One of the risk factors for dry eye is the use of contact lenses. Here are 5 things to guide you in taking care of patients with dry eyes caused by contact lenses.
1. Address the use of digital devices.
“An increase in palpebral fissure size might expose the ocular surface when the eyes are in upward gaze viewing digital gadgets, resulting from tearing film destabilization,” explains Dr. Barnett, Principal optometrist at the University of California Davis Health Eye Center. When the palpebral fissure narrows in downward-looking, a sustained tear film may occur. Instruct patients to set up their workplaces so that their eyes are somewhat downward when viewing digital gadgets. Subjective comfort and dry eye characteristics improved when objects were viewed at about 90 cm or around 35 inches with a downward gaze angle (10 degrees).
Computer-related dry eye problems can also be reduced by using proper lighting, changing chair positions, lowering computer monitors, and using a desktop humidifier. Blinking exercises (gently closing eyes for two seconds, opening eyes, gently closing eyes for two seconds, squeezing eyelids closed for two seconds) have been demonstrated to help prevent ocular damage from screen use. It is critical to teach patients why these tactics are vital and to train them on how to utilize them throughout the day, whether they are at a computer, on a mobile device, or playing video games. Every patient should understand the 20-20-20 rule: stare at anything 20 feet away for 20 seconds every 20 minutes.”
According to Dr. Barnett, there are a variety of daily replacement contact lens choices available to improve lens comfort.
2. Recommend daily replacement contact lenses to patients.
“One of the many suggestions made by the Tear Film and Ocular Surface Society Contact Lens Discomfort Analysis Working Group to reduce contact lens discontinuation was to set the replacement rate to every day,” she continues. “People who have reusable contact lenses have a 12.5-fold higher risk of corneal infiltrate events (CIEs) than people who wear daily dispo sable contact lenses, according to a study. I recommend that all new contact lens wearers begin with daily replacement lenses if their circumstances allow. Daily replacement contact lenses may help prevent future difficulties for contact lens wearers who are not experiencing any discomfort.”
3. Replace the water with a hydrogen peroxide solution.
Hydrogen peroxide (H2O2) systems, according to Dr. Barnett, are an alternative for reusable contact lens wearers since they are simple to use, safe, pleasant, and effective. She continues, “H2O2 releases free radicals that function as oxidizing agents, causing biocide by destroying microorganismal cell membranes and critical cell components.” According to the author, “Analysis has indicated that multipurpose solutions induce large staining while H2O2 solutions cause minimal corneal staining.” According to the Centers for Disease Control and Prevention’s lens care standards, just 13% of individuals using multipurpose solutions were compliant, compared to 100% of those using H2O2 solutions.
Dr. Barnett also cited current scientific and clinical evidence indicating that hydrogen peroxide solutions encourage pleasant lens wear and are simple to use, have minimal interactions with lenses or the ocular surface, are antimicrobial effective, and support ocular surface health. According to her, patients who used the H2O2 system were also more likely to follow a practitioner’s lens care brand recommendation (79 percent vs. 34 percent), were four times more likely to use fresh solution for daily disinfection, and were seven times more likely to replace their lens case as recommended.
4. Encourage the use of moist heat compress therapy.
“Applying focused warmth to the meibomian glands enhances meibum production, making warm compresses a commonly advised treatment,” according to Dr. Barnett. “Researchers who are at the University of Alabama in Birmingham School of Optometry examined the effects of moist heat compress is the first-line treatment for contact lens distress in those who have dry eyes from their contacts. These data show that using a moist heat compress is a first-line treatment for contact lens wearers experiencing pain. Those who applied the moist heat compress were able to extend the time they could wear their contact lenses comfortably by up to three hours.”
5. Inquire about the patients’ facial and eye products.
“It is critical to assess which products are being used for their faces and eyes for people with dry eyes or who wear contact lenses,” explains Dr. Barnett. “Many cosmetics have chemicals that can produce dry eye conditions like ocular sensitivity, blepharitis, and meibomian gland toxicity. Any eye products, whether used by a male or female, have the potential to cause problems. Consider recommending nonirritating products to patients”, says Dr. Barnett, who also recommends the Think Dirty® app and the Environmental Working Group’s Skin Deep® for learning about cosmetic ingredients. “All the patient, particularly those who wear contact lenses,” she continues, “needs a healthy tear film.”
