Contact Lenses Vs. Water

death1234567

When Irenie Ekkeshis's eye started to itch she assumed it would soon settle down. It didn't. Before long, she found herself in excruciating pain and lost her sight in that eye. And the cause may have been nothing more than handling her contact lenses with wet fingers.

One Saturday morning in January 2011, ...

BBC

A word of warning for any contact lens wearers. I hope her campaign to put the warning label on the contact lens boxes succeeds.

TheChizler

That's terrifying. I've recently stopped drying my hands after washing them before putting in lenses in an effort to stop towel fibres getting on the lens. Not any more...

Arbie

It is very difficult to explain to people that getting just a few drops of water on lenses even 1 time can lead to blindness.

There are always people who try their best to disagree with or modify the medical evidence in order to convince themselves and others that what they are doing is reasonable. It is a human trait to think "It could never happen to me".

As an example, have a look at this thread: http://touch.boards.ie/thread/2057706180/1

In my experience, people will hear from a friend that the friend overuses or showers/swims/sleeps in the lenses "all the time" and "has never had a problem". They then doubt the medical advice and say they will chance it themselves. They try it a few times, have no problems, and then it becomes routine.

Then 1 day they do get an infection and end up in the eye hospital and there are usually 2 responses: "I only did it once" or "I've been doing it for years and have never had a problem" and always, always they will say "I'm so unlucky, I never thought it could happen to me". Lenses are fantastic when used correctly; unfortunately if used improperly then there is a risk something bad will happen.

The friend who reassures you that "it's grand" will not be there when you are getting drops every 30 minutes 24/7 for a week in a hospital bed. It is a rotten experience that disrupts sleep, family life, work, etc. And that friend will not be left with blurry vision in one eye and unable to wear contact lenses for the rest of their lives.

There is enough eye disease in the world without us contact lens wearers contributing to it. It is deeply frustrating to see people suffer with preventable diseases.

Fair play to this woman, I hope her campaign is successful.

TheChizler

Would drying your hands with a paper towel before inserting lenses be enough to minimise the risk in your opinion? Not looking for medical advice, just wondering what you do personally.

seamus

That's interesting about the showering. I've never heard showering mentioned as an issue before and even the information leaflet on my lenses makes no comment on it.

It says to be aware of an increased risk from swimming or hot tubs, but that's it. No recommendation to remove the lens before getting in the water or having a shower.

I wear continuous wear lenses and my experience has been that I experience far less issues with them, than when I removed the lenses on a daily basis. Probably because I'm sticking my fingers in my eyes once a month rather than 60 times a month.

So I'm not sure if taking the lens out for every shower (which can be 3 times a day sometimes) and exposing myself to that infection risk is less than the infection risk from the shower.

Though this thread reminds me that I'm well overdue an optician's appointment, so I'll discuss with im.

Arbie

TheChizler wrote: »

Would drying your hands with a paper towel before inserting lenses be enough to minimise the risk in your opinion? Not looking for medical advice, just wondering what you do personally.

I use towel/paper towel/airdryer, whatever will make my hands visibly dry and dry to touch.

Arbie

seamus wrote: »

That's interesting about the showering. I've never heard showering mentioned as an issue before and even the information leaflet on my lenses makes no comment on it.

It says to be aware of an increased risk from swimming or hot tubs, but that's it. No recommendation to remove the lens before getting in the water or having a shower.

I wear continuous wear lenses and my experience has been that I experience far less issues with them, than when I removed the lenses on a daily basis. Probably because I'm sticking my fingers in my eyes once a month rather than 60 times a month.

So I'm not sure if taking the lens out for every shower (which can be 3 times a day sometimes) and exposing myself to that infection risk is less than the infection risk from the shower.

Though this thread reminds me that I'm well overdue an optician's appointment, so I'll discuss with im.

Eye surgeons and optometrists are clear that showering is an absolute no - see references below. The degree of risk can be heightened by certain contact lens types and other factors - everyone is free to evaluate the risk as they see fit.

With professional knowledge of the subject, I would not shower in lenses.

