CONTACT LENSES - WHAT'S ALL THE FUSS?
Why do I have to have yearly exams? I have been wearing contact lenses for years, I have never had a problem, and I am still seeing just fine!
These are valid questions that deserve consideration and answers.
First of all, the fact that you have worn contact lenses successfully for a long time is a very good thing. It does not, however, guarantee that this success will continue. The longer you wear contact lenses, the better chance you have of a number of issues arising from wearing contact lenses. I will discuss a couple of the more common problems below.
Under the eyelid are tiny pores that, under normal circumstances, produce up to 2% of the tear layer. This portion of the tear layer is mucous and it is responsible for cushioning the eye. If the pores become irritated due to foreign material such as protein buildup on a contact lens resulting from overwear, or not changing contact lenses often enough, or other factors that change the content of the tear layer due to factors too numerous to mention – diet, health, age, etc., the pores undergo an autoimmune reaction causing the pores to increase in size and overproduce mucous, commonly referred to as “GPC” (giant papillary conjunctivitis) and the underside of the eyelid takes on a very large “cobblestone” appearance.
This is not an infection, but rather an inflammation. If it is left untreated, the contact lens will become increasingly uncomfortable and the contact lens will need to be changed more frequently. In later stages, the eye will have excessive matter causing the eyelids to appear to be stuck together in the morning when waking up, mimicking a bacterial infection, of which it is not.
Another problem with long term contact lens wear is an extended lack of oxygen. The eye gets oxygen from three sources.
1. Direct air (which contact lenses obviously cut down on).
2. Tears.Tear flow can be reduced by tight fitting contact lenses, again from overwearing or not replacing the contact lens often enough, causing the contact lens to fit too tight and thus causing a lack of oxygen from the tears.
3. Blood Flow. If the eye doesn’t get enough oxygen from these first two sources, the eye will actually grow new blood vessels to carry more oxygen to the cornea that the contact lens sits on. Why is this a problem? If the vessels grow into the cornea far enough, they will permanently alter your vision. Even if you stop wearing contact lenses, the blood will recede from the vessels, but it will leave behind an empty blood vessel which is known as a “ghost” or “empty” vessel. When light hits this ghost vessel, it will scatter, making night driving most difficult. Even daytime vision will be permanently decreased due to trying to look through the ghost vessels which are in the line of your vision. This is a permanent condition and nothing can be done if it gets to this point. (If you look closely at the picture, you can see a blood vessel that has grown from the left side of the cornea into the center. When the pupil dilates at night, the vessel remains in the same spot, right in the line of vision.
Wearing contact lenses can be very beneficial for a lot of people, but not at the expense of your vision. If, at a yearly eye exam, I notice any of these (or other) problems, at this time I can go to different contact lenses that are more breathable. Sometimes it may mean going to a looser fitting contact lens to allow more tear flow under the contact lens. Most problems can be headed off if addressed early enough, often well before symptoms are present. If I feel contact lenses are possibly going to damage your eyes, I will discourage continued wear in order to save your vision.
I once had a new patient that saw me two years after the fact. She had overworn one contact lens which resulted in an infected corneal ulcer that was not treated properly nor in a timely fashion. This patient ended up with permanent scaring across her cornea. At the tender age of 14, her contact lens wearing is over because the damage dropped her vision from 20/20 to 20/60 best corrected (that means even with glasses) and we can’t risk anything happening to her good eye. The sad part of this story is that this could all have been prevented with proper and timely treatment.
EXAMINATIONS AND LIABILITY
The previous story is one reason our contact lens examination fee covers any and all visits related to contact lenses for an entire year. My philosophy is to treat small problems before they become big problems with possibly permanent effects.
One final comment about contact lenses that we all are aware of is liability. If I had no time restrictions on contact lens purchases and something serious and permanent happened to your eye, I would be liable for your vision loss, and rightfully so.
In 1995, a Consumer Protection law was passed that, in generic terms, states that I can expire contact lens prescriptions before one year, if I think the patient is noncompliant (overwearing contacts, etc.). I try to never do this. My contact lens' prescription is for a year's worth of contacts lenses. Yes, I have a liability issue to consider for myself, but I also legitimately care for the health of my patients’ eyes.
Frankly, would you really want to go to a doctor who was so unconcerned about your future vision that he/she dispensed contact lenses as often and as long as anyone wanted? I care far too much to do this, even if liability was not an issue, as I treat my patients the way I would want to be treated.
