The presence of pinguecula and loosening or excess growth of the conjunctiva are risk factors for the development of subconjunctival hemorrhage (SCH) among contact lens wearers, according to a study published online this month by the American Journal of Ophthalmology.

Subconjunctival hemorrhage

Researchers in Japan evaluated 45 contact lens wearers (ages 18 to 45) with SCH, 200 age-matched control subjects who did not wear contact lenses and 200 age-matched controls who wore contacts. None of the eyes in the control groups had subconjunctival hemorrhages.

The conjunctiva (the clear, thin membrane overlying the sclera or “white” of the eye) was divided into eight equal regions and evaluated for the presence of pinguecula, conjunctivochalasis (loosening and/or excess growth of the conjunctiva) and other abnormalities.

Results of the study included:

• Contact lens-related SCH typically affected one or two temporal (lateral, closer to the ear) regions of the conjunctiva.
• SCH occurred significantly more frequently in eyes with pinguecula and conjunctivochalasis.
• The effect of downward gaze or digital (finger) pressure on the extent of conjunctivochalasis was more marked in eyes with SCH.

The study authors concluded that pinguecula and conjunctivochalasis are major risk factors for contact lens-related subconjunctival hemorrhage.

Though the exact cause of pinguecula and conjunctivochalasis is unknown, they may result from chronic dry eye, overexposure to the sun’s ultraviolet (UV) radiation or allergy-related swelling with eventual stretching of the conjunctiva.

Severe cases of pinguecula and conjunctivochalasis that are unsightly or cause eye discomfort can be treated surgically.

In her recent music video, “Bad Romance,” pop star Lady Gaga’s appearance is more arresting than usual thanks to a bit of computer magic: Her eyes were digitally altered to appear bigger.

Not surprising, the doe-eyed look she has in the video has inspired a fad among many teenage girls and young women: wearing special color contacts that mimic the anime-style look. These so-called “circle” contacts have a darkly tinted zone that makes the wearer’s pupil look much larger than normal.

The problem is that circle contact lenses are being sold illegally via the Internet without a contact lens prescription, which eye doctors say could cause serious eye problems ranging from minor eye discomfort to serious eye infections, including potentially blinding infections such as Acanthamoeba keratitis. This especially is true when contact lenses are not properly cleaned and disinfected after each use and/or are shared among friends.

Today, the American Academy of Optometry (AAO) and American Optometric Association (AOA) issued a joint statement titled, “Concern Regarding Cosmetic ‘Circle’ Contact Lenses.”

In the document, the organizations point out that all contact lenses, whether they correct vision or are used simply for cosmetic purposes, are classified as medical devices by the U.S. Food and Drug Administration (FDA) and cannot be obtained legally in the United States without a prescription, which requires a contact lens fitting by a licensed eye care practitioner.

The joint statement also says studies show individuals who purchase contact lenses via the Internet or mail order have a four times greater risk of eye infections than those who purchase their lenses from an eye care professional.

The AAO and AOA also warn of the dangers of sharing or swapping contact lenses with friends and advise consumers desiring cosmetic contact lenses to alter or enhance their appearance to do so only after consultation with their eye care provider.

The AAO/AOA joint statement follows a similar warning about circle contacts issued earlier this month by the American Academy of Ophthalmology.

Since disposable contacts were introduced in 1987, there has been plenty of controversy about how frequently you should replace your contacts to keep the lenses comfortable and your eyes healthy.

A consensus opinion doesn’t seem to exist among optometrists, as evidenced by a point-counterpoint discussion of the topic published in the June 2010 issue of Contact Lens Spectrum.

Colleen M. Riley, OD, vice president of professional development at Vistakon / Johnson & Johnson Vision Care, says disposable contact lenses should be replaced every two weeks for better vision, less contact lens discomfort and fewer complications.

Offering a different opinion, Peter D. Bergenske, OD, director of professional support at Ciba Vision North America, says popular and highly oxygen-permeable silicone hydrogel contact lenses make monthly replacement sufficient, and replacing contacts on a monthly basis is easier for contact lens wearers to remember than a two-week replacement schedule.

Other eye doctors prefer weekly replacement of disposable contacts. Weekly replacement is more likely to keep the lenses clear and comfortable, and a one-week replacement schedule is very easy for lens wearers to remember and comply with, they say.

Still other eye care practitioners say daily disposable contact lenses are the best choice. With daily disposables, there is no need to remember when to replace your contacts since they are discarded after a single use. Though daily disposable contacts may be the most costly option, many contact lens wearers prefer the convenience of not having to clean and disinfect their contacts at the end of the day, and there is no need to purchase lens care products.

So which contact lens replacement schedule is best for you? That may depend on your eyes as much as your personal preferences.

To determine the type of disposable contacts and the lens replacement schedule that are best for your needs, budget and lifestyle, it’s wise to discuss all options with your optometrist or ophthalmologist.

Need another reason to quit smoking? How about because it might make your contact lenses feel better and decrease your risk of eye problems?

Researchers at Case Western Reserve University (Cleveland, Ohio) recently fit 205 patients with CIBA Vision’s Night & Day silicone hydrogel contact lenses for continuous wear and followed them for a period of one year. The purpose of the study was to identify risk factors associated with the development of corneal infiltrates during extended wear of the lenses.

Corneal infiltrates are small, hazy, gray-appearing areas that appear in the clear front surface of the eye (cornea) as evidence of inflammation. They are composed of inflammatory cells such as white blood cells, and typically appear in the periphery of the cornea, often under the upper eyelid.

Symptoms of corneal infiltrates include a foreign body sensation (feeling something is “in” the eye), red eyes, excessive tearing, sensitivity to light and contact lens discomfort.

The researchers found that smokers who wore the Night & Day contact lenses on a continuous basis had greater than four times the risk of developing corneal infiltrates, compared with non-smokers.

Treatment options for corneal infiltrates include discontinuing contact lens wear, use of topical antibiotics (to treat or reduce the risk of infiltrate-associated eye infections) and/or use of topical anti-inflammatory medications.

A full report of the study was published on the Investigative Ophthalmology & Visual Science website on June 10, 2010.