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Eye research charity poll shows Brits put their eyesight at risk through dangerous contact lens habits. Poll results released today (11/07/2019) by charity Fight for Sight highlight that many Brits are frequently putting their eyesight at risk through unsafe contact lens habits, unaware that these could lead to a painful and sight-threatening eye infection called Acanthamoeba keratitis.

Of those Brits who wear contact lenses polled by YouGov on behalf of the charity, 56% admitted they’d worn their contact lenses for more than the recommended time of 12 hours a day; over half (54%) admitted to having gone swimming or showering in contact lenses, and 47% of contact lens wearing Brits admitted to having slept in them.

15% had put contact lenses in their mouth to clean or lubricate them, and two percent had even shared contact lenses with others when they had already been used.

According to the poll, almost a third (33%) of Brits who wear contact lenses do not know that wearing contact lenses that have been washed in water can be sight-threatening, highlighting a lack of awareness around the risks associated with exposing contact lenses to water. Nearly half (47%) said that information about the dangers of exposure to tap water was not clear on contact lens packaging or accompanying information materials.

Fight for Sight is raising awareness of the need to wash contact lenses in the correct solutions, after research funded by the charity last year showed a rise in cases of this type of eye infection. [1] The charity also is urging manufacturers to make the ‘no water’ message clearer on packaging.

The most severely affected patients (a quarter of the total) have less than 25% of vision, face prolonged treatment or become blind following the disease. Overall, 25% of people affected require corneal transplants to treat the disease or restore vision.[2]

Dr Neil Ebenezer, Director of Research, Policy and Innovation at Fight for Sight, said: "This type of infection can have serious consequence and even result in blindness, so the lack of awareness around the correct use of contact lenses is concerning. People who wear contact lenses need to make sure they thoroughly wash and dry their hands before handling them, and should avoid wearing them while swimming, face washing or bathing. Contact lens manufacturers should also do their part by making the ‘no water’ message clearer on all contact lens packaging and accompanying literature, and this message should be re-emphasised by opticians to ensure patients follow this important advice.”

Nick Humphreys (29) from Shrewsbury, contracted Acanthamoeba keratitis in January 2018 and now has no sight in his right eye.
Nick thought he simply had a bit of grit in his eye, until one day he couldn’t manage to open his eye at all and was having to drive with one eye shut. Concerned, he went to see his optometrist who referred him to hospital, where, seven days later and after multiple tests, he was diagnosed with Acanthamoeba keratitis. After two different treatments, Nick has no sight in his right eye but is waiting for a corneal transplant which he hopes will restore some of his vision.

“The whole experience was terrifying – it was agonisingly painful and I didn’t know what was going to happen with my sight. At the beginning, I was in and out of hospital daily having toxic drops put in my eye every hour. I couldn’t work for six months, having to sit in a dark room wearing sunglasses because I was so photosensitive. Eventually, after months of doctors not knowing what to do about it, I had treatment - corneal cross linking, a procedure that aims to make the tissues in your cornea stronger. Coincidentally at around the same time, the bug finally went. This allowed me to go back to work for a month before I had a second surgery – an amniotic membrane transplant – which involved having a contact lens stitched onto my eyeball. It was as vile as it sounds.

“Though medically speaking the operation went well, when I removed the patch and looked at the eye in the mirror, my heart sank. I felt like something from the exorcist was looking back at me. Though I was now pain-free and able to resume a normal life, depression and anxiety kicked in because of my changed appearance. I’m now starting to feel slightly better about it all but still do not have sight in my right eye and am waiting for a corneal transplant to try and improve my vision.

“There needs to be more information on contact lens packaging about the risk of Acanthamoeba keratitis – so few contact lens wearers are actually aware this could happen if you don’t use contact lenses correctly.”

Nick is now working with Fight for Sight to help raise awareness of the condition following his experience.

What is Acanthamoeba keratitis?

Acanthamoeba keratitis (AK) is a sight-threatening infection of the cornea - the clear ‘window’ at the front of the eye - and can be very painful. The infection is caused by a microscopic organism called Acanthamoeba, which is common in nature and is usually found in bodies of water (lakes, oceans and rivers) as well as domestic tap water, swimming pools, hot tubs, soil and air.

Acanthamoeba keratitis currently affects roughly 1.2 to 3 million people each year across the world, and contact lens wearers constitute ≥90% of affected patients in the UK.[1]

Using tap water to clean or store contact lenses, contaminating lenses with tap, pool or hot tub water and having poor contact lens hygiene increases the risk of infection. Examples of poor lens hygiene are not using disinfection solutions properly, reusing the solution in the contact lens case, failing to empty and dry the contact lens case after use and storing lenses in water overnight.

Wearing contact lenses when swimming or taking a shower also increases risk, as does putting in lenses with wet hands from tap water.

