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Medical Forum / General / Vision / August 2006Allergic to Contacts?
Last week I posted a message in which I asked the group which IOL they thought would be right for me. I had just seen a Lasik/Opthamologist Surgeon, and he suggested a Clear Lens Extraction for me. I told him it had become increasingly more difficult for me to tolerate wearing my lens (just a -12 in my left eye . . . right eye has perfect vision). The doctor told me I was becoming allergic to my lens, that over time the eye reacts to the proteins built up and starts to reject the lens. I wear an AcuVue 2, and can keep it in my eye for as long as two weeks. Often, I'm hardly aware of it at all. Sometimes, after only a day, I wake up in the middle of the night and my eye feels like it is in a vise, and I have to rip it out and throw it away. It takes at least a day or two before my eye feels well enough for me to put in another lens. The eye stays with a raw feeling, as if I had scratched it. I am finding it more difficult to put the lens in. It used to pop right in and now it seems as if my eye wants to spit it out. Sometimes it takes me 4 or 5 tries to get it in, whereas it used to be much simpler. Today I went back to my longtime Opthamologist and she said my eye was not allergic to anything. She said my cornea looked as perfect as could be and showed no signs whatsoever that I've been wearing a lens in that eye for 25 years. She suggested that my eye simply gets dry and I should try and maintain a more consistent regimen of lubrication. Regular lubrication as opposed to when it started to feel a bit dry. She is having me try the AcuVue Advanced, as she says it is even easier to wear than the AcuVue2's. Are their any other extended wear lenses in -12 which would be easy to wear, or is the AcuVue Advanced the best? She is also going to let me try a Multifocal contact, in case it does continue to become intolerable for me to wear a lens, and I opt for the CLE. As someone suggested to me in my other post, it would be a trial of sorts as to how I'd adjust to a Restor lens rather than a monofocal IOL. For the time being, I am not considering a CLE. I wouldn't think of getting surgery on my eye unless there was no other options. Wearing the lens is something I've been doing for a longtime, and if I can continue to do so, I'm happy with it. It was only because I thought I could no longer comfortably wear a lens that I even considered implantables or other options. If you have been wearing the same contact for two weeks strait, no wonder your having problems! You may wear the same brand you prefer, but take it out before you go to bed and insert it after you wake! You may occasionally sleep in contacts with some risk but its very bad to wear the lens 2 weeks strait without taking it out to clean and give your eye(s) a rest! >Last week I posted a message in which I asked the group which IOL they >thought would be right for me. I had just seen a Lasik/Opthamologist [quoted text clipped - 5 lines] >The doctor told me I was becoming allergic to my lens, that over time >the eye reacts to the proteins built up and starts to reject the lens. It's called Giant Papillary Conjunctivitis (<http://tinyurl.com/l4v7e>). >I wear an AcuVue 2 Acuvue 2? How medieval. >and can keep it in my eye for as long as two weeks. Often, I'm >hardly aware of it at all. Sometimes, after only a day, I wake up in >the middle of the night and my eye feels like it is in a vise, and I >have to rip it out and throw it away. It takes at least a day or two >before my eye feels well enough for me to put in another lens. Maybe your eye is trying to tell you something? Maybe your eye bothering you shouldn't be the barometer for when you decide to replace your contacts? Put another way, are you obeying your doctor's instructions when it comes to your lens replacement schedule? Additional newsflash: Don't wait until your teeth hurt before you brush them. Don't wait until you feel like crap before you decide to take your high blood pressure or diabetic medications. We're talking Common Sense 101 here. >The eye stays with a raw feeling, as if I had scratched it. I am >finding it more difficult to put the lens in. It used to pop right in >and now it seems as if my eye wants to spit it out. Sometimes it >takes me 4 or 5 tries to get it in, whereas it used to be much >simpler. Classic GPC symptoms. >Today I went back to my longtime Opthamologist and she said my eye was >not allergic to anything. Please tell me she everted ("flipped") and examined underneath your upper eyelids. >She said my cornea looked as perfect as could be and showed no signs >whatsoever that I've been wearing a lens in that eye for 25 years. [quoted text clipped - 6 lines] >Are their any other extended wear lenses in -12 which would be easy to >wear, or is the AcuVue Advanced the best? The only frequent replacement soft contact lens that I am aware of that is approved for >6 days of continuous wear is Ciba's Focus Night & Day. But that isn't available in a -12D. If you insist on wearing the lens that long, then that is the only lens IMHO you should be prescribed 99%+ of the time in 8/2006. For GPC (and for pretty much every HEMA SCL wearer, especially a -12D myope), I'd either put you in one the various silicone hydrogel CLs with a rigorous cleaning regimen and frequent replacement schedule (first choice/mild cases) or a daily disposable (second choice/severe cases). I know the Acuvue Advance and the Acuvue Oasys (approved for <=6d of continuous wear) come in -12D, but none of the other silicone hydrogels do. I prefer the Acuvue Oasys over the Acuvue Advanced if I have a choice. >She is also going to let me try a Multifocal contact, in case it does >continue to become intolerable for me to wear a lens If the reason CL wear is