The use of contact lenses, not just for beauty

The use of contact lenses, not just for beauty

This interactive health column is jointly run by The Jakarta Post
and Singapore-based Parkway Group Healthcare. Readers are
encouraged to ask questions through features@thejakartapost.com
or direct to Parkway's san-san@gleneagles.com.sg.

SINGAPORE (JP): "Beauty is in the eyes of the beholder!" Among
the fairer sex of this world...there is no doubt that each would
vie for the acclaim of being the "fairest of them all"!

The commonest indication for using contact lenses has always
been attributed to "beauty-consciousness" and certainly Dorothy
Parker's famous quote, "Men seldom make passes at girls who wear
glasses!" helps to justify a woman's desire to wear contacts.

The simplest reason for wearing contact lenses is of course
to restore vision, without distorting or lessening the beauty of
the wearer. The "bottle glass" appearance of thick myopic
corrective lenses certainly does an injustice to many a fair
maiden. Contacts restore nature's intended good looks to the
wearer.

Other reasons for using contacts are for professionals like
airline staff, actors or actresses and deep sea divers where
spectacles would be cumbersome. Persons with high astigmatism or
keratoconus certainly have much clearer vision with Rigid Gas
Permeable (RGP) lenses.

There are other medical conditions like dry eyes with cornea
problems wherein contacts are used as therapeutic bandage lenses.

The consideration of "sight" or "clear vision" with contact
lenses certainly deserves a comparison of pros and cons and a
review of history, indications, contraindications, advantages and
disadvantages.

History

Persons with refractive errors like myopia (shortsightedness)
hyperopia (farsightedness), astigmatism (defect of vision causing
improper focusing) certainly have blurred and distorted vision.

It was Leonardo da Vinci who invented the corrective lenses
for myopia. In the 1800's the first experimental glass contact
lenses were tried, and with progress in technology, different
materials were utilized.

Compositions have evolved from hard to softer materials for
comfort and from low water content to high water contents as high
as 85 percent, made from copolymer vinyl lenses.

However, they proved too fragile and new materials like
silicon were tried. This material is certainly stronger and is
extremely oxygen-permeable, but because of its hydrophobic
properties it also has drawbacks. So, hard lenses with high gas-
permeability evolved as a great challenge in contact lens wear.

The popularity of contact lenses resulted from the clear
vision that was made possible with both hard and RGP contact
lenses. Then when soft lenses improved the comfort and even more
people started wearing them, but persons with astigmatism of more
than -1.00 DS could only manage to get the desired clarity with
Toric Soft lenses or RGP lenses.

Contraindication

But, there are some contraindications of wearing contact
lenses. Eye disease, recurrent infections and eye allergies make
wearing of contact lenses difficult or impossible for some.
Intolerance of contact lenses has prevented others from being
able to wear contacts, but this has become rarer with the
development of superior types of lenses.

High water content lenses produced problems not only through
their increased susceptibility for bacterial infection, but from
users wearing them beyond the recommended wearing time because of
increased comfort causing increased accumulation of lens
deposits.

These lens deposits were usually mixed deposits of organic
(muco-protein, lipoprotein) or mineral"jelly-bumps"( iron,
calcium). With prolonged wear, and the mechanical microtrauma of
the upper palpebral conjunctivae, the incidence of giant
papillary conjunctivitis (GPC) became as high as 12.5 percent
among contact lens wearers (Malaysian study, 1994).

Daily, Weekly, Bi-weekly and Monthly Soft Disposable lenses
have decreased and almost totally eliminated GPC among contact-
lens wearers. All these lenses however, have been worn with the
precaution of daily removal and overnight soaking in "all in one
sterile preserved solutions". Yet now "after a 10 year hiatus,
soft contact lenses that can be worn for more than 24 hours and
for up to four weeks, are being relaunched", according to John
Dart of London's Moorfieid Eye Hospital.

Complication

Complications for contact lens wearers were numerous until
materials, design and water content were improved. Among some of
the former complications, which occasionally may still be seen
are -- GPC, Contact Keratoconjunctivitis, Dry Eye Syndrome,
Superficial Punctate Keratitis (SPK), Cornea Infiltrates and
Vascularisation, Acute Occlusive and Overwearing Syndromes.
(Ruben M a Khoo CY, Contact Lenses, Medical Aspects).

Extended wear contact lenses have a group of complications
peculiar to them, because of relatively reduced oxygen
availability, such as corneal infiltrates, microcysts and limbal
neovascularization.

Acanthamoeba and fungal infections are a danger, but their
incidence have been reduced with better patient education and
better training for eye-professionals who fit contact lenses.

Are contact lenses safe for children? This is the most
frequent question asked by my patients.

There are ongoing studies on the special usage RGP Contact
Lenses in stabilization of Progressive Myopia in children.

It has also been the subject of world-wide studies to
determine whether RGP lenses retard the progress of myopia,
during its most rapid period of development from 10 to 13 years
of age.

A three-year study reported by Singapore's Dr. Khoo Chong Yew
in 1996, validated that progressive increases in myopia were
reduced among wearers of RGP lenses compared with spectacle
wearers.

Dr. Jenny P. Deva is a consultant ophthalmologist for Ophir Eye
Clinic, Klang, Selangor; Visiting Consultant, Selangor Medical
Center, Shah Alam; Honorary Lecturer, Department of Ophthalmology
Medical Faculty University of Malaya, Kuala Lumpur, Malaysia.