Advice from Moorfields Eye Hospital - http://www.moorfields.nhs.uk/content/your-contact-lens-questions-answered
Advice from American Academy of Ophthalmology - https://secure.aao.org/pdf/051139_Sample.pdf
Advice from the Royal College of Ophthalmlogists - https://www.rcophth.ac.uk/wp-content/uploads/2016/04/Patient-Information-Laser-Vision-Correction.pdf
Advice from Specsavers - https://www.specsavers.com.au/help-and-faqs/can-i-shower-while-wearing-contact-lenses

seamus

Arbie wrote: »

With professional knowledge of the subject, I would not shower in lenses.

Advice from Specsavers - https://www.specsavers.com.au/help-and-faqs/can-i-shower-while-wearing-contact-lenses

The Irish Specsavers site tells people to ask their optician about showering in lenses.

The UK specsavers site makes no mention of it at all.

Contrast that with the Australian site which effectively treats it as an emergency - "If this happens, immediately close your eyes and carefully step out of the shower until you can remove the lenses correctly"

Why do you think there's such a stark difference in professional advice, not even between countries, but even within countries?

Indeed, there seems to be a real disconnect, no real agreed medical position on best practice. For example, ome of the links you post effectively say, "never ever sleep in contact lenses", but then companies sell lenses and specifically say that they're designed to be slept in.
The advice seems to range from, "you should avoid doing <X> in contact lenses", to "if you do <X> in contact lenses your eyes are going to fall out. Never do it".

So you can see why people would be at best lackadaisical about best practice when even the professionals don't put out a congruent message.

Arbie

seamus wrote: »

The Irish Specsavers site tells people to ask their optician about showering in lenses.

The UK specsavers site makes no mention of it at all.

Contrast that with the Australian site which effectively treats it as an emergency - "If this happens, immediately close your eyes and carefully step out of the shower until you can remove the lenses correctly"

Why do you think there's such a stark difference in professional advice, not even between countries, but even within countries?

Indeed, there seems to be a real disconnect, no real agreed medical position on best practice. For example, ome of the links you post effectively say, "never ever sleep in contact lenses", but then companies sell lenses and specifically say that they're designed to be slept in.
The advice seems to range from, "you should avoid doing <X> in contact lenses", to "if you do <X> in contact lenses your eyes are going to fall out. Never do it".

So you can see why people would be at best lackadaisical about best practice when even the professionals don't put out a congruent message.

There is no incongruence.

The largest professional bodies representing eye surgeons in the world (the Royal College of Ophthalmologists in the UK and the American Academy of Ophthalmology in the USA) are clear in their advice against using contact lenses in the shower, per the links above.

I included the Australian Specsavers website just as an example of optometrist advice. The fact that their UK site does not mention it is irrelevant and the fact that the Irish one says speak to your optometrist does not contradict the message either. There are certain lenses which are marketed for use overnight or for longer periods of time, but these are the minority of lenses sold and are not suitable for everyone. The advice given on these websites is for the majority of lens users and is accurate.

Ultimately it is up to the user to decide whether they will heed the advice of eye care professionals. We cannot do anything for people who apply motivated reasoning to find a way to justify using a medical device in an unnecessarily risky manner.

seamus

Arbie wrote: »

There is no incongruence.

Clearly there is. Otherwise every single optician and professional body in the world would say the same thing and treat it with the same level of importance.

Ultimately it is up to the user to decide whether they will heed the advice of eye care professionals. We cannot do anything for people who apply motivated reasoning to find a way to justify using a medical device in an unnecessarily risky manner.

Agreed.

But, for example, I've been wearing contact lenses for 19 years. Today is the first time I've ever heard anyone say not to wear lenses in the shower. I've been aware not to use water for cleaning or storing lenses. But not that there was any specific risk from showering or swimming with them in.

It is only possible for people to heed advice that's given. If this is as important a point as you appear to believe it is, shouldn't there be a united front on this? "Speak to your optician" is not advice. In fact that's code speak for, "there's a small risk here, but not enough to make a big deal out of".

Arbie

seamus wrote: »

Clearly there is. Otherwise every single optician and professional body in the world would say the same thing and treat it with the same level of importance.