becoming intolerable is because of GPC, then your doctor needs to do the things that need to be done to manage your condition which include any, some or all of the following: o Discontinuing CL wear for 2-4 weeks. o Switch to a more frequent replacement schedule -- daily disposable is often best. o Topical mast-cell stabilizer (long term) or topical glucocorticosteroids (short term). o Stop wearing contacts on a continuous wear basis. o Proper lens cleaning regimen. >and I opt for the CLE. As someone suggested to me in my other post, >it would be a trial of sorts as to how I'd adjust to a Restor lens [quoted text clipped - 6 lines] >comfortably wear a lens that I even considered implantables or other >options. Having to completely discontinue contact lens wear secondary to GPC is quite rare in 8/2006. I am not a big fan of clear lens extractions when a patient is essentially contact lens tolerant. Talk to your doctor regarding the following advice: Stop sleeping in your lenses. Clean them thouroughly daily or switch to daily disposables and in all likelihood, your will be able to resume successful contact lens wear again. "Talk to your doctor regarding the following advice: Stop sleeping in your lenses. Clean them thouroughly daily or switch to daily disposables and in all likelihood, your will be able to resume successful contact lens wear again." My own optometrist tells all his patients to never sleep in contacts. Sleeping in contacts the occasioanl night isnt too bad, sleeping every night and not removing your contacts for a week or more is. [snip] >My own optometrist tells all his patients to never sleep in contacts. >Sleeping in contacts the occasioanl night isnt too bad, sleeping every >night and not removing your contacts for a week or more is. Continuous wear is relatively risky. It increases your risk for microbial keratitis, GPC and other contact-lens related problems over daily-wear of contact lenses. Taking a nap or sleeping in your lenses overnight on an occasional basis (1X/week or less) while in silicone hydrogel lenses is something I normally don't have a problem with and something I've found to be relatively safe. However, daily wear only is best. > Continuous wear is relatively risky. I find it helps to give comparisons, i.e. relative to what? DrG >> Continuous wear is relatively risky. > >I find it helps to give comparisons, i.e. relative to what? Relative to NOT sleeping in your lenses. Anywhere from 6 to 12X greater risk of microbial keratitis versus DW. > Are their any other extended wear lenses in -12 which would be easy to wear, > or is the AcuVue Advanced the best? It depends on one's criteria. Having worn both, my opinion is that the Acuvue Oasys is a better lens, with higher oxygen permeability, lower water content, and it is available up to -12D. > She is also going to let me try a Multifocal contact, in case it does > continue to become intolerable for me to wear a lens, and I opt for the CLE. > As someone suggested to me in my other post, it would be a trial of sorts as > to how I'd adjust to a Restor lens rather than a monofocal IOL. Why not monovision in that eye? > For the time being, I am not considering a CLE. I wouldn't think of getting > surgery on my eye unless there was no other options. Wearing the lens is > something I've been doing for a longtime, and if I can continue to do so, > I'm happy with it. It was only because I thought I could no longer > comfortably wear a lens that I even considered implantables or other > options. Indeed, a very wise choice. Besides, has anybody recommended topical treatment for your "allergy," such as Patanol, twice daily? DrG ----- Original Message ----- From: "Dr. Leukoma" <drg@leukoma.com> Newsgroups: sci.med.vision Sent: Thursday, August 03, 2006 8:36 AM Subject: Re: Allergic to Contacts? >> She is also going to let me try a Multifocal contact, in case it does >> continue to become intolerable for me to wear a lens, and I opt for the [quoted text clipped - 4 lines] > > Why not monovision in that eye? Perhaps monovision. The thought was Restor would perhaps eliminate the need for reading glasses. However, I would be a bit leery of the possibility that having only one lens and one good eye, there might be a difficult period of adjustment, or none at all. So, the thought would be to test it out. If I go with an IOL, and at this point it is not a sure thing at all, I could easily go with monovision and continue to use reading glasses. [snip] >The thought was Restor would perhaps eliminate the need for reading >glasses. However, I would be a bit leery of the possibility that >having only one lens and one good eye Wait. You have only *one good eye*, but have been abusing your eyes by sleeping in contacts only approved for up to 6d of EW for 2+ weeks straight? (Cyrnfr chg gur penpx cvcr qbja.) And you are considering CLE, or a multifocal IOL? I wouldn't consider those in 99+% of monocular patients. Get another opinion. > [snip] > [quoted text clipped - 13 lines] > > Get another opinion. Yea its sad how many eyes get ruined. I read that eyes get the least care of any body part! People take better care of their teeth than eyes! Alot of people are uninformed of the risks of extended wear contacts, some dont give a darn, I know about 5 people like that. Thousands more ruin their eyes by getting lasik, especially if they are bad candidates. Why do some people post asking "should I get lasik" and when we all say "no, your a bad candidate" or "not a good idea" they go ahead anyway and get lasik? Some people just wont listen! > Yea its sad how many eyes get ruined. I read that eyes get the least > care of any body part! People take better care of their teeth than > eyes! I agree. Brush your eyes twice a day and see your optometrist every six months. -MT |
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