An Angry Eye
Not a pretty picture, huh? This picture shows an eye with a fungal corneal ulcer. Aka an angry eye. This ulcer is an example of what could happen when contacts are worn on an extended wear basis. Although patients have always improperly over worn and slept in their contact lenses, the introduction of extended wear lenses has likely pushed this trend over the edge.
Silicone hydrogel contact lenses, the new generation of contacts, have now been out for nearly a decade. The silicone material allows the cornea to receive more oxygen than conventional water based contacts. Thus, the marketing of these lenses as extended wear or “the kind you can sleep in” has, no doubt had an impact in the way patients wear their lenses. Although certain brands are FDA approved for extended wear up to 30 days, this is not commonly promoted by your optometrist. Well, at least not me. Some eyes may be able to get away with it, but most will end up having an unpleasant complication. Any time a foreign body is placed on the eye and then introduced to low oxygen levels with practically no tear flow as is seen in the sleeping eye, we are asking for trouble. This environment creates the perfect conditions for bacteria and fungi to colonize and even invade an intact cornea. Albeit this picture depicts an extreme example of what may happen when lenses are slept in or wrongly cared for, these patients definitely turn up in our chair, urgently needing help. Fungal ulcers are insidious infections that can be very difficult to treat, often requiring several months of topical and oral medication. Even with vigorous treatment, conventional management may fail with the end result being a corneal transplant or even a blind eye.
Am I telling you all this to scare you into properly caring for your contacts? Maybe. Sometimes pictures like this have a way of relaying a message that I am incapable of. Bottom line for all you contact lens wearers.. you only have two eyes so be sure to give them that oxygen they crave, clean and store them with disinfecting solution and clean cases, and replace them in a timely fashion.
All the best to you and your two windows to this crazy, beautiful world!