will acuvvue oasys or advance 2 be okay for swimming?

Discussion in 'Optometry Archives' started by Spockie Hendrick, May 18, 2006.

  1. will acuvvue oasys or advance 2 be okay for swimming?


    i would like some contacts for swimming in the ocean
     
    Spockie Hendrick, May 18, 2006
    #1
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  2. Salt water shrinks all soft contacts. Soft lenses are between 1/3 and
    2/3 water, and that water content is needed for the lens to hold its
    shape. Our "normal" tears are like normal saline, and have a little
    bit of salt in them. When we cry an emotional tear, the salt content
    is much higher. This is why soft contacts hurt more and misbehave when
    you have been crying over the loss of a loved one, etc. Also, there is
    an infection risk. Ocean water grows many microbes, plus your lenses
    will stick like glue to your corneas.

    Buy a really airtight goggle if you swim in soft contacts, and throw
    them away after each swim. If you are nearsighted and don't have a lot
    of astigmatism there are ready-made swim goggles with minus lenses in
    them from -1.00 to -6.00. They retail for about 35 bucks and they are
    worth every penny!
     
    doctor_my_eye, May 18, 2006
    #2
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  3. doctor_my_eye, May 18, 2006
    #3
  4. Spockie Hendrick

    LarryDoc Guest

    IMHO, silicone lenses provide a certain degree of safety for those who
    swim with lenses on the eye. They tend to not dehydrate in hypertonic
    saline ocean water as much as other materials and therefore less likely
    to adhere to the cornea. They are also less likely to harbor
    pathogens--bacteria and viruses that are found (sadly at intolerable
    levels in some places) in ocean water.

    Lenses that have been exposed to ocean and even swimming pool water
    should not *ever* *ever* be slept in without prior cleaning and
    disinfection. For extra safety, remove lenses following swimming and
    disinfect them prior to re-use. For even better safety, use daily
    disposable lenses and toss them (not in the ocean) after your swim.

    The "official" rule is: do not swim with contact on. The safest route is
    to use prescription swim goggles. But if you must, follow the guidelines
    above.

    LB, O.D.
     
    LarryDoc, May 18, 2006
    #4
  5. Really? I always thought the major lacrimals secreted a lower salinity
    than that of the normal precorneal film.
    Where does all that salt come from? If it's stored up in the lacrimal
    gland, it must deplete with continued crying, no?
    I thought it was because of just the opposite, more dilute salinity in
    the cry tears causing the cornea and contacts to take on too much fluid
    and swell.

    Infection risk in the ocean is pretty low. The high salinity there is
    strongly anti-microbial.
    Like glue? I would think low water lenses (like modern silicone based
    ones) are less prone to osmotic dehydration, and unless swimming under
    the surface with eyes open, not a big factor.
    I don't think so, unless you happen to swim into a plume of recently
    released marine mammal excrement.

    w.stacy, o.d.
     
    William Stacy, May 18, 2006
    #5
  6. Spockie Hendrick

    Dr. Leukoma Guest

    Studies show that acanthamoeba has a prediliction for attachment to
    silicone-hydrogel lenses. What this means in terms of infection is not
    clear at this time. However, I would not want to be wearing a lens
    that had attracted thousands of little amoebic organisms from swimming.

    DrG
     
    Dr. Leukoma, May 18, 2006
    #6
  7. Spockie Hendrick

    Neil Brooks Guest

    Bill Stacy replied:
    Candidly ... not so much since Otis reduced his posting frequeny here
    ;-)
     
    Neil Brooks, May 18, 2006
    #7
  8. Spockie Hendrick

    Neil Brooks Guest

    Mmmmm. Data.

    http://www.ncbi.nlm.nih.gov/entrez/...ve&db=PubMed&list_uids=16360208&dopt=Abstract

    OR: http://tinyurl.com/p5mvj

    Attachment of Acanthamoeba to first- and second-generation silicone
    hydrogel contact lenses.

