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Saturday, May 16, 2009

CONTACT LENS OVERWEAR

This patient wears standard disposable contact lenses all day long. You can see from the photos before that there are blood vessels growing into the cornea and inflammation associated with the cornea being starved from oxygen. Solution for this is to get refit in a contact lens that breathes more oxygen and wear glasses more. A little less convenvient but the eyes are worth it! As I've been telling patients lately, we'll go through a lot of cars in our lives but only one set of eyes.







Friday, May 15, 2009

Unusual Cortical Cataract


This is an interesting type of cataract. It is difficult to tell if this is congenital or acquired. Likely it is acquired because you would think and eye doctor would have told the patient about this when he was younger. This cataract does not effect central vision because the central visual axis is still clear. But at night when the pupil dilates, the patient may see haloes and starbursts.

Wednesday, May 13, 2009

CORNEAL ABRASION


This patient had a mild abrasion on the cornea. You can see small dot on the surface. This should clear up fairly quickly and was covered with antibiotic drops.

Thursday, May 7, 2009

GHOST VESSELS


This is the patient below, a week after giving contact lenses that breath more oxygen. You can see the vessels without blood in them. This significantly decreases risks for inflammation and infections in the eye.

Friday, May 1, 2009

BLOOD VESSELS GROWING INTO CORNEA FROM EXCESSIVE CONTACT LENS WEAR






The above photos demonstrate blood vessels growing in to the cornea on a patient who wears their contact lenses every waking hour. You can see the redness also around the cornea/conjunctiva margin. These blood vessels grow because of decreased oxygen getting to the cornea. The body tries to compensate by growing blood vessels.
Unfortunately increased blood vessels to the cornea result in increased risk of future immune responses (episodes of redness, pain, inflammation, swelling, light sensitivity, and decreased vision) and also indicate an increased risk for severe corneal infection. These can result in corneal ulcers where the bacteria actually eat away at the cornea. These ulcers are treated aggressively to prevent loss of the eye or loss of vision . They result in permanent scars that, if located centrally, sometimes require a corneal transplant.
I refit this patient in to a lens that breathes about 5 times more oxygen than the standard contact lens. Even so, it is recommended that patients give their eyes a rest from their contact lenses a few hours in the evening and maybe a day or two during the week when possible. LASIK is actually less risky than continuing to wear the same lens the same amount of time.
It is tempting for contact lens patients to overwear their contact lenses either to save money or because of convenience. There are many people who get away with it without insult. However, when serious problems occur, it is almost invariably in those patients who overwear their contact lenses. Either they wear them from the time they get up to the time they go to bed every day, or they sleep in them on a regular basis, or they don't replace them when they're supposed to, or they don't replace their case when they should . Rarely do these individuals have a good pair of glasses that they like.