Researchers may have found a new way to effectively treat a serious contact lens-related eye infection called Acanthamoeba keratitis: topical application of riboflavin (vitamin B2), followed by exposure to select wavelengths of UV light (UVA).

In a study conducted by The Johns Hopkins University School of Medicine (Baltimore, Md.), two patients with confirmed cases of the infection and one patient with a presumed case — all characterized by painful corneal ulcers that were resistant to conventional medical treatment — underwent two 30-minute sessions of the vitamin B2/UVA photochemical therapy. Read more…

Using costume contact lenses without a proper fitting and care significantly increases your risk of eye infections.

Wearers of costume contact lenses — special colored contacts that dramatically change the appearance of the eye — are significantly more likely to experience contact lens-related eye infections, according to a European study.

Researchers in France conducted the study at 12 university hospitals between July 2007 and July 2009 to evaluate the risk of eye infections among individuals who wore costume color contacts (also called theatrical contact lenses), compared with people who wore conventional (non-costume) contact lenses. Read more…

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.

In today’s issue of Contact Lenses Today, optometrist and contact lens specialist Morris Lehrfeld, OD, shares the following tips he gives to his patients to help keep their eyes healthy when wearing contact lenses:

1. Use only solutions prescribed by your eye doctor. Older and generic contact lens solutions can cause compatibility issues, especially with modern silicone hydrogel contacts, says Dr. Lehrfeld.
2. Use fresh contact lens solution every day. Many contact lens wearers are guilty of “topping off” the contact lens solution left in their lens case from the previous day. This reduces the effectiveness of the disinfection process, potentially leading to serious contact lens-related eye infections.
3. Replace your contact lens case at least every three months. Even with proper lens care, bacteria and other infection-causing agents can accumulate in contact lens cases over time. Routine replacement of your lens case can reduce the risk of contamination and eye infections.

Dr. Lehrfeld is an eye care provider at Palatine Vision Center, a group optometric practice in Palatine, Illinois. Contact Lenses Today is a weekly e-mail newsletter for eye doctors sponsored by the professional journal, Contact Lens Spectrum.

In this month’s issue of Contact Lens Spectrum, editor and contact lens specialist Jason J. Nichols, OD, warns that current economic conditions may be affecting how people are wearing and caring for their contact lenses.

Dr. Nichols says hard economic times can alter people’s behavior regarding their health, including how frequently they replace their contacts and how they use contact lens solutions.

“I am hearing more and more reports of patients looking for the cheapest ‘bottle’ on the shelf, which just happens to be saline rather than an appropriate care solution,” he says. Many contact lens wearers may also be using their lenses for longer periods of time rather than discarding and replacing them according to the schedule their optometrist or ophthalmologist recommends, according to Dr. Nichols.

Internet blogs and social networking sites may be contributing to the problem: some sites feature discussion boards where contact lens wearers report how they routinely wear their disposable contacts longer than recommended.

Dr. Nichols warns that poor contact lens habits frequently lead to contact lens-related eye infections, including severe infections like Acanthamoeba keratitis. He urges eye doctors to continue educating and re-educating their patients about proper contact lens wear and care.

In a related story published in the journal, a survey released by the American Optometric Association indicates 52 percent of consumers are visiting their eye doctor less frequently due to economic reasons. The same survey says 59 percent are visiting their primary care physician less frequently.

Silicone hydrogel contact lenses, even more than conventional soft contacts, require a rubbing step when cleaning and disinfecting the lenses with “no-rub” contact lens solutions, says a prominent contact lens specialist.

Michael A. Ward, MMSc, FAAO, instructor in ophthalmology at Emory University School of Medicine (Atlanta, Ga.) and director of Emory Eye Center‘s Contact Lens Service, says adding the manual cleaning step maximizes comfort, improves vision and reduces the risk of contact lens-related eye infections.

Researchers are finding that one-step (“no-rub”) contact lens solutions often do not completely remove environmental debris, skin oils and make-up from the surface of contact lenses. These lens deposits can cause eye discomfort and vision problems, and may also decrease the effectiveness of lens disinfectants and lead to serious problems, including bacterial and fungal eye infections and Acanthamoeba keratitis.

Silicone hydrogel lenses, which allow more oxygen to reach the cornea than regular soft contacts, are as likely as regular soft lenses to accumulate lens deposits if they are not properly cleaned and disinfected after each wearing period.

