Dessi: “Doctor said I needed these nifty colored glasses to hep wit my contacts; but I can’t tell if they’re the right size.”
Mey: “Dessi, those are drinkin glasses; go back and get some seein glasses.”
Often I see patients that say they can’t wear contacts any more due to irritation. In fact, this is one of the most common reasons for contact lens discontinuance nationwide, if not the world.
The causes are varied, but often have some similarities. First, and possibly foremost, is the over wear of contacts. People assume that a two-week soft lens is good for a month or so because it still feels good, or because they want to save money. What they aren’t aware of is the fact that contact lenses are porous.
Over time the lens pores get clogged up with microscopic proteins, and don’t allow oxygen through, as they should for optimum eye health. As this happens the lens also changes shape and fits tighter, not allowing tears to get underneath to bring in nutrients to the eye surface and flush out waste products. This then leads to a toxic condition that can cause not only irritation due to lack of lubrication, but also eye infection, scarring and loss of vision.
Another cause is due to hormonal changes, either age related, or from medicines. The tear oil glands normally produce enough lubrication to coat not only the eyelid inner surface and eye surface, but also both sides of a contact lens as well.
As the hormonal changes occur the glands can’t keep up with the lubrication demand, and dry spots start to appear. Friction then occurs due to moving parts sliding past each other-very much like an engine that’s low on oil. This causes irritation and damage to the eye.
The third cause is nutritional. What we used to see in older adults is now becoming fairly common in teenagers and college age people. The food diets are causing higher cholesterol and inflammation. This then leads to break down in eye surface tissue and oil glands.
These changes not only cause irritation, but also cause the eye lid to become more flaccid; and not able to move the contact lens underneath for good tear perfusion underneath the lens, similar to the over wear patient mentioned previously.
There are some remedies to counteract the causes of contact lens difficulties. The first is easy; just replace the lenses more often as directed by your eye doctor and the FDA.
Sometimes changing lens material and/or solutions can make a difference. New Scleral Rigid Contacts are starting to come out that have the comfort of soft lenses but the superior optics of a rigid lens.
The second and third causes often require some work-up to find the best treatment to the problem. There are eye drops, both over the counter and prescription, certain procedures to keep the tears around longer for better lubricant ability and supplements to improve nutrition to alleviate the underlying problem.
Therefore, if contacts have been “irritating “ you, check with your eye doctor for the latest in advances to remedy the situation.
Dr. Scott Borgholthaus is owner of Vision Haus Optometry in Cheney. He is a member of the Optometric Physicians of Washington and has been in private practice for over 27 years.
Dr. Borgholthaus would love to answer and/or include any questions or comments in future columns. Please send questions or comments to drb@cheneyvision.com.
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