Caring for your lenses

World renowned Moorfields Eye Hospital has recently launched a campaign to encourage contact lens wearers to ensure they take care of their eyes. The hospital has seen a marked increase in cases of eye infections relating to contact lens wear. Most worryingly an increase in an infection called acanthamoeba keratitis which can be extremely difficult to treat and in the most serious cases, can see the patient require a corneal transplant.

Tiny parasites called acanthamoeba can live in water so should your lenses come in contact with water the parasites can take up residence in your eye. If they aren’t killed through thorough cleaning, this serious infection can develop. This is a serious yet thankfully uncommon infection, however with cases of it on the increase, now is a good time to remind yourself of some basic guidance which applies to all lenses.

• Always wash and dry your hands thoroughly before handling your lenses.
• After removing your lenses, clean them immediately. Don’t store them without cleaning them first. Cleaning will remove mucus, protein, make up and debris that naturally build up on the surface during the day.
• Never use tap water (or saliva!) to rinse your lenses or case. Microorganisms can build up in water, even distilled water, and can cause infections or even sight damage.
• Ensure your lens case is kept clean. Replace your case every time you open a new bottle of solution.
• Use clean solution every time. Don’t reuse or top up.
• Do not sleep in your lenses unless advised by your optometrist.
• Ideally lenses shouldn’t be worn when swimming but if you do wear them make sure you wear goggles to reduce the chance of contact with pool water.
• Follow the cleaning guidelines you were given, using the recommended products. Doing this will reduce the chance of picking up a nasty eye infection.
• Insert your lenses before applying make up.
• Have an up to date pair of spectacles on hand should you pick up an infection. Many treatments require you to stop wearing your lenses for the duration of the treatment so don’t be caught without a backup.
• Don’t use any eye drops without advice from your optometrist.

Remember these three simple questions:

• Do my eyes feel good with my lenses? You have no discomfort.
• 
Do my eyes look good? You have no redness.
• 
Do I see well? You have no unusual blurring with either eye.

If the answer to any of these questions is no, take out your lenses and consult us straight away.

Here’s a helpful video produced by Moorfields to guide you through the process for soft contact lenses and one for gas permeable lenses

Lenses for occasional wear

We’re supplying a patient with free lenses ahead of their participation in the Spartan Race in Edinburgh later this month. She’s running, as well as tackling various obstacles and mud, in aid of Downs Syndrome Scotland so we’re delighted to help out. She’s a glasses wearer but obviously glasses and muddy, wet obstacle courses don’t go too well together. The point of this blog is to highlight that lenses don’t have to be a fulltime commitment. You can dip in and out as you please.

The great thing about most lenses on the market is they don’t actually take much getting used to, especially daily disposables which are what we usually recommend for occasional use. Sometimes there is a bit of trial and error before we find you the perfect pair, but because we know our patients’ eyes so well we almost always find them the right pair first time.

Participating in a sporting event is an obvious time where glasses wearers can struggle. Whether on the ski slopes, to partake in some holiday snorkeling or when running a marathon, glasses are just not the practical option. Or maybe it’s a vanity thing – nothing wrong with that! You perhaps don’t want to wear glasses to attend a stylish black tie do. Occasional contact lens wearing is perfectly possible. Once you’ve tried them, you won’t look back.

Worrying figures show reluctance to get an eye exam

Spectrum Thea produced an interesting piece of research which showed two thirds of optometrists have seen an increase in the number of younger patients presenting with eye problems. It points to the increased use of PCs and deteriorating health of a generation as possible factors. This is certainly something that we as an industry need to try to tackle, however the part of the research I found most worrying, was the fact that still one in ten would only have an eye exam if they were experiencing problems.

Cameron Optometry has a strong focus on expertise and the use of the most advanced technology. This isn’t because we like to show off with the latest piece of kit. It is because our technology allows us to pick up issues in the very early stages. At the point when we can hopefully do something about it, either with treatment to eradicate the issue or by devising a programme of treatment to ensure the progression of the condition is slowed. If we only see people when they identify issues themselves then it could well be too late to halt the condition’s progression.

Eye exams must be seen as part of maintaining general health and as such we must ensure people have their eyes examined at least every two years, more frequently if they have any vision issues.

I was also concerned to read that still two thirds of Brits would go to a doctor with an eye infection with only a fifth opting to visit their optometrist. Yet, it is an optometrist who will have the correct equipment to undertake a thorough eye examination required and a prescribing optometrist will also be able to give you an NHS prescription if required, same as a GP.

Another worrying figure was a massive 90% of optometrists surveyed felt that they don’t think people take their eye health seriously or look after their eyes as much as they should. In addition, less than half of patients say they would get checked out if they had blurred vision after spending time in front of a screen and a third wouldn’t visit an optometrist even if they were unable to read small print. Worryingly for road users only 55% of those surveyed would visit an optometrist if they struggled to read road signs.

