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You may have heard recently in the news about a very bad infection related to soft contact lenses. The infection is from a fungus called Fusarium and it has drawn a fair amount of media attention. I would like to clarify some of the information surrounding this situation. Although this type of infection is a very serious one and has received a great deal of attention that is certainly appropriate, the number of cases have been rather small. Out of the more than 30 million contact lens wearers, there have only been a little more than 100 cases reported. Due to the serious nature of the infection however, the Center for Disease Control (CDC) has been investigating its epidemiology. Bausch and Lomb's Renu with MoistureLoc soft lens solution has been implicated in a disproportionate number of these cases. Bausch and Lomb, while conducting their own investigation, took the initiative in the interest of patient safety, to remove this product from the market. At the conclusion of the investigations, it was shown that even though Renu with MoistureLoc is effective at killing Fusarium, if certain poor contact lens care regimens were followed, this particular solution's disinfection properties could be rendered ineffective against Fusarium. Bausch and Lomb has permanently removed this particular product but continues to manufacture other Renu products which have not been implicated with this problem. I believe that this situation underscores the importance of proper lens care by the patient to ensure healthy contact lens wear. I would like to review the proper contact lens care regimen that all soft contact lens wearers should follow so that the chances of compromising ocular health are minimized.
Follow these recommendations and continue to be a safe and happy contact lens wearer.
Dr. Maller
One of the problems that can arise out of Lasik is a complication referred to as Diffuse Lamellar Keratitis (DLK). This can be a very serious complication and does require immediate topical steroid treatment. In a recent case that was reported, a 26 year old man developed DLK in both eyes following his Lasik procedure. After a period of approximately 6 weeks of the topical steroid treatment it was noticed at the 6 month follow up visit that there was a significant hyperopic (far-sighted) shift in one of his eyes. A significant hyperopic shift may be associated with DLK after Lasik.
Smoking obviously has many negative effects on the body and according to a recent study one more additional negative impacting factor can be added to this list. The ocular surface has a structure know as the "tear layer," which is actually made up of a complex mixture of fluids and molecules. One of the fluid layers that make up our tears is a layer know as the Lipid Layer. Smoking has been shown to have deteriorating effects on the Lipid Layer of the tear film of the eye. Among the implications of this are the possibilities of the individual to suffer with Dry Eye Syndrome. The symptoms of Dry Eye Syndrome can range from mildy annoying to significant discomfort.
A recent article reported on data from the National Ambulatory Medical Care Survey, the National Hospital Ambulatory Medical Care Survey and the National Hospital Discharge Survey on the trends in eye injury in the United States between 1992 and 2001. The rates of injury were broken down by age, gender and race. The overall rate of eye injury is 8.2 to 13.0 per 1000 people. The highest risk category is men and those aged 39 and younger. There was also an overall decrease in the incidence in eye injury to all groups during this study period. Remember to wear safety glasses/goggles when appropriate.
Thyroid dysfunction has long been associated with the eye in the form of Thyroid Eye Disease but little has been done to investigate the link of Thyroid Eye Disease and its effect on refractive changes. In a recent study, the connection between Thyroid Eye Disease and refractive error has been demonstrated. There is a hyperopic shift (far-sightedness) associated with Thyroid Eye Disease which seems to be associated with the increase in orbital contents resulting from the disease. After orbital decompression surgery there is an induced myopic shift (near-sightedness). This information is important because clinically a hyperopic shift in someone with Thyroid dysfunction could indicate the increase in orbital contents and the implication of Thyroid Eye Disease.
The Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study looked at seven years of data of nearly 1000 Keratoconus subjects. Among information obtained from this study was the effect of Keratoconus on visual acuity over time. The results showed a slow but steady decrease of best corrected visual acuity (BCVA) which mirrors the progressive nature of the condition. Low contrast acuity decreased more rapidly than high contrast acuity. This means that although a Keratoconus patient can read the high contrast acuity chart in the office year after year, they could be having progressive more significant vision problems in the "real world" lower contrast situations.
Sometimes while on the web, I will come across some item that is just fun. I have incorporated this into the website because everyone should have a little fun occasionally. I have decided to put at least one "fun" thing into each newsletter. I hope that you enjoy it. This particular item is called Click Drag Type 2. There are 10 puzzles, each of which can be selected in any order. The timer continues to run while you are playing but stops when you are on the main selection screen. There are no instructions - you'll see what I mean. :-) Good Luck! You can find this puzzle at Click Drag Type 2.
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A Message From Dr. Maller
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