    Beattie TK, Tomlinson A, McFadyen AK.

    Department of Vision Sciences, Glasgow Caledonian University, Glasgow,
    Scotland, United Kingdom.

    PURPOSE: To investigate the attachment of Acanthamoeba to first- and
    second-generation silicone hydrogel contact lenses, and to determine
    if patient wear or the presence of a bacterial biofilm coating affects
    attachment characteristics. DESIGN: Experimental study. PARTICIPANTS
    AND CONTROLS: Attachment to the silicone hydrogel lenses was compared
    with that to a conventional hydrogel control lens. Sixteen replicates
    (n = 16) were carried out for unworn, worn, and biofilm-coated lenses
    of each type. METHODS: Unworn, worn, and Pseudomonas aeruginosa
    biofilm-coated first-generation (lotrafilcon A) and second-generation
    (galyfilcon A) silicone hydrogel and conventional hydrogel (etafilcon
    A) lens quarters were incubated for 90 minutes in suspensions of
    plate-cultured Acanthamoeba castellanii trophozoites. MAIN OUTCOME
    MEASURES: Trophozoites attached to one surface of each lens quarter
    were counted by direct light microscopy. Logarithmic transformation of
    data allowed the use of parametric analysis of variance for
    statistical analysis. RESULTS: Attachment of Acanthamoeba was affected
    significantly by lens material type (P<0.001), with higher numbers of
    trophozoites attaching to the first-generation lotrafilcon A silicone
    hydrogel lens, compared with the second-generation galyfilcon A lens
    and the conventional hydrogel lens. Attachments to the latter 2 lenses
    did not differ significantly from each other (P = 0.126). Patient wear
    and the presence of a bacterial biofilm had no significant effect on
    attachment to the lotrafilcon A lens (P = 0.426) but did significantly
    increase attachment to the galyfilcon A (P<0.001) and the etafilcon A
    (P = 0.009) lenses; attachment to the latter 2 lenses was still
    significantly less than that found with the first-generation silicone
    hydrogel (P<0.001). CONCLUSIONS: Acanthamoeba demonstrated a
    significantly greater affinity for the first-generation silicone
    hydrogel lens as compared with the second-generation silicone hydrogel
    and the conventional hydrogel. If exposed to Acanthamoeba (e.g., when
    showering or swimming, through noncontinuous wear and ineffective lens
    care regimes), first-generation silicone hydrogel lenses may promote a
    greater risk of Acanthamoeba infection due to the enhanced attachment
    characteristics of this lens material. However, prospective studies in
    patients are required to determine if these experimental results are
    clinically significant.
     
    Neil Brooks, May 18, 2006
    #8
  9. Spockie Hendrick

    retinula Guest

    nice find on the abstract Neil! new information for me!

    wouldn't one expect that overnight hydrogen peroxide treatment (e.g.
    ClearCare) might appropriatedly disinfect SiHy lenses that were worn
    for swimming? i usually recommend that but i admittedly haven't seen
    any proof that it actually works (for bacteria, acanthamoeba, and other
    organisms). anyone know or have an opinion?

    ==========
     
    retinula, May 18, 2006
    #9
  10. Spockie Hendrick

    Dr. Leukoma Guest

    Actually, I'm glad you asked. Some 15 or so years ago, during THE
    acanthamoeba scare, I remember receiving an advisory from the
    University of Texas Southwestern Medical Center about appropriate lens
    disinfection. The advisory recommended a minimum 6 hour soak in 3%
    hydrogen peroxide to kill the acanthamoeba trophozoa and spores.
    Unfortunately, with commercially available hydrogen peroxide systems,
    the concentration begins to drop immediately as soon as the peroxide
    comes into contact with the catalyst.

    However, the Optifree solution with Aldox also kills acanthamoeba
    spores following a 6 hour exposure.