Clearly as an industry we still have a battle on our hands when it comes to communicating the importance of looking after ones eyes. I would say that Cameron Optometry patients are generally better ‘trained’ in the importance of good eye care having had it drummed into them over the years but how many times do I have to say to people, you only get one set of eyes so look after them?

Corrective tablet screens good news for some

Another BBC article that caught my attention this week, this time about a VDU that can correct vision problems to negate the need for glasses or contact lenses. In short, because it is very technical, the technology is powered by software and algorithms that change the light that a screen emits to distort the image a user sees to their prescription.

When the article talks about one in three people suffering from some form of myopia (short-sightedness), the fact is the vast majority of these people need corrective lenses or glasses for more than just using a tablet. For these people this piece of technology is unlikely to be of any use.

However, there is a very small group who could find this technology hugely beneficial. Even with the most sophisticated contact lenses or glasses, some people with conditions such as keratoconus still see halos and ghosting when looking at VDUs. My hope is that it is that this group that may benefit from this specialist technology. Keratoconus can affect people from a relatively young age, people for whom computers an integral part of their lives both in the work place and at home, so hopefully for this group, this technology could make a real difference.

Watch out for sun damage

I was pleased to read an article on the BBC website raising awareness of sun damage and the eyes yesterday. Rightly so, the importance of protecting the skin from the harmful effects of UV rays is well documented. People now take the issue seriously piling on sunscreen, ensuring everyone in the family is covered. However often the eyes are overlooked.

b- sunburn

Perhaps it’s the fact that you can’t see the burn. If you forget to wear sunglasses you don’t wake up the next morning with red, sore skin. But your eyes are also burning, you just can’t see it but the damage that is being done.

As discussed in the article, there are a number of serious conditions associated with exposure to UV rays like cataract and macular degeneration. All develop slowly over time and the effects will be felt as the body’s ability to repair diminishes. Ultimately in later years, the various conditions could cause serious vision problems and in some cases a total loss of sight.

Something that always surprises me is that parents don’t always think of sunglasses for their children. I think it’s an awareness issue. I know keeping sunglasses on a toddler is not easy but getting them used to wearing sunglasses and a hat from an early age, could help prevent them developing these serious eye conditions in years to come.

I wrote a blog back in May on selecting sunglasses. If you’re planning to buy a new pair, familiarise yourself with considerations when making your purchase.

When you think suntan lotion, think sunglasses as well.

New antibiotics make life easier

There’s been a lot of talk about increased resistance to antibiotics in the press recently with the Prime Minister himself calling for action to improve their effectiveness.

Fortunately, eyes are a special case. Drops used on the surface of the eye (termed ‘topical’ as opposed to ‘oral’ or ‘intravenous’) very rarely contribute to any resistance problems and in fact the main stay of infection treatment in eyes, chloramphenicol for bacterial conjunctivitis, has been heavily in use since 1950s and is still going strong.

One of the main issues with this drug is that it penetrates the eye pretty poorly so has to be put in quite often. A typical treatment does is every 2 hours for the first day then 4-6 times a day for 4 days. This is quite a burden if you are trying to put it in children or have trouble putting drops in yourself.

However there has now appeared a new drop called Azyter which is a drug called azithromycin. This was discovered in the 1980s and is widely used orally but is relatively new to use in the eyes. It has proven to be very effective and the dose is a much more manageable 2 times per day for only 3 days.

Because it’s much more powerful, Azyter is available only on prescription from an independent prescribing optometrist where chloramphenicol is available over the counter. Both Gillian and myself are qualified to prescribe this and Claire is undertaking the required training as we speak so you might well find us recommending this is you’ve got conjunctivitis.

Bear in mind there are many things that feel and look like bacterial conjunctivitis to the untrained eye that may require a different treatment so always come in and see us rather than your GP or just buying the drops from a pharmacy.

A smart fit for diabetics

As many of you know, one of our specialisms here is contact lenses so when stories come out about new developments, we all gather round with our morning coffee to discuss. Yesterday’s news regarding the licensing of Google’s ‘smart lens’ to Novartis lead to one of those discussions.

Googles-Smart-Contact-Lenses-Image-3
We see many patients with diabetes, managing the unique issues they face as a result of the condition. I know this story will be of particular interest to them. The smart lenses are designed to measure the level of glucose in the wearers tears so could eliminate currently invasive ways of testing glucose levels, whilst correcting vision at the same time. The licensing of this technology means the possibility of diabetics benefitting from it is now one step closer.

