Dry eyes and contacts

[bruinrab]

Dr Doan and others,

Several years ago, I started to wear contacts (B & L, Optima FW, 38% water content), but I stopped after a few months because my eyes would get very red and itchy after just a few consecutive days of wearing them.

I put up with glasses for a few years and decided just recently to give them another shot. This time, it was Acuvue 2 contacts (58% water content). I've been having the same problem, but this time just wearing them for one day is causing problems. My eyes get itchy and red after just a few hours. The redness starts out as a line from the medial side of the eye to the iris. As the day goes on, that area gets worse, and eventually my eyes are totally bloodshot. It's a little better if I put in rewetting drops, but I have to do that every couple of hours.

Is it, as I suspect, dryness? Or could something else be going on here? Also, are there any other things I could try -- cleaning solutions that might work better, or rewetting drops for sensitive eyes?

I'm getting sick of glasses and I can't afford Lasik before med school.

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[Andrew_Doan]

You may have dry eyes. An examination is useful here.

Also consider an allergy to the preservatives in your cleaning and contact solutions. Try preservative-free products.

This may also be due to corneal ischemia. The new silicone hydrogel CLs have a higher oxygen permeability, and your cornea may be more agreeable to this. I suggest the Focus Night & Day CL (http://www.nightanddaycontacts.com/html/articles.shtml). Although these CLs are made for 30 day continuous wear, I don't recommend sleeping in your CLs.

When was your last examination by an optometrist for contact lens fitting? Your contact lenses may not be fitted properly for your eyes.

 

[Andrew_Doan]

Also read this thread: http://forums.studentdoctor.net/showthread.php?t=49668

 

[bruinrab]

Also consider an allergy to the preservatives in your cleaning and contact solutions. Try preservative-free products.

Ah, that must be it! I've had allergic reactions to the dilating drops, so I wouldn't be at all surprised if I was also allergic to something in the solutions. Do you happen to know some preservative-free brands off-hand?

When was your last examination by an optometrist for contact lens fitting? Your contact lenses may not be fitted properly for your eyes.

Just a few weeks ago -- same base curve as when I had them years ago. That's why I was puzzled, because the first few days of a new set are always ok, it's just regular use that is problematic.

Thanks for the tips, I'll switch solutions ASAP and see if that helps.

 

[Andrew_Doan]

Most manufacturers have stopped using preservatives that are the major problems; however, some sensitive eyes may still have problems. Use of preservative-free solutions or a solution with a different preservative may be all that is necessary to correct the problem. In the contact lens clinic here, patients have had success with Bausch & Lomb ReNu Multi-Purpose and Opti-Free Express Lasting Comfort, No-Rub, Multi-Purpose cleaners. Perhaps others can give you brands that they have found to be useful for sensitive eyes.

If this doesn't work, then consider the newer silicone hydrogel contact lenses.

 

[Tokey]

Another option that may interest you is 1-day disposable contacts. They cost a little more, but you don't need solution, so the cost pretty much equalizes out. You can use unpreserved saline if you need a rinsing agent. These contacts are great if you have sensitive eyes and you get a fresh, new pair everyday - and you don't have to worry about cleaning your CL ever!

 

[bruinrab]

Most manufacturers have stopped using preservatives that are the major problems; however, some sensitive eyes may still have problems. Use of preservative-free solutions or a solution with a different preservative may be all that is necessary to correct the problem. In the contact lens clinic here, patients have had success with Bausch & Lomb ReNu Multi-Purpose and Opti-Free Express Lasting Comfort, No-Rub, Multi-Purpose cleaners. Perhaps others can give you brands that they have found to be useful for sensitive eyes.

If this doesn't work, then consider the newer silicone hydrogel contact lenses.

Hmm. Those are the two brands of multi-purpose solution that I've used.

I looked into it a bit more, it seems like the only truly preservative-free solutions are the hydrogen peroxide ones. Anyone have experience with the ones from Ciba (Clear Care, Pure Eyes, AOSEPT)? Are they more risky to use? I don't mind if it's several steps, I already take good care of my lenses and an extra step wouldn't be a big deal, I just don't want to damage my eyes in the process.

 

[bruinrab]

Just to follow up, I tried Clear Care from CIBA and for the first time EVER, I can't even tell that I'm wearing contacts!!!

It's a hydrogen peroxide system, but there's a neutralizer in it so that it's essentially saline by the morning. Plus I rinse with unpreserved sterile saline before putting them in.

Thanks for mentioning the possibility of allergies. Now I can wear them to a wedding next week without looking like I was "festive" before the main event.