Infected eyes

[Dolphin]

Hi All,

I wear scleral lenses and for the past few months I have been experiencing times when my eyes become very gunky when I wear my lenses and very sticky when I wake up in the morning. Because these symptoms are similar to conjunctivitis I often go to my GP who gives me some drops. I am now not sure if my eyes are infected when this happens as it is happening quit a lot. I am now thinking/wondering if these symptoms are a side effect from wearing sclerals rather than it being an infection.

What I would like to know is if there is anyone else who wears scleral lenses that gets these type of symptoms, or do you think I am getting infected eyes. If I am constantly getting infected eyes then is it ok to keep using the drops?

I know that it's not ideal to ask or expect to get medical advise from this site, it's just that my GP does not understand my condition and I just think I panic when I get these symptoms as it means not wearing my lenses for 7 days.

Any advice would be great.

Dolphin.

[rosemary johnson]

Hallo Dolphin,
SOrry to hear of the problems you've been having.
It is possible that the symptoms are not infections. If so, then keeping using antibiotic eye drops is doing nothing to help and only helping to spread the rise of antibiotic resistance amongst the bacteria population, which is not a good idea.
It is also possible you are having continuous eye infections. I can't see your eyes and certianly haven't done labs tests.
The best thing to do is to do back to the person who fitted your contact lenses and describe the situation to him or her.
I certainly have had the type of symptoms you describe - though not in the last few years to the extent you are getting them.
I got a lot of gunky eyes in previous years (when I was still using PMMA - Perspex - scleral lenses). Not so much recently - may be partly at least due to change to sclerals mad eof RGP polymers.
Hay fever season was prime culprit - not in your case if this has been oging on over winter! Anything else you're allergic to?
I've also experienced GPs who don't know much about eyes, see a red sore eye and say "conjunctivitis" and prescribe antibiotic drops, even when it isn't.
In fact, I once met and had some interesting conversations with a group of yong doctors, via a med school contemporary of their who'd become a friend of mine while oing postgrad research.
One of them exclamed in shock at my haivng KC; he said he didn't believe people weally got KC, it had just been invented to torture medical students!!! - enlightened him on that.
What came out was that eyes are so specialised that most doctors don't like to get too near them - "If it's red and sore it's conjunctivitis; if it isn't conjunctivitis, send them to Moorfields" was, they reckoned, the rule of thumb of most GPs about eyes. (These were all London-based, I should explain.)
I digress....
Could be several reasons for the gunk - but either the lens fitter, or if necessary your ophthalmologist (hospital eye doctor) would have a better idea what is exactly the problem.
It could be problems withthe fit making the lens rub, inadequate tears, allergy to something.
Don't rely on these; see your fitter - but: are you keeping them scrupulously clean? have you changed solutions recently? have you changed diet? have you changed working environment?
Hope you get it sorted - do keep us posted.
Rosemary

[GarethB]

A few years back I used to get a clear jelly like substance build up in my eyes which I thought might be early conjunctivitis but later found this was part to do with dry eyes. The lipid component of the tears couldn't flow properly ni the watery component because a surfactant in the tears that help the other two components work together was missing to some extent. Since using lubricating eye drops I rarley get this jelly like material build up.

If it is an infection one way (not ideal) is to go without lenses while you use the antibiotic drops and regularly clean the sclerals in the cleaner and leave to saok to sterilise them. Once the infection has cleared, go back to sclerals. If it is an infection and the antibiotics have worked and the lenses have been cleansed the infection should not return if you follow good hygiene.

Should the problem reoccure it might be a side effect of the scleral wear such as dry eyes. Your opthalmologist and lens fitter might be better placed to comment rather than a GP.

[Dolphin]

Thanks for the advice

I have spoken to my specialist about it before and not much is said about it. I will try again next time I go for my appointment.

Gareth, can I ask how you would soak and disinfect scleral lenses as I have always been told that you clean them an store them dry (I use MiraFlow for cleaning and thats it). I have often wondered why sclerals don't need disinfecting and soaking and other lenses do. If I were to start disinfecting them where would I get a case that is big enough to do so?

Apart from not disinfecting them, I am, most of the time very good with my cleaning regime.

Dolphin

[dazzabee]

Hi Dolphin

I too wear Sclerlal lenses, albeit only for three months so nowhere near as long as some so I am a bit inexperienced when it comes to them. However, having worn a hard corneal RGP lens for many years prior to Sclerals I did have the problems you mention.

In my case I was told it was not an infection, just overwearing the lens. I continued to wear the lens for too long instead of taking it at the first stage of it telling me "I have had enough, get me out". I would definitely speak to you optometrist and check for any additional scarring to you cornea. It could also be hayfever or anyother allergy causing your problems. I would try and leave the lens out, if possible, and make an earlier appointment to find out more.

As for the cleaning of sclerals, I too use Miraflow to clean the lens and wash the access liquid off under a downstairs kitchen tap before drying with a soft tissue and storing dry. When I next put the lens in I clean again with Miraflow before rinsing off with Saline before insertion again with Saline.

Good luck and let me know how you get on.

Jay

[GarethB]

Sorry Dolphin, can't help on the soaking front, it was just a sugestion.

As far as I am aware most scleral lenses are made from a similar RGP material to the contact lenses and those you dissinfect in the conditioning solution which for RGP also dissinfects the lenses too. I wasn't sure if the case for a scleral lens could be filled with this solution to dissinfect the scleral.

[Andrew MacLean]

I as told to store my scleral dry, and to clean it well before insertion with a disinfectant/cleaning fluid (I used 'Total'). the lens does not really need to be 'soaked' like one of those thinner lenses.

Before insertion, I'd then rinse well with sterile saline, and fill the lens with more saline before putting my eye into it.

Andrew

[GarethB]

I know a few people who store their corneal RGP lenses like you guys do with sclerals beacue they are alergic to the lens solutions.

As there might be the posibility of infection it may be a case the scleral lens in this case needs soaking for a more thorough disinfection to take place.

Ideally this needs discussing with the optom or even ophthalmologist.

[rosemary johnson]

Scleral lens cases are generally made with the intention you dry the lens and store it dry, so aren't made to be filled with solutionand aren't watertight.
If you want to soak them overnight, use something like a wine/sherry/whisky glass, or an eggcup - and make sure your family know what it's there for!
I was advised to soak mine periodically, many years ago when I first got the things.
Haven't done so for years.
Long ago changed to washing them well in washing up liquid, which seems to do the trick admirably - and is apparenlty what the people at the company who make my sclerals do to clean the ones at their place. As with all cleaners, the key point is you must rinse of the cleaning stuff thoroughly.
Rosemary

[Dolphin]

Thanks all for your great advice,

I have not worn my lenses now for a week and have finished my course of antibiotic eye drops as advised by my GP. They are no longer sticky but are still very dry, and sting all the time. I went back to my GP yesterday and was told I have a severe cas of dry eye. I was given celluvisc to use with my lenses and a gell to use when i'm not.

However before i started using them i got a feeling in one of my eyes that i have something in it and now it is very uncomfortable to blink. Is this another symptom of having dry eyes or should i go to my very unsympathetic local eye hospital who always make me feel like i'm wasting there time, to have it checked out?

I can't go to where i see a specialist as i live to far away.

I am so fed up with al these side effects, it's bad enough having to deal with the KC. I am due to qualify as a nurse in 3 wks and soon start my new job. The last thing i need is to keep having more time off. Not the best way to start a new job.

Sorry about the moan

Dolphin