The lenses will probably fall under current contact lens regulation which means that they can only be fitted by a registered and qualified optometrist. As such we are likely to be fitting these ‘smart lenses’ when they eventually make it to market. That will be some years off, but we will follow the progress with great interest and the ‘smart lens’ is sure to be the basis of many more discussions around the coffee pot in the coming months and years.

Detecting Alzheimer’s through the eyes

Almost three years ago I wrote a short blog about an eye test that was being developed in a bid to spot the early signs of Alzheimer’s. So I was pleased to read over the weekend that this research is continuing with signs of success.

That said, whilst the test described may be relatively ‘simple’ in the eyes of the patient, what they are in fact describing is a process involving a very expensive and specialist piece of laser scanning technology, which is still in the developmental stages. The progress has undoubtedly been encouraging but we are still many years away from seeing it in practice.

I have already been asked if this will form part of a regular eye exam. I would suggest this is doubtful. The technology would be very expensive for a practice to purchase and a very small number of patients would fall in to the ‘at risk’ category so it is unlikely to be something you’ll ever see at your optometrists. However I hope that when it is ready, it will be easily accessible to those who would benefit from its use. It could form part of a valuable early detection system, allowing for a plan to be formed with other medical professionals to manage, and hopefully delay, the onset of Alzheimer’s disease.

It is such a devastating disease for those affected, so I do hope that research continues both in to this technology and the quest to find a drug to manage the disease.

Vision for the competitive edge

Watching the England vs. Uruguay match following the decisive goal from Luis Suarez I heard one of the commentators saying “Suarez sees things that bit quicker than anyone else.” Perhaps his competitive edge did in fact come from his eyes but over the last few days it’s become clear he can’t keep his temper under control properly.

luis_suarez_bite

Whatever the sport, football, cricket, rugby or tennis, all participators want to see the ball first. Now teams are recognising that examining vision may help their players gain the edge over the competition. Specialists such as Sport Vision work with teams and individual competitors to maximise all aspects of vision. It isn’t just about having perfect eye sight, there are many factors that contribute to clarity of vision. Aspects like depth perception and having the ability to focus accurately, would also examined by these experts.

Not every aspiring sports person has access to these services and it is worth speaking to your own optometrist about your vision in relation to your sporting performance. We have a lot of experience in the practice working with top sporting professionals experience that you we would be delighted to share.

Choosing the right contact lenses is a good place to start. Some lenses have features that are especially beneficial to sportsmen and women. For example, custom tinted lenses can be selected to reduce glare when playing under floodlights or in bright sun, and may also improve reaction times. Custom tinted lenses can be worn purely for their tint even if no vision correction is required.

In addition, a trip to your optometrist should include a test of your peripheral vision using specialised technology. You might not notice any issues with your peripheral vision on a daily basis but in sport it could mean your opponent sees the ball that vital split second before you. And even for those who consider themselves to have 20/20 vision, the competitive advantage that could be gained by making even the smallest of corrections should not be underestimated.

Blurred lines

Last week I carried out a first ever eye examination on former Scotland rugby captain Mike Blair who was recounting stories of problems he has experienced with colour deficiency prompting me to write this blog. In one particular match in Aberdeen he stepped out on to a snow-covered pitch an hour before Scotland were set to kick off, only to find the lines had been marked out in red to make them standout from the snow. However for Mike, this meant the lines were now indistinguishable. From the usual crisp, clear lines he was used to seeing, he could now only see the grass and snow. The result was the groundsmen had to busily change them before kick-off and spectators arrived to see a rare sight – a pitch with pink markings.

ishihara
This is a classic example of red/green colour deficiency which affects around 5% of men and very few women. The degree to which people are affected varies. Usually individuals can distinguish between very bright reds and greens. It is the less vibrant versions of the colours that cause the problems, and distinguishing between shades of red or green can be nigh on impossible. The condition is often referred to as ‘colour blindness’ which is an inaccurate term as those with the condition can still see colour not black and white.

The reason that more men suffer this form of colour deficiency relates to the fact that it is carried through the 23rd chromosome, commonly referred to as the sex chromosome. So both a mother and father would have to be carriers of the faulty gene for it to be passed to a daughter whereas just the mother has to be a carrier for her to pass it to her son.

Whilst it rarely causes individuals major problems, it does rule out certain professions-pilots and electricians are two that spring to mind. It is worth parents noting that the condition may go unnoticed as it is may not be routinely tested for. It is advisable to get children (really only boys) tested for colour deficiency before they start school to ensure it is spotted early. Many learning materials are not tailored to the needs of those with colour deficiency so children may struggle unnecessarily if undetected.

PS. If you can’t see the 29 on the coloured dot diagram above (called the ‘Ishihara test’ by the way), you should come and get your eyes examined!

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