If patients at Emory Contact Lens Service are not compliant with a rub-and-rinse lens care regimen and lens deposits are noted, switching to a hydrogen peroxide-based lens care system often solves the problem, Ward told online newsletter Contact Lenses Today (Oct 22).

Another option for people who are prone to contact lens deposits or fail to care for their lenses properly is to switch to daily disposable contacts, which are designed to be discarded after a single use.

What is the best method for cleaning and disinfecting your contact lenses?

In a recent issue of Contact Lens Spectrum, two prominent researchers addressed this issue in a point-counterpoint debate.

Charlotte Joslin, OD, PhD, epidemiologist and assistant professor of ophthalmology and visual sciences at the University of Illinois at Chicago, prefers hydrogen peroxide-based contact lens solutions. She says that a recent study found that only a two-step hydrogen peroxide lens care system was effective against a microorganism that can cause a serious eye infection called acanthamoeba keratitis.

In addition to being proven effective against Acanthamoeba organisms, two-step hydrogen peroxide-based (HPB) contact lens care solutions also are the most effective against bacterial and fungal eye infections, according to Dr. Joslin. She also said that there have been two worldwide recalls of (non-hydrogen peroxide) multipurpose contact lens solutions due to outbreaks of amoeba and fungal eye infections associated with the use of these one-step solutions.

Dr. Joslin’s argument was countered by Craig A. Woods, PhD, research manager at the Centre for Contact Lens Research, School of Optometry, University of Waterloo (Ontario, Canada).

Dr Woods believes multipurpose contact lens care solutions offer the best combination of safety, cost and effectiveness.

He says that one-step (“no rub”) multipurpose solutions are less expensive and easier to use than HPB disinfecting solutions, and contact lens wearers are more likely to use them properly. He says that there have been “only rare reports” of complications associated with multipurpose solutions, and that they are proven safe and effective.

Dr. Woods also says that hydrogen peroxide-based lens care systems require contacts to be exposed to the hydrogen peroxide solution for a significant amount of time, and that single-step HPB systems may not allow sufficient time for complete disinfection.

He says that while the recent outbreaks of eye infections that caused global recalls of certain multipurpose care solutions were “horrendous for the individuals involved,” he believes these were isolated incidents and not representative of the overall performance of multipurpose disinfecting solutions.

The full point-counterpoint discussion of contact lens care solutions featuring Drs. Joslin and Woods appears in the June 2009 issue of Contact Lens Spectrum.

Soon there may be a novel way to reduce the risk of contact lens-related eye infections: antibacterial contact lenses.

Researchers in Australia have discovered that incorporating melimine, a cationic peptide, into the the lens material of silicone hydrogel contact lenses reduced the incidence of contact lens induced acute red eye (CLARE) and contact lens induced peripheral corneal ulcers (CLPU) in rabbit and guinea pig eyes fit with contact lenses and exposed to common infection-causing bacteria.

Peptides are naturally occurring organic molecule formed by the linking of two to 50 amino acids. (Larger sequences of amino acids are called proteins.)

Cationic peptides range in size from 12 to 50 amino acids and have a broad spectrum of antimicrobial activity, including protection from bacteria, viruses and fungi. “Cationic” refers to the positive charge of the molecules, which enables them to interact with and affect negatively charged bacterial membranes.

The researchers concluded that incorporating the cationic peptide melimine into contact lenses may prevent the growth of bacteria on contacts and reduce the incidence and severity of contact lens-related eye infections.

Additional studies are needed to confirm the effectiveness of this approach and the feasibility of commercially developing such lenses.

Source: In vivo performance of melimine as an antimicrobial coating for contact lenses in models of CLARE and CLPU. Investigative Ophthalmology & Visual Science. (Published online ahead of print August 26, 2009.)

Rinsing silicone hydrogel contact lenses with an approved contact lens solution after removing them from the eye removes more than half the protein that accumulates on the lenses, according to a new study.

Researchers at The Ohio State University College of Optometry found that rinsing silicone hydrogel contacts thoroughly as part of a “no rub” lens care system removes protein deposits from the lenses significantly better than foregoing the rinse step.

