Knowledge is Safety
‘Lens Calculi’ often referred to as ‘jelly bumps’ on the surface of a soft lens. These deposits often cause discomfort and have the potential to cause abrasions, allergic lid reactions and can lead to the binding of bacteria, fungi and other nasties with potentially sight threatening sequelae!
Some handy tips for safe, comfortable contact lens wear:
- Never wear lenses longer than prescribed. Do not wear daily lenses while sleeping.
- Do not wear your lenses overnight unless recommended by your contact lens practitioner. Overnight wear of contact lenses increases the risk of complications.
- Always wash, rinse, and dry your hands before handling lenses. Avoid pump and moisturising soap and use lint free cotton towels and tissues.
- Do not use saliva to wet your lenses. Do not put lenses in your mouth.
- Use only approved contact lens solutions for lubricating or wetting your lenses.
- Always use fresh solutions in your lens case when disinfecting your lenses.
- Ask your contact lens practitioner about wearing lenses during water activities and other sports. In some cases alternative lenses may be prescribed for sport, other hobbies and activities.
- Schedule and keep follow-up appointments with your contact lens practitioner.
- Never use non-sterile home-prepared saline. The use of home-prepared saline with contact lenses has been associated with serious infections.
- Contact lens storage cases can be a source of bacteria and other microbial growth. Lens cases should be cleaned, rinsed, and allowed to air dry each time the lenses are removed. Replace the lens case frequently. Household bleach is an excellent disinfectant for contact lens cases but make sure the case is compatible with this and rinse and dry the case thoroughly.
- If your eyes become red, irritated, painful, abnormally light sensitive or if your vision worsens while wearing lenses, immediately remove the lenses and consult a contact lens practitioner.
- Do not get lotions, creams, sprays or chemicals in your eyes or on your lenses. It is best to insert lenses before applying make-up and remove them before removing make-up. Water-based and gel-based cosmetics are less likely to damage lenses than oil-based products. Do not apply eyeliner on the inside rim of the eyelids.Make-up and cosmetics, especially inner lid margin eye-liner can block the numerous meibomian glands, cause stasis, infections, discomfort and lens deposits, as illustrated. Eye care practitioners can and do recommend the appropriate methods/cosmetics/application to minimise such reactions.
Make-up counter assistants/advisors must be aware of these potential problems when recommending cosmetics, eye shadow, foundation, mascara, sun block and moisturisers!
Cosmetics should be discarded and replaced with new, fresh make-up, according to manufacturers recommendations as old, expired make-up has been shown to harbour various bacteria, fungi and other micro-organisms thus dramatically increasing the risk of eye infections!
- You should have eye examinations every six to 12 months or as recommended by your contact lens practitioner.
- Contact lenses wear out with time and should be replaced regularly.
- Disposable lenses should be thrown away after the recommended wearing period prescribed by your contact lens practitioner. Daily disposable lenses should not be re-used.
Know your Routine
- Different solutions cannot always be used together and not all solutions are safe for use with all lenses. Use only the lens care solutions recommended by your contact lens practitioner, and do not change brands without first consulting your contact lens practitioner.
- Follow directions in the package inserts for the use of contact lens solutions.
- There are three essential steps in contact lens care 1. Cleaning 2. Rinsing 3. Disinfecting
- Every time contact lenses are removed, they must be cleaned, rinsed, and disinfected before wearing again. Some solutions are designed to perform more than one of these functions, but may not be as effective.
- Always remove, clean, rinse, enzyme and disinfect your lenses according to the schedule of your contact lens practitioner.
- The use of an enzyme or any cleaning solution does not substitute for disinfection.
- Lenses stored longer than 12 hours may require cleaning, rinsing and disinfecting again before use. Consult the package literature or your contact lens practitioner for specific instructions.
A central corneal scar on a final year medical houseman’s cornea following a bacterial ulcer that developed after he re-used a disposable lens that had been left soaking for months in unpreserved saline. [He had re-used it (against instructions) following damage to his regular lens, which had caused a minor abrasion.] He thus introduced the bacterially contaminated lens to his eye [ex the unpreserved saline storage]. The bacteria thus penetrated his damaged corneal epithelium, caused an ulcer and one of his medical colleagues erroneously treated a bacterial ulcer with cortisone eye drops thus exacerbating his ulcer. Fortunately we caught it before he suffered permanent visual loss – a potentially career threatening, yet avoidable problem.
The moral of the story? If even medical experts can make such a mistake how can we expect an untrained assistant to be able to give advice on such matters as lens care and treatment? Always consult an optometrist or ophthalmologist if you have any signs of red, sore, light sensitive eyes or abnormal symptoms or visual problems!
Always refer red eyes and contact lens complications to an optometrist or ophthalmologist who are the only people who have the necessary skills, microscopes, equipment and experience to correctly diagnose, refer or treat such problems!
Know your Products
- Cleaning solutions remove dirt, protein, oils, mucus, and debris that get on the lens during wear.
- Disinfecting solutions kill bacteria and other germs on the lenses. Disinfection is necessary to help prevent serious eye infections.
- Rinsing solutions remove other solutions from the lenses. They also prepare the lenses for wear.
- Enzyme solutions remove protein and other deposits that accumulate on the lenses over time.
- Rewetting solutions are used to wet [lubricate] the lenses while you are wearing them, to make them more comfortable.
- Never use unpreserved saline from a bulk container. Only single dose unpreserved saline may be used.
- If preserved saline is not available then purchase either unit-dose unpreserved saline or aerosol saline solution.
- Some solutions may have more than one function, which will be indicated on the label. Read the label on the solution bottle.
- Keep solution containers tightly closed and upright in a clean, dry, cool place when not in use.
- Solutions may become contaminated after opening. Throw away opened solutions as recommended. Do not use solutions after their expiry date.
- Remember the expiry date refers to the unopened container.
- Pay scrupulous attention to hygiene when handling the bottle tip and lid. Never touch the tip of the container with any other surface including fingers, and always handle the bottle lid with dry hands.
- Do not put solutions directly in the eye, unless they are designed for that purpose. Make sure you don’t put cleaners or disinfecting solutions in the eye, by mixing up the bottles.
This image shows a lens that was thermally disinfected in scorbic acid preserved saline. The scorbic acid discoloured a normally perfectly transparent soft lens. This represents one of the myriad problems associated with pharmacy assistants [and others] ‘selling/recommending’ incorrect/improper lens care products. Only the prescriber has the knowledge to recommend the correct modality/care regimen for the wearer and this should never be altered except in consultation with a registered contact lens practitioner. A small chip is also visible on the left hand edge of the lens which can lead to discomfort and possible irritation/inflammation or even infection of the sensitive ocular tissues.
This image shows how an RGP lens has been used to rehabilitate vision in a patient who had undergone Radial Keratotomy [RK], an early version of refractive surgery.
The fine radial cuts can be seen radiating out from the centre of the cornea, behind the lens. This form of surgery has demonstrated a tendency to over-correct vision usually resulting in hyperopic astigmatism and irregular, distorted corneas – some years after the surgery – which was performed to correct myopia.