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Can You Sleep With Contacts In?
Sleeping in contacts is a very bad idea. In fact, patients can get an eye infection from sleeping in contacts. Some of these infections are very dangerous and can even result in a loss of vision permanently. When a patient wears their contact lenses during sleep, bacteria are given a chance to accumulate and cause problems. The contact lens also prevents oxygen from reaching the eye. Although there are newer lenses now that have greater permeability for oxygen, most ophthalmologists would advise that you do not sleep in contacts. Here are some of the things that can happen if you do:One of the most devastating complications of choosing to sleep in contacts is developing a corneal ulcer. This is an aggressive and potentially sight-threatening eye infection. Corneal ulcers are usually very painful and will likely cause the eye to look very red. You may see a whitish mark on the front part of your cornea, but also they can be very hard to see without a microscope. If you have been sleeping in contacts, and start having a lot of pain, you should see an ophthalmologist immediately. An ophthalmologist is an eye doctor who has gone to medical school and has then completed a four year surgical residency in ophthalmology. They will be able to look with a microscope and evaluate if you have an ulcer. Corneal ulcer treatment includes antibiotic eye drops that patients usually have to put in every hour, and sometimes even every 30 minutes for several days. The choice of antibiotic and the frequency of treatment depends on how bad the eye infection is. Most patients will not be able to wear contact lenses for several months. Some patients may never be able to wear contact lenses again. There are several other issues that patients can have from wearing contact lenses while sleeping. One of these is corneal neovascularization. This means that new blood vessels can develop over the front part of the eye. Another issue is a called marginal keratitis. Marginal keratitis can cause red eye, blurry vision, and patients will also need to discontinue contact lens wear while they are getting treated for this.Placing contacts in water overnight or during the day is also another very bad idea. Although water may seem "clean" there is an increased chance of developing certain types of infections when mixing water and contact lenses. For this same reason, ophthalmologists will tell you to not shower, swim or use a hot tub with your contact lenses in. If you are looking for a substitute for contact solution overnight, unfortunately, there is no good substitute. The beauty of wearing daily contact lenses is that you can just throw the contact lens pair out at the end of the day.There are some contact lenses that are approved for use overnight. While they may be technically okay, most eye doctors will not advise patients to sleep in their contact lenses. Though many patients who sleep in contacts will not develop corneal infections, there will be some who do, and for some of these patients the outcome could be not being able to wear contact lenses at all. The best type of contact lens to use is one that is a daily contact lens. This means that patients can put in a fresh pair of contact lenses each day. This minimizes the risk of infection and also makes it convenient for patients who find it annoying to place their contacts into solution each night. The downside to daily contact lenses is that they tend to be on the more expensive side. Do not sleep with contact lenses in. It puts you at a much higher risk for infection. Also, do not use water to store your contact lenses or swim in your contact lenses. Daily contact lenses can offer a benefit to patients who may have trouble remembering to store their contacts properly at night.Sources:Alafaleq M, Knoeri J, Boutboul S, Borderie V. Contact lens induced bacterial keratitis in LCD II: Management and multimodal imaging: a case report and review of literature. Eur J Ophthalmol. 2021 Sep;31(5):2313-2318. doi: 10.1177/1120672120968724. Epub 2020 Oct 30. PMID: 33124478.https://pubmed.ncbi.nlm.nih.gov/33124478/Cabrera-Aguas M, Khoo P, Watson SL. Infectious keratitis: A review. Clin Exp Ophthalmol. 2022 Jul;50(5):543-562. doi: 10.1111/ceo.14113. Epub 2022 Jun 3. PMID: 35610943.https://pubmed.ncbi.nlm.nih.gov/35610943/Arshad M, Carnt N, Tan J, Ekkeshis I, Stapleton F. Water Exposure and the Risk of Contact Lens-Related Disease. Cornea. 2019 Jun;38(6):791-797. doi: 10.1097/ICO.0000000000001898. PMID: 30789440.https://pubmed.ncbi.nlm.nih.gov/30789440/
4 min read
Myopia Is Nearsightedness