    DrG
     
    Dr. Leukoma, May 18, 2006
    #10
  11. Spockie Hendrick

    CatmanX Guest

    The better option would be to buy a set of dailies and use them. Once
    you get to waist depth, squint your eyes a bit and splash some water on
    the lenses. This will tighten them and stop them from coming off.

    I have a few ocean swimmers and triathletes as patients and this is the
    procedure we use. Discard the lenses after swimming.\

    dr grant
     
    CatmanX, May 18, 2006
    #11
  12. Spockie Hendrick

    Neil Brooks Guest

    After the Renu MoistureLoc thing, I got smart/silly/scared/wise and
    bought the PuriLens system (no financial interest, blah, blah, blah).
    The few studies I saw seemed to indicate pretty good efficacy against
    most of the creepy-crawlies ... except ... of course ...
    acanthamoeiba.

    Not sure I really plan to be *that* careful or *that* meticulous, BUT
    .... if I did swim in the ocean, I would likely use a "standard"
    chemical method in addition.

    So far, the PuriLens seems to do a heck of a job taking my potential
    exhaustion/laziness out of the equation and maintaining at least a
    high (if not ultimate) level of cleanliness and sterility.

    The whole "15 minutes" thing, too ... neat.

    Kind of wonder, by the way, whether a *second* 15-minute cycle would
    be any more effective against acanthamoeba than just one go.....

    http://www.ncbi.nlm.nih.gov/entrez/...uids=14722469&query_hl=13&itool=pubmed_docsum

    OR: http://tinyurl.com/ord42

    Disinfection capacity of PuriLens contact lens cleaning unit against
    Acanthamoeba.

    Hwang TS, Hyon JY, Song JK, Reviglio VE, Spahr HT, O'Brien TP.

    Ocular Microbiology and Immunology Laboratory, The Wilmer Eye
    Institute, Johns Hopkins University School of Medicine, 600 North
    Wolfe Street, Woods 259, Baltimore, MD 21287-9121, USA.

    PURPOSE: The PuriLens contact lens system is indicated for cleaning
    and disinfection of soft (hydrophilic) contact lenses by means of
    subsonic agitation to remove lens deposits and microorganisms, and
    ultraviolet irradiation of the storage solution for disinfection. The
    capacity of the PuriLens system to disinfect storage solutions
    contaminated with known concentrations of Staphylococcus aureus,
    Pseudomonas aeruginosa, and Acanthamoeba species was evaluated.
    METHODS: An in vitro assessment of the antibacterial and antiparasitic
    efficacy of the PuriLens system was performed. Separated batches of
    the storage solution for the cleansing system were contaminated with
    stock strains of S. aureus and P. aeruginosa. A comparison of the
    microbiologic content was made between the solution before and after
    the cycle. RESULTS: The PuriLens system effectively eradicated S.
    aureus and P. aeruginosa organisms after a 15-minute cycle. However,
    viable cysts of acanthamoeba were recovered in the solution after the
    15-minute cycle. CONCLUSIONS: The PuriLens system is highly efficient
    in protecting against contamination with common bacterial ocular
    pathogens. Acanthamoeba cysts, however, can survive in the solution or
    contact lens bath undergoing integrated subsonic debridement and
    indirect ultraviolet light disinfection. Use of chemical disinfecting
    solutions that contain agents such as chlorhexidine or other cationic
    antiseptics may be advisable in conjunction with use of the PuriLens
    device, especially in high-risk settings.

    http://www.ncbi.nlm.nih.gov/entrez/...uids=10946984&query_hl=13&itool=pubmed_docsum

    OR: http://tinyurl.com/p82fk

    Evaluation of the PuriLens contact lens care system: an automatic care
    system incorporating UV disinfection and hydrodynamic shear cleaning.

    Choate W, Fontana F, Potter J, Schachet J, Shaw R, Soulsby M, White E.

    Department of Physiology and Biophysics, University of Arkansas for
    Medical Sciences, Little Rock 72205, USA.

