general advice which could be helpful?

Euan replied, "It's hard to be general, but there are some things which I do keep going back to.
 Firstly, not all artificial tears are the same.  It is important to find one which works well for you, although I would say that preservative free artificial tears are generally all better than others."

"There may be an element of trial and error to begin with, however, my go-to artificial tear at the moment is one called "Hylo".  This contains an excellent agent for nourishing and protecting the eye, Sodium Hyaluronate, which is found naturally in the tear film.  It comes in unique bottle allowing it to be both preservative free and usable for up to six months from first opening."

We have found this to be so successful we have decided to stock it in our office to make it easier to find, it is available at pharmacies and drug stores, however, some patients did comment that it was difficult to find.

As Hylo is preservative free it is also suitable for contact lens wearers to use, even with their contact lenses in.  So if you find that your contact lenses dry out your eyes or have difficulty in handling your lenses at the end of the day, this may just be the solution you are looking for.

"There are two things I keep coming back to as well," responds John, "Omega-3 fish oils and an eye mask"

Dr. John Wilson using a Thera Pearl Eye Mask

"The Omega-3 supplements have been shown to be useful in helping manage dry eye conditions, it is important to choose the fish oil, however, and not the flax seed oil (which may have other benefits).  There are certain things to look for, so a little research is definitely useful to ensure it will fit in with your needs and lifestyle."

"Eye masks are a great resource for patients with dry eyes.  We recommend the Thera Pearl eye mask and again have decided to always have it available here at Ocean, as we were so impressed.  It can be used for both warm compresses, to help open up the meibomian glands and improve their function, and cold compresses, to help calm down an angry and inflamed eye.  I have been so impressed with this simple product that I have one at home for myself to use!"

John concludes, "While this advice may not be for every patient, it may be beneficial for many patients and, at times, I do wonder if we should all be performing eye-lid cleaning and warm compresses as part of our daily routine, like brushing and flossing our teeth."

One final piece of advice from both or our optometrists: Don't forget the 20/20/20 rule - for every 20 minutes you are using your computer (or tablet/smartphone) you need to look at something 20 feet away for at least 20 seconds.

If you have any concerns about dry eye, please feel free to make an appointment.  The first step is a comprehensive eye examination to rule out other factors and then, if appropriate, we can schedule a dry eye assessment appointment.