Myopia is not being able to see clearly at a distance without the help of glasses or contact lenses. This means that you are near-sighted because you can see clearly at a near distance. If you are the opposite, which is far-sighted, you have difficulty seeing clearly up close, but, at a distance, you can see clearly. The opposite is called hyperopia.Many patients wonder how myopia is different from astigmatism. When you have myopia you a negative lens to correct your vision problem. When you have astigmatism you may need a positive or a negative lens to correct this. Astigmatism and myopia can happen independent from one another or they can happen together. Astigmatism correction in glasses is made up of two different sets of numbers. The first number is the level of the astigmatism, meaning how much astigmatism the eye has, and the second number is the axis of the astigmatism. For example, in a prescription -2.00 sph, the patient only has myopia. But, if the prescription were to read -2.00 -1.00 x 180, then the patient has both myopia and astigmatism. This patient has -1.00 astigmatism at the axis of 180. You must have an axis when you are talking about astigmatism.When you have myopia your prescription starts with a negative number. When you have hyperopia, or have farsightedness, you prescription starts with a positive number. For example, someone with myopia may have a prescription of -2.00, while a person with hyperopia, or farsightedness may have a prescription of +2.00. You can not have both myopia and hyperopia in the same eye. You can have myopia in one eye and hyperopia in the other eye. This is not very common but it is possible. An example of this is a patient who may have a prescription of +1.00 in their right eye, but -0.50 in the left eye. Both myopia and hyperopia can be treated with glasses or contact lenses. This is the most common way that myopia is treated. There is also permanent treatment for myopia which involves laser vision correction surgery. There are a few different types of laser vision correction surgery including PRK (photorefractive keratectomy), LASIK (laser in situ keratotomy), and SMILE (small incision lenticule extraction). Depending on your eye and your prescription the eye surgeon performing these surgeries may recommend one surgery over another type of surgery. A less common option for treatment of myopia is orthokeratology, or ortho-k. In orthokeratolgoy, a specially designed contact lens is used to temporarily reshape the front part of the eye, which is called the cornea. Usually these lenses are worn at night and their purpose is to reshape the cornea while you sleep. The vision improvements are usually temporary but it may be possible for longer lasting effects if you continue to use the contact lenses. Laser vision correction and orthokeratology are usually not covered by insurance and they typically cost a few thousand dollars. Some portion of glasses and contact lenses are usually covered by vision insurance plans. If you have myopia, you should consider this when choosing your insurance plan coverage. Myopia is defined by having a negative prescription for your eyes and the inability to see clearly at a distance. The more negative your prescription is, the higher your degree of myopia. Patients who have a prescription of -1.00 can see more than people who have a prescription of -5.00. You can have myopia and astigmatism at the same time, but you can not have myopia and hyperopia in the same eye. Myopia is usually treated with glasses and contacts. Myopia can also be treated with laser vision correction. Laser vision correction is not covered by insurance and usually costs a few thousand dollars per eye.
4 min read
Contact Lens Stuck In Eye? What Should You Do?
For contact lens wearers, one of the most stressful things is having a contact lens get stuck in their eye. The good news is, in most situations, this is more of an annoyance and once the contact lens is removed, you are unlikely to have any long term issues. If you are just starting to wear contact lenses, it is a good idea to try getting them in and out of your eye during normal business hours so that if you do have a problem, you can easily get in touch with your eye doctor. No, it can not get stuck behind the eye. This is a common myth / misconception. The part of the eye where a contact lens is placed does not directly connect to the tissue that is located behind the eye where the optic nerve is. So, while the contact lens can get stuck under the lower eyelid or under the upper eyelid, a contact lens is not able to travel behind the eye.As long as you can have the contact lens removed in a timely fashion (within a few hours), a stuck contact lens is unlikely to cause any major eye problems. If you are new to wearing contact lenses, this is why it is important to try taking them in and out of your eye during normal business hours. This way if you are unable to take your contact lens out, your eye doctor is likely to be available in the office. If you are not confident in your ability to take your contact lenses in and out of your eye, do not try to this over a weekend when someone may not be available to help you. If a contact lens stays in the eye for too long, there are some dangerous things that can happen to your eye. Some of the things that can occur if the stuck contact is in the eye too long include a corneal abrasion (scratch on the eye), and in a more severe case, patients can even get a corneal ulcer. The first step is to call an eye doctor. An eye doctor can use a special microscope called a slit lamp to examine your eye and figure out where the contact lens is. The eye doctor may use a special yellow dye called fluoroscein to help locate where the contact lens is. The eye doctor may also have to flip your eyelid in order to get a better view if they think the contact lens is hiding under the eyelid. If the ophthalmologist finds a scratch on the eye, which is called a corneal abrasion, they will likely give you antibiotic eye drops for this.