Treatment

Acanthamoeba keratitis needs immediate attention, as it can result in permanent visual impairment or complete sight loss. It’s difficult to treat, with treatment requiring prolonged use of antiseptic and sometimes antibiotic eye drops. Painkillers may also be necessary.

The most serious infections will need a corneal transplant, which involves surgery to remove the damaged cornea and replace it with a healthy one from a suitable donor.

Fight for Sight, who established the UK corneal transplant service in 1983, is actively campaigning to raise awareness of the preventable nature of Acanthamoeba keratitis through proper contact lens care, believing there is a lack of information from contact lens dispensers and manufacturers on the risks associated with exposing contact lenses to water. Fight for Sight is actively encouraging contact lens manufacturers to provide more contact lens care literature in all packaging.

About Fight for Sight

Fight for Sight is the leading UK charity dedicated to funding pioneering research to prevent sight loss and treat eye disease. Fight for Sight’s overall research commitments currently amount to £8m for over 160 research projects at 49 different universities and hospitals across the UK.

Over the course of its history the charity’s research has resulted in breakthroughs that include new treatments to save the sight of premature babies, the world’s first clinical trials to test gene therapies for inherited eye conditions and the creation of a corneal transplant service in 1983.

For more information visit www.fightforsight.org.uk

Postscript from ADP-EyeCare: While the CL industry looks at ways to improve its message to wearers, ADP-EyeCare and its partner practices will be issueing written guidance to support exam converstaions at each contact lens exam and whenever lenses are dispensed to patients. 

References

[1] Carnt, N., J. J. Hoffman, S. Verma, S. Hau, C. F. Radford, D. C. Minassian and J. K. G. Dart (2018). "Acanthamoeba keratitis: confirmation of the UK outbreak and a prospective case-control study identifying contributing risk factors." Br J Ophthalmol.
Lim, C. H. L., F. Stapleton and J. S. Mehta (2019). "A review of cosmetic contact lens infections." Eye 33(1): 78-86.
[2] https://www.moorfields.nhs.uk/news/outbreak-preventable-eye-infection-contact-lens-wearers

Fight for SightAll figures, unless otherwise stated, are from YouGov Plc.  Total sample size was 2024 adults of which 276 wear contact lenses. Fieldwork was undertaken between 19-20 March 2019. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Content published with kind permission of Fight for Sight Charity representing Press Release 11 July 2019.

 

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Contact Lens FAQs

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Kathyrn Chidwick BSc(Hons) Ophthalmic Dispensing, in a recent article in Re:View the ABDO College journal, discussed the possible interactions between ocular cosmetics and contact lenses. Her critical research analysis found studies revealing eyeliner to migrate into the tear film and interacting with contact lenses. One of the interactions was to decrease the light transmission through the lens, where as another separate interaction caused some lens materials to expand and others to contract! 

Eyeshadow was also found to cause changes in lens hydration and swelling, with a particular material in many lenses absorbing far more pigment than others.

Good practice would be for patients to apply contact lenses before cosmetics and remove them before using cosmetic cleansers.

Even without adverse contact lens effects, her critical research analysis also found studies that revealed high contamination of ocular cosmetic products being used by patients with potential sight-threatening bacteria and fungi. It is strongly advisable for ocular cosmetics not to be shared or used past their expiry date. 

The same research analysis found studies showing eye liner can destabilise the tear film and block the vital meibomian glands in the eye lid. Many skin-care products contain retinoids, these may cause or exacerbate meibomian gland dysfunction, more on this can be found here.

Allergic reactions to the multitude of chemicals found in ocular cosmetics have been known for many years, even leading to a dermatitis condition on the eye lids, from the ocular cosmetics themselves, or hair products

The complete article, kindly granted permission for republication here, can be found in the December 2021 issue of Re:View  

Application

Always apply makeup outside the lash line and apply mascara from the tips rather than the roots of the lashes, preferably to the top lashes only.

Never apply eye makeup over the oil glands that line the very edge of your upper and lower lids, just inside the eyelash line. These are the glands that secrete oils to keep the eye lubricated. If you need to use an eye drop, apply it 15-30 minutes before putting on your makeup.

Removal

It is a must to remove makeup before bed. Sleeping with eye makeup on can lead to clogging of the oil producing glands and eye infections. Try a gel based product that is oil and paraben free. Avoid getting the makeup remover into the eyes as this may irritate them further.
Avoid mineral oil, sodium lauryl sulfate, and diazolidinyl urea. While they work well to remove makeup, they are known to cause irritation to the eyes.
A gentle lid scrub with baby shampoo on a clean cotton pad or soft cloth or a store bought lid scrub can help remove excess makeup and unclog the eye’s oil glands.
 