The professional bodies do say the same thing. Can you point to one that says it is ok to use them in the shower?

seamus wrote: »

But, for example, I've been wearing contact lenses for 19 years. Today is the first time I've ever heard anyone say not to wear lenses in the shower. I've been aware not to use water for cleaning or storing lenses. But not that there was any specific risk from showering or swimming with them in.

It is only possible for people to heed advice that's given. If this is as important a point as you appear to believe it is, shouldn't there be a united front on this?

That's true, we can only follow the advice we are given. Any eye care professional I know will always say: 1 - don't overuse them, 2 - don't sleep in them, 3 - wash and dry your hands before use and never let water come in contact with them (including showering/bathing/swimming).

What you or I personally believe is irrelevant - the medical literature has long been clear that any water contact is risky, including showering. Even if it hasn't been well communicated to you that doesn't mean it isn't true.

seamus wrote: »

"Speak to your optician" is not advice. In fact that's code speak for, "there's a small risk here, but not enough to make a big deal out of".

You are referring specifically to the Specsavers website, which is 1 company and not representative of eye care professionals as a whole. You are interpreting "Speak to your optician" as code for something - it could just be accidentally ambiguous, or poorly worded, or a way for them to promote people visiting their optician, or a way to get people to discuss and consider contact lens risks, etc.

I certainly don't know why they have written it this way, but it doesn't change the fact that the actual professional bodies, (including the eye surgeons who deal with the serious eye infections that can result from contact lens misuse) are clearly united in their message that they should not come into contact with water.

seamus

Arbie wrote: »

Can you point to one that says it is ok to use them in the shower?

I never said any of them did.

What I'm pointing out are the mixed messages, or rather the lack of urgency in regards to this issue.

What you or I personally believe is irrelevant - the medical literature has long been clear that any water contact is risky, including showering. Even if it hasn't been well communicated to you that doesn't mean it isn't true.

I have no personal belief on this. Like I say, today is the first I've heard of it.

I'm simply raising the question of why - given that you believe this to be an urgently important message to contact lens wearers - do opticians and professional bodies not communicate this message explicitly?

The Irish College of Ophthalmologists' own advice is to "never allow water to come into contact with soft lenses". That appears to me to be far too broad; most people wouldn't hear that message and think "swimming" or "showering", instead they would think of situations like cleaning or handling the lens.

Arbie

seamus wrote: »

I never said any of them did.

What I'm pointing out are the mixed messages, or rather the lack of urgency in regards to this issue.

I didn't mean to imply that, but I asked the question to highlight that none of them do. A mixed message would suggest that some experts say it's ok, while others say it's not - that isn't the case here as we can't find any authorities that say it's ok.

I don't see a difference in the urgency, just different language used, but that may be my interpretation. Can you quote specific examples?

seamus wrote: »

I have no personal belief on this. Like I say, today is the first I've heard of it.

That was a reference to your comment "If this is as important a point as you appear to believe it is" - I wanted to be clear that our personal beliefs are immaterial in the face of evidence.

seamus wrote: »

I'm simply raising the question of why - given that you believe this to be an urgently important message to contact lens wearers - do opticians and professional bodies not communicate this message explicitly?

The Irish College of Ophthalmologists' own advice is to "never allow water to come into contact with soft lenses". That appears to me to be far too broad; most people wouldn't hear that message and think "swimming" or "showering", instead they would think of situations like cleaning or handling the lens.

As we are discussing my beliefs again rather than the facts, I can confirm that my beliefs are in line with the professional bodies, which is to never let water come into contact with lenses. We can all agree that they could do a better job of advertising these issues, but different organisations will communicate the same message in different ways, some clearer than others. It doesn't change the fact that water and lenses shouldn't mix, whether the water comes from a tap/shower/bath/pool, etc.

Anyone reading this thread will have to bear in mind that we are anonymous users who may have no idea what we are talking about. I could be a shower fitter, a contact lens sales reps, a corneal surgeon, an astronaut, or even the Pope*.

The best course of action is always to discuss with a qualified professional and to follow the advice of reputable professional bodies, such as the AAO/ICO/RCOphth/Moorfields, etc.

(*I am not the Pope)