Subjects participating in the study were fit with silicone hydrogel lenses manufactured by CIBA Vision and then wore the lenses on a daily wear basis for five days. They were instructed to use Aquify Multi-Purpose Disinfecting Solution (CIBA Vision) after each day of wear, following the manufacturer’s “no rub” care instructions.

The study participants then returned to the clinic and their lenses were removed by a gloved examiner. One lens was rinsed with the contact lens care solution and the other was not. Protein was then chemically removed from all lenses and quantified.

More than 50 percent more protein was chemically extracted from the lenses that did not undergo the rinse step after removal from the eye.

The results of the study suggest silicone hydrogel lenses have significantly less protein build-up if they are thoroughly rinsed with a multi-purpose contact lens care solution when removed from the eye. Including this rinse step as part of a “no rub” care system therefore may decrease the risk of contact lens discomfort and contact lens-related eye infections.

A full report of the study appears in the August 2009 issue of Optometry and Vision Science.

Soon people who need to use medications frequently for eye infections, glaucoma and other health problems may be able to wear contact lenses that provide a sustained release of the medicine they need.

Researchers at Massachusetts Eye and Ear Infirmary, Harvard Medical School and Massachusetts Institute of Technology recently developed and tested prototype drug-eluting contacts with promising results. If these contact lenses are proven successful and commercially viable, they may be a more convenient and reliable drug delivery system than eye drops.

The lenses were created by coating films containing test compounds with a soft contact lens material by using ultraviolet light polymerization.

One compound tested was ciprofloxacin (or “Cipro”), an antibacterial drug with multiple applications. After a brief initial burst, the prototype drug-eluting lenses demonstrated a controlled release of Cipro for more than 4 weeks, and the lenses inhibited ciprofloxacin-sensitive Staphylococcus aureus bacteria at all time-points tested.

Though additional testing is needed, the researchers concluded that it appears contact lenses like those produced in the study could be used successfully for ocular drug delivery with widespread therapeutic applications.

The full report of the study appears in the July 2009 issue of Investigative Ophthalmology & Visual Science.

A new investigation finds that some contact lens solutions do not provide protection from Acanthamoeba — a free-living organism commonly found in soil, freshwater lakes and streams, seawater, tap water and hot tubs — that can cause a painful vision-threatening form of keratitis.

In 2007, a multi-state outbreak of Acanthamoeba keratitis led to an investigation by the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services. The investigators found an association with the use of Complete MoisturePlus multipurpose contact lens solution, manufactured by Abbott Medical Optics (formerly Advanced Medical Optics), which has since been withdrawn from the market.

Recently, researchers at CDC compared 11 different contact lens solutions for their ability to kill three Acanthamoeba species associated with the 2007 outbreak. Of the 11 solutions tested, only the two containing hydrogen peroxide showed any disinfection ability for cysts of two of the three Acanthamoeba species.

The researchers said a “systematic method for evaluating contact lens solutions will reduce the chance that inefficacious solutions are available.”

The study was reported in the July 2009 issue of the Journal of Clinical Microbiology.

Researchers at the University of California, Los Angeles (UCLA) recently performed an analysis of the types and prevalence of contact lens-related complications among patients seen in the university’s clinic.

Of the 846 eyes of 572 contact lens wearers evaluated in the study, approximately 50 percent of eyes had at least one contact lens-related complication, the researchers said. Among the findings of the study:

• Rigid gas permeable contacts had a statistically lower average number of complications than soft contact lenses.
• Conjunctival papillae and giant papillary conjunctivitis were the most prevalent complications among both gas permeable (GP) and soft contact lens wearers.
• Silicone hydrogel contact lenses had a slightly lower (though not statistically significant) rate of complications than regular soft lenses.
• Extended wear contacts had a slightly higher complication rate compared with daily wear lenses.
• Use of contact lens solutions not recommended by the wearer’s eye doctor — including generic and private label solutions — was associated with the highest rate of complications for both GP and soft contact lenses.

Conjunctival papillae are bumpy lesions on the inner surface of the eyelids that can affect contact lens comfort. Giant papillary conjunctivitis (GPC) is an allergic inflammation of these papillae characterized by redness, itching and contact lens intolerance.

The researchers said the significant prevalence of contact lens-related complications identified by this study — regardless of lens design, material and wearing schedule — highlights the importance of routine professional eye care for all contact lens wearers.

The full report of the study appears in the July 2009 issue of Eye & Contact Lens: Science and Clinical Practice.