Dr. Gregory A. Atkins
CONTACT LENS PRICING
Our contact lenses are priced below 1800Contacts and are for our patients only. We cannot fill outside contact lens prescriptions because of the concerns identified above. Also, due to the vast number of contact lenses that are available and all the different powers available, we do not stock boxes of contact lenses for sale. However, we can usually order and have your contact lenses within 3-5 business days. We do require payment at the time of the order.
CARING FOR YOUR CONTACT LENSES (AND YOUR EYES)
There are many articles in trade magazines that address the many issues that affect contact lens wear. The primary problem is that patients are noncompliant; that is, patients are given instructions on wearing their contacts and for whatever reason, decide they don't have to do it that way. Following are guidelines that should be followed to help insure that your eyes are being cared for while wearing contact lenses.
Wash your hands!
This is nothing new. More than ever,we are reminded every day to wash our hands. This is especially important when handling your contacts. Remember, contact lenses are like sponges; they will absorb what you have on your hands.When we wash our hands, we give a lot of attention to the palms, but not so much attention to the tips of our fingers, the very area we are using to touch our eyes! So remember, wash your hands thoroughly before handling your contacts.
Unless approved by Dr. Atkins, contact lenses should be removed every night. At this time, they should each be placed in the palm of your hand with a couple drops of solution, and be gently rubbed for 5 seconds, then turned over and rub the other side. This process will remove approximately 90% of the protein buildup from your contact lens. Its not the solution that removes the buildup, but instead it is the friction caused by rubbing your contact lens. Cleaning your contact lenses each night this way will make them last longer and make them more comfortable to wear.
Dump the solution!
After cleaning your contact lenses, they should be put in your contact lens case with just enough solution to cover the contact lenses. The next morning, after putting your contact lenses in, DUMP all of the solution out of your contact lens case; rinse the case with water, and then leave the case open during the day to air-dry.
Several years ago, there was a scare with one of the name brand solutions thought to be causing eye infections. The company pulled all of its products and did an extensive study. What they found out was this: there was nothing wrong with the solution, instead it was being used improperly. Instead of dumping the solution nightly, people just added solution - called "topping off." Remember, your contacts have absorbed all kinds of stuff during the day, and if they aren't put in clean solution, the "topped off" solution becomes a breeding ground for germs, leading to infections.
If contacts lens solution is too expensive for you to use in this way, then you should reconsider wearing contact lenses.
Saline vs. solution . . .
Know your contact lenses and what solution you should be using! Different types of lenses need different types of care. Most soft, disposable contact lenses should be cleaned with and stored in a multi-purpose solution for soft contact lenses. This type of solution is not only for storing the contacts, but also for cleaning. Saline solution is only for storing and does not clean nor disinfect the contact lenses. The solution should not be used as a treatment for contact-lens related dry eye. Solution has some salt in it to mimic the tears. Using the solution as artificial tears only makes matters worse, since the salt contact will further dry out your eye. Solution is harmless to you eye as far as putting your contact lenses in straight from the solution.
If you are sensitive to chemicals, you may be on a chemical-free cleaning program. This means you store your contact lenses in a specific solution for no less than 6 hours and you only use preservative-free saline solution. There are new products on the market that cut down the amount of time the contacts lenses must stay in the solution.
Never use tap water to store your contact lenses! Contact lenses require saline solution (also contained in multi-purpose solutions). Regular tap water damages the contact lenses to the point that they even change shape!
If you have any questions about what solution you should be using, or any other questions about caring for your contact lenses, just give our office a call! We'll be happy to help!
CONTACT LENS PRICING
Our contact lens exam fees are as follows:
Standard (spherical) $97.00
Gas Permeable $157.00
The exam fee increases as the complexity in fitting increases. Even though you may be a current contact lens wearer, each time you are seen could mean a different lens with different fittings. Additionally, the longer you wear contacts, the more prone you are to problems. The fitting fee includes all follow up visits, any trial lenses, plus any office call during your year involving eye irritation and/or inflammation due to your contacts (as discussed at the beginning of this page).
THE LONG AND SHORT OF IT ALL . . .
You wear contact lenses most likely because you don't like wearing glasses. How many years of your life you are able to wear contact lenses, is entirely up to you. When considering whether or not you should wear your contact lenses for weeks at a time, or stretch the wear of one set of lenses, you should ask yourself "will I be ready to be back to wearing glasses in 5 to 10 years . . permanently?" No one is superman or superwoman. No one can push their body past its limits and not have consequences. So, before Dr. Atkins has to tell you that you can no longer wear contacts, take responsibility for your own eyes. Get those lenses out so your eyes can breathe and change your set of contacts lenses at least monthly!