Makeup Hygiene

Keeping makeup applicators clean is critical to keep infection at bay. Make sure to sharpen your makeup pencils before application to remove the top coat of bacteria. Also, wash makeup brushes as well as using a brush cover to keep them clean. Avoid using store samples, but if you must make sure to use a fresh applicator.
Do not use the same applicator on different parts of the face. For example, do not use the same pencil on your lips and your eyes.
Avoid sharing makeup with anyone else and using makeup past its expiration date. As a rule of thumb, dispose of your eye makeup every three to six months. You can keep a marker in your makeup kit to note the date the makeup was opened.
Do not use any type of eye makeup if you have an eye infection and see your optometrist right away. If you do develop an infection, throw away all your eye makeup and buy a new set to start with after your optometrist OKs you wearing it again.
Always wash your hands before applying makeup and avoid using saliva to assist in putting your makeup on as this could lead to an eye infection.
 

Makeup Type

The tiny particles in glitter and powder based shadows and foundation can get into and aggravate the eyes. Instead sparingly use cream shadows, highlighters and foundations.
Use a thickening mascara instead of lash-lengthening or waterproof ones as they are less likely to flake and get into the eyes.
Stick with hypoallergenic brands to avoid excess irritation. Avoid makeup with arsenic, beryllium, cadmium, carmine, lead, nickel, selenium, and thallium.
 

Find Alternatives

A plastic eyelash curler is a great alternative to mascara. (The metal in regular eyelash curlers can cause irritation and dryness around the eye).
You might also get away with less eyelid makeup if you concentrate on your eyebrows instead.

If you suffer from severe and chronic dry eye and are intolerant of eye makeup try highlighting other aspects of you face, such as your lips and cheeks, which allows you to highlight your natural beauty without ever touching your eyes.

There is a small but real risk of contracting eye infections from water, possibly the most serious infection, but not the only one, is Acanthamoeba Keratitis, it can be sight-threating and life-changing. The wearing of swimming goggles or a mask over contact lenses reduces the risk of infection but doesn't eliminate it.

Therefore to be as risk adverse as possible anyone with a vision correction wanting to partake of water sports should wear prescription goggles, not contact lenses at all. This also has the benefit that should anyone want to fall asleep after their exercise in the water the can do easily!

Yes, certainly this is quite possible. Key to success is recognising these are rather special and perhaps require even more ‘TLC’ in the exam, assessment and prescribing process.

Yes, this is quite possible. The answer almost certainly lies in improving the quantity and quality of the tears in a specific way, something simple dry eye drops can’t do. So as part of the exam, assessment and prescribing process, specific dry eye therapy may be included. As part of the ethos of providing the best care possible we recognise accurate and timely testing in eye care is vital, as it is in medicine generally, we both have available a test that can not only detect dry eye and contact lens discomfort inflammation, but measure its degree as well, no other test in the world does this and we are proud to be pioneers in its use. 

InflammaDry
InflammaDry detects and grades eye surface inflammation helping targeted treatment.

Yes, certainly. Contact lenses for astigmatism have been available for over 40 years. Generally success rates and vision, with an ever expanding range of designs and prescriptions, has never been higher. I have a unique approach to assessing these lenses, so we can gauge probable success in your real world.

Yes, certainly. Multifocal contact lenses have been available for over 40 years. Generally success rates and vision, with an ever expanding range of designs and prescriptions, has never been higher. I have a unique approach to assessing these lenses, so we can gauge probable success in your real world.

Yes, good vision in contact lenses is a combination of factors; the power of the lenses, the way the lens sits on your eyes surface and the influence of your eye lids and tears. All need to work in harmony to give good stable vision.

It is always best to take an individual approach to prescribing contact lenses, looking in detail at all of the influences that contribute to vision in contact lens, especially before you commence wear. Only when all these factors are at their best do you get your optimum contact lens vision.

Yes, while modern contact lenses, especially soft lenses, are inherently comfortable initially, it is true comfort very often reduces later in the day, leaving many wearers wishing they could wear them for longer.

Knowing this is the case for you I would prescribe specific lens designs and materials I know contribute to comfortable wear, while at the same time I would assess your eye’s surface and make it as healthy as possible for lens wear. In my view it is the sub-optimal surface of the eye, very common nowadays, that while not giving problems when not wearing lenses, very often leads to contact lens discomfort. This doesn’t have to remain the case. As part of the ethos of providing the best care possible we recognise accurate and timely testing in eye care is vital, as it is in medicine generally, we both have available a test that can not only detect dry eye and contact lens discomfort inflammation, but measure its degree as well, no other test in the world does this and we are proud to be pioneers in its use. 

InflammaDry
InflammaDry detects and grades eye surface inflammation helping targeted treatment.