3 min read
Myopia Vs Hypermetropia
Hypermetropia (also called hyperopia) and myopia are both words used to describe a person’s need for glasses to see better. When someone is hyperopic (has hypermetropia) it means that they are far-sighted and when someone is myopic it means they are nearsighted. Nearsighted people see clearly up close and have blurry vision at a distance, and for far-sighted people, the opposite is true. Patients with myopia will have a negative sign in front of their prescription, such as -4.00. Patients with hyperopia or hypermetropia have a plus sign in front of their prescription, such as +4.00. These terms are related to how and where the light rays are focused when they enter the eye. This is called the focal point. The focal point of an eye is determined by how light is bent as it passes through the eye structures including the cornea, aqueous humor, lens and vitreous.In hyperopia, without corrective lenses the light is focused posterior to the retina. This causes the focal point of the eye to be past infinity which will cause blurred vision at near greater than at distance. Correction for hyperopia uses plus power (or convex lens) glasses or contact lenses to correct the focal point to exactly infinity (also called emmetropia). Plus power lenses are thicker in the center of the lens and thinner on the outer rim of the lens. In myopia, the light is focused anterior to the retina without corrective lenses. This causes the focal point of the eye without correction to be closer than infinity. The location of the focal point is based on the amount of myopia. Someone with low amounts of myopia will have a focal point 15 or 20 feet away whereas someone with high myopia may have a focal point just a few inches away from their eye. Correction for myopia involves minus power (or concave) glasses or contact lenses. Minus power lenses are thinner in the center of the lens and thicker on the outer rim of the lens.An eye doctor can determine the level of hyperopia or myopia by performing a refraction. This involves a patient looking through a machine called a phoropter which holds a large number of different powered lenses. These lenses are shown to the patient one at a time to determine the lens which provides the best vision and, therefore, determines the lens power to put in that patient’s glasses. In nonverbal patients a glasses prescription can also be found through a technique called retinoscopy. This involves shining a thin beam of light into a patient’s eye while looking through a lens of a specific power. The reflection of light can be used to determine the correct lens power needed to provide the patient with emmetropia. There are certain medical conditions that are more prevalent in patients with myopia versus hyperopia. The risk of these medical conditions is mostly related to the size of the eye. Hyperopes have shorter eyes on average and are at higher risk for conditions related to having a short eye including angle closure glaucoma and accommodative esotropia. Myopes have longer eyes on average and are at higher risk for conditions related to having a long eye including retinal detachment, posterior vitreous detachment, open angle glaucoma and cataracts.Treatment for myopia and hyperopia is most commonly done with glasses, contacts or both. Before the advances of modern surgery, glasses and contacts were the only ways to treat myopia and hyperopia. However, there are now procedures available known as refractive surgery which can correct certain levels of myopia and hyperopia. These include procedures like laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and small incision lenticule extraction (SMILE). Eligibility for refractive surgery will depend on a number of factors including a patient’s prescription, corneal thickness and type of refractive surgery. A full evaluation should be performed by a refractive surgery specialist to determine an individuals refractive surgery options.When you can not see far, a person is usually has myopia. People with myopia usually have a negative prescription. The opposite is true for people who have hypermetropia, also called hyperopia. Patients with hyperopia have difficulty seeing up close and their prescriptions are positive, or have a plus sign in front of them. You can correct both of these eye problems with glasses, contacts, or refractive eye surgery.Sources:Moore BD, Augsburger AR, Ciner EB, Cockrell DA, Fern KD, Harb E. Optometric Clinical Practice Guideline: Care of the Patient with Hyperopia. St. Louis, MO: American Optometric Association; 1997:1-29American Association of Pediatric Ophthalmology. Retinoscopy. http://www.aapos.org/terms_faqs/faq_list/retinoscopy. [May 2010]American Association of Pediatric Ophthalmology. Refractive errors. http://www.aapos.org/faq_list/refractive_errors . [May 2010].
4 min read