Quarantine Part-Timers

Here in my household, I did a comprehensive survey amongst contact lens wearers. It appears that 50% of respondents reported ‘significantly less contact lens wear’ during quarantine times, the other 50% wears lenses as usual. It may not be fully representative, with an n=2. But it is something to consider that part-time lens wear may be more of a thing now than in normal times.

Disinfect. In Fact.

Lens wearers should be aware of the disinfection method used if lenses are worn occasionally. For instance, peroxide systems are excellent in killing almost all bugs on a lens – but the simple definition of disinfection tells us it is not sterilisation. The obligatory neutralising step of the peroxide solution means that it changes from hydrogen peroxide to plain saline (and oxygen: the bubbles we see). After that cycle, a solution needs a long-term preservation-ingredient to prevent the few bugs to multiply that in theory could survive the disinfection cycle. In other words, with peroxide, the cycle needs to be repeated regularly if lenses are stored for longer periods. How regularly? Recommendations vary between companies from every 24 hours to once a week.

“the simple definition of disinfection tells us.. it is not sterilisation”.

Multi-purpose solutions have that ‘preservation system’ built in which, in theory, can last up to 30 days – if the lens case remains unopened. To be safe my recommendation would be, that before putting lenses in the eye - to always manually clean and rinse them with fresh contact solution after lenses are stored for longer periods. Dispose of the lenses ánd the storage case timely (not extending their life). And NEVER use tap water for cleaning, storing or rinsing soft lenses. EVER. That’s a fact. And daily disposables are actually a pretty safe way for lens wear these days and for part-time lens wearers in general – without the need for disinfection.

Orthokeratology & Myopia Management

For many of our specialty lens wearers, part-time wear is not an option – think of orthokeratology lens wearers for instance. Here too, more than ever, daily cleaning and disinfection is important: we don’t want corneal infections. Many orthokeratology-lens wearing children do so as part of a myopia management strategy to slow down the progression. What is absolutely imperative in this, is that whatever therapy is adhered too – it needs to be consistent. Studies in kids with glasses for instance show that it is too easy to take them off during sports and playtime, and the myopia reducing effect is therefore diminished. Same with atropine treatment: some parents ‘experiment’ with refraining from drops during vacations or in the weekends. That inconsistency is killing for the effectivity of the procedure. In other words: in lockdown, it is important to ‘lock’ lens wear in kids to everyday use. In orthokeratology that is relatively easy, as part time wear is not really an option. But this is also true for soft lenses for myopia management.

Eef@online_Part_Timers

22-04-2020

This Eef@online series is kindly supported by an educational grant from Contamac