Persistent redness and pain induced by focus night and daycontacts?

Discussion in 'Contact Lenses' started by Joshua Bilsky, Dec 13, 2003.

  1. Ok, I've been lurking the forum for a few weeks now, and I'm hoping that
    somebody might be able to help me here.

    I'll try to give you a bit of background. I am 23 year old male. I'm in
    good general health. I've worn contacts since I was 13, starting with daily
    wear lenses for 2 years, then switching to Surevues for about 2 years, and
    Acuvues for 5 years. I've been through three courses of Accutane
    (isotretinoin) therapy, all three 80mg/day for 5 months. My first course
    was in 1997. I had no major eye issues prior or after that first course of
    therapy. Second course of therapy was in 2000. After that therapy, my eyes
    were a bit drier so my optometrist switched me over to Proclear Compatibles.
    I was able to tolerate these lenses relatively well. My eyes were a bit dry
    but certainly not extremely dry and redness was minimal. I would experience
    a bit more dryness upon waking up in the morning. Anyway, this past May
    (2003) I started a third (which will be my last) course of Accutane.
    Everything seemed to be going well. I was still wearing my Proclears, but I
    would give my eyes a rest every so often because I know how Accutane can dry
    the eyes out. No major problems really. I went through four of the five
    months of therapy wearing the Proclear lenses. Then in September, I had my
    routine checkup with my optometrist, and he suggested that I switch to these
    new Focus Night and Day lenses because they allow more oxygen to the eye.
    He felt this would be better with my slight dry eye condition. Anyway I
    figured that he knows what's best for me so I agreed to try them and he
    fitted me with the lower base curve first, 8.4 I believe. He gave me a
    trial pair and asked me to come in for a follow up in a week.

    Next day I put these contacts in. First off they did seem to be more
    noticeable in my eye, I could feel them. Other than that feeling, they
    didn't feel too bad but not as comfortable as the Proclears. They felt like
    they had some movement in my eye though so that's probably why I seemed to
    notice them more. I went into work with the N&D's in. Later that day, a
    coworker of mine told me that my eye looked really red. I told her that my
    eyes have always been a little red. She agreed but she said they looked a
    lot more red than usual. So I went over to a mirror to check them out and
    sure enough, they were red as can be. I could just see the veins. Anyway,
    I decided to pull them out when I got home and stayed off the contacts until
    I asked him about it. The following week I went in and told him what
    happened. I asked him if this was normal. He said that a few of his
    patients had this problem with the Night and Days and that it took them a
    few days of wear to get used to them. He gave me a new trial pair just in
    case something was wrong with the old pair. I tried them for a few days but
    I still had the same redness. The following week I wore them into the
    office and showed him how red my eyes were. He took a look and told me the
    redness was due to dry eye. He gave me artificial tears and told me to try
    laying off the contacts a bit. I followed his orders and discontinued lens
    wear and started with the preservative free tear treatment. Another week
    passed and my eyes were still red. He still thought it was dry eye and
    advised me to take flax oil supplements to help with tear
    quality/production. Three more weeks went by with no improvement in the
    redness. He asked me if I wanted to try the steeper base curve 8.6 and see
    if they felt better. I agreed to try them. They didn't feel like they moved
    as much but these lenses were just as bad if not worse than the others.
    They made my eyes red and also they seemed to cause pain in my eyes. Even
    upon removal the pain would continue until it would go away. In additional
    to the scatter veins, it seemed like I could see a ring of veins where the
    edge of the contact would be. So needless to say, I wore those maybe three
    days and gave up. So now I'm here, three weeks later, and I still have this
    redness. It's not extremely red but still noticeable and definitely not the
    occasional scattered vein that I'd see in my eyes prior to the N&D use. My
    eye doc still thinks it's dry eye. I mean maybe this third round of
    Acctutane did the job on me but I don't understand how I could go through 4
    months of treatment with no major eye issues, then in the final month of
    treatment I encounter problems...and my final month of treatment
    corresponded to me starting the N&D wear. I've been off Accutane for 6
    weeks now so it should be out of my system. What concerns me is lately I've
    experienced some eye pain and occasional sensitivity to light even though I
    haven't worn the lenses in 3 weeks. The pain is not a foreign sensation
    pain, its more of a soreness, ache especially when I move my eyes.

    The bottom line is I think these Night and Days did something. I'm looking
    for some ideas before I contact him on Monday. I know I have dry eyes but
    this seems to be going beyond my dry eye condition. I never suffered this
    until I tried these lenses. I don't know if I'm allergic to the silicon or
    if the lens geometry just messed something up, but I need to get to the
    bottom of it. My eye doctor is a reasonable guy and he's treated me well.
    I've been doing a lot of work on his computers at his practice so I haven't
    paid anything for any of the recent visits. Oddly enough, I was talking to
    his secretaries and they were asking me what was going on with my eyes, and
    I told them that I was having problems since wearing the Night and Days.
    And they told me on the QT that a few patients have complained about having
    the same symptoms as me and that one had to be referred to another doctor
    because of it. Could it have been the Accutane? I suppose but I find it
    more than a coincidence that the day that I switch from Proclear to N&D, is
    when I encounter these problems. At this point, any lens is completely out
    of the question. He gave me Ocuflox on Monday just in case there was some
    infection but it hasn't done anything. I'm still taking the flax
    supplements. I've tried warm compresses just in case my glands were clogged
    but no improvement with that either. Does anybody have any advice,
    suggestions, or theories on what is going on here? Sorry for the long post.

    Thanks in advance,
    Joshua Bilsky, Dec 13, 2003
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  2. Joshua Bilsky

    Dr Judy Guest

    If the eyes remain red after stopping cl wear for three weeks, it is highly
    unlikely that the lenses caused the redness. Accutane is well known to
    cause tear film abnormality and dryness and it is not unreasonable to expect
    it to get worse the longer you use it. Wait until a month or two after
    finishing your skin treatment to try the contacts again.

    Dr Judy
    Dr Judy, Dec 14, 2003
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