The Contact Lens Conundrum

I find myself having this conversation over and over with my patients.  I love contacts, I wear them myself but if not taken care of properly or over worn it can lead to serious complications.  The topic at hand: The importance of soft contact lens care and maintenance. 

Simply put: over wearing your contact lenses can lead to very serious infections that can lead to vision loss.  The surface of the eye, the cornea, is avascular.  Meaning it has no oxygen supply.  As soon as you insert a contact lens you are diminishing the amount of oxygen getting through to the cornea.  Any patient who is a contact lens wearer is at a slightly higher risk of infection vs. a patient who does not wear contact lenses.  That risk increases if you sleep in them when you are not supposed to or if you wear them longer than the indicated time.  Most soft contact lenses are replaced daily, bi-weekly and monthly.  Daily disposable lenses are thrown away every night.  Two week and monthly replacement lenses must be removed daily.  The appropriate solution must be used to clean and store these lenses.  Some lenses are meant to be slept in and some are not.  What determines this? The amount of oxygen that the contact lens allows through to the eye.  Only wear your contact lenses as indicated. 

Here are some of the most common contact lens complications I see.

Neovascularization of the cornea
The abnormal growth of blood vessels due to a lack of oxygen.  Most common cause: contact lens wear.  When the cornea is deprived of oxygen it's going to start to form it's own blood supply.  If the blood vessels get within the line of sight it can be detrimental to one's vision.  The cornea must be clear to provide us with optimal vision.

 

Corneal Infiltrates

Infiltrates are usually the precursor to an infection usually an ulcer.  They are white grayish cells that appear on the cornea.  They usually happen due to lack of oxygen to the cornea or due to a toxic reaction to the preservatives in contact lens solution.  Patient will present with light sensitivity, redness, tearing or discomfort. 

 

 

Corneal Ulcer

Ulcers are probably one of the most painful complications of contact lens wear.  It's an open sore on the surface of the eye that has become infected.  It is also known as a bacterial keratitis.  It's literally bacteria growing on your eye.  Imagine the petri dishes that you grew in science lab.  When you first culture the bacteria the petri dish is clear as the islands of the bacteria start to grow they start to become fuzzy.  That's what an ulcer essentially looks like a tiny island of bacteria growing on your eye.  Most common symptoms include redness, pain, light sensitivity, blurred vision, inability to open eye, foreign body sensation or lid swelling.  Though there are many reasons for an ulcer one of the most common causes is contact lens over wear.  Ulcers are a serious complication and need to be treated right away as they can cause a permanent loss of vision.

 

 

 

 

If at any time you experience a painful, red eye remove your contact lenses and see your eye care provider right away.  A patient should always have a pair of glasses to reduce the amount of contact lens wear.