Like a bad habit: Patients’ 6 common contact lens mistakes

Like a bad habit: Patients’ 6 common contact lens mistakes

Acanthamoeba keratitis is not a virus, but it spread like one recently in a horrifying Internet tale of optometrists' warnings come true.
A Taiwanese student reportedly went blind after she left a pair of disposable contact lenses in her eyes for six months straight, allowing the infectious amoeba to eat away at her corneas.

"All these bad habits are due to a lack of understanding on the part of patients."

It's a rare circumstance, but the proof is in the cornea, so it seems. Contact lenses are among the safest forms of visual correction, but if not used as directed, there can be serious consequences.

Thomas Quinn, O.D., AOA Contact Lens and Cornea Section (CLCS) chair, says now is the time to talk with patients about the importance of proper contact lens wear. And through an informal query of other practitioners, he highlights six of the most common mistakes made by contact lens patients.

Bad news practices

  1. Overstayed welcome. Studies have indicated around half of disposable and frequent replacement lens users wear lenses longer than their recommended schedule. What barometer do patients use to change their lenses? They wait until the lenses become bothersome. "That's like saying, 'I'm going to wear my underwear until they start to bother me,'" Dr. Quinn says. "No, you change them before they start to bother you."

  2. Caught dirty-handed. The cleanest, daily disposable lenses are all for naught if wearers do not wash their hands before handling their lenses. Dr. Quinn recalled a teenage patient with daily disposable lenses who persistently would be treated for corneal infiltrative events (CIEs). He learned the teen's hands were never washed before handling lenses.

  3. Damp digits. The flip side of the coin: Although most patients do think to wash their hands, sometimes they forget to dry their hands before handling contact lenses. Water can harbor harmful microorganisms that can be transferred onto the lens and subsequently onto the eye if wearers fail to dry their hands with a clean surface.

  4. No respect for the system. Not all contact lens care systems are created equal, in terms of disinfection, and chemical sensitivities and incompatibilities with lens materials. Patients might opt for a cheaper, generic solution as opposed to the care system specifically designed for their lenses. "The cheapest solution isn't always the best solution," Dr. Quinn says.

  5. A case of grimy cases. Proper contact lens care extends to storage cases, as well. The AOA recommends wearers replace lens cases at least every three months, and cases should be cleaned and disinfected periodically in between. But Dr. Quinn says that information tends to be lost on patients, and optometrists are partly to blame—how to care for cases is the overall top question submitted to Dr Quinn: "People aren't caring for their cases, but partly because they don't know how to do it."

  6. Dozing dangers. And finally, people snoozing in contact lenses that are not designed to be slept in are at a five times higher risk of developing CIEs, according to some studies.Even extended wear lenses carry some risk of infection as compared to daily wear lenses.

But what should optometrists do about these? Dr. Quinn urges continued education, but also highlights the benefits of daily disposable lenses as a way to eliminate several of these bad habits.

"All these bad habits are due to a lack of understanding on the part of patients," he says.

July 21, 2014

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