    PURPOSE: This study evaluates lens care using the PuriLens System, an
    advanced way to clean and disinfect soft hydrophilic lenses using
    subsonic agitation and UV radiation, respectively. METHODS: A
    two-period crossover lens cleaning and safety investigation was
    conducted using 80 patients. Disinfecting efficacy was tested in
    accordance with standard FDA protocols. Lens compatibility was studied
    with Group I and Group IV lenses during the equivalent of a 6-month
    care regimen by measuring: lens power, base curve, wet diameter,
    refractive index, clarity, and tint. Safety was evaluated through
    slit-lamp findings, wearing time, comfort, and visual acuity. RESULTS:
    The mean wearing time of patients in the study was 13.79 hours. No
    slit lamp findings greater than grade 2 were noted. Visual acuity was
    20/25 or better in 92.5% of examinations. None of the patients lost
    more than two lines of acuity. Lens surface evaluation showed no
    deposits (grade 0) to very slight deposits (grade 1) in 94.4% of
    examinations. Lenses cleaned with the PuriLens System were cleaner by
    a statistically significant margin (P=0.02) compared to lenses
    digitally cleaned with a leading multi-purpose solution (ReNu, Bausch
    & Lomb). Overall, neither the Group I nor Group IV lenses were
    affected after 180 cleaning cycles. CONCLUSIONS: The PuriLens System
    provides automatic lens care compliance, superior antimicrobial
    efficacy, and eliminates the need for daily digital cleaning.
     
    Neil Brooks, May 18, 2006
    #12
  13. Spockie Hendrick

    Dr. Leukoma Guest


    True, but I saw four cases in a 6 month period two years ago.
    You should speak to the mother who emailed me today about her
    daughter's experience with acanthamoeba keratitis and 3 subsequent
    corneal transplants. I'm pretty sure how she would answer your
    question.

    DrG
     
    Dr. Leukoma, May 23, 2006
    #13
  14. Spockie Hendrick

    Dr. Leukoma Guest

    I think you are in need of updating your numbers, which reflect the
    annual incidence in the overall population. Contact lens wearer is one
    of the chief risk factors for this disease. The updated incidence is 1
    in 30,000 soft contact lens wearers per year.

    Then, you should be telling them that their risk of contracting the
    disease is 1 in 30,000 per year, which will go up significantly if they
    swim in their lenses, rinse them with non-sterile solution, or fail to
    disinfect them properly.

    Cancer may not be preventable, but acanthamoeba keratitis is highly
    preventable if patients avoid the major risk factors, which include
    swimming in their contact lenses (34%), and failure to disinfect their
    lenses (62%).

    DrG
    http://www.copfameye.com
     
    Dr. Leukoma, May 23, 2006
    #14
  15. Spockie Hendrick

    Dr. Leukoma Guest

    I agree, except that we don't really know what the risk is for people
    who routinely swim in their lenses. It could be 1 in 500.

    Overall, contact lens wear is the least risky form of vision correction
    other than wearing spectacles.

    DrG
     
    Dr. Leukoma, May 23, 2006
    #15
  16. I think it would make a huge difference WHERE they are swimming. To me,
    swimming in the ocean is very safe for your eyes (only) due to the
    antimicrobial effect of strong saline, more risky in private swimming
    pools, riskier yet in public pools, very risky in hot tubs, and
    extremely risky in freshwater ponds.

    w.stacy, o.d.
     
    William Stacy, May 23, 2006
    #16
  17. Spockie Hendrick

    Dr. Leukoma Guest

    I'm not aware of any studies that would either support or contradict
    your view. I know that one study of acanthamoeba claimed that the risk
    was greater if the water was soft rather than hard. Then someone came
    along and debunked that idea. If acanthamoeba didn't like salt water,
    then they wouldn't inhabit the salty environment of contact lens
    solutions.

    I think that the risks need to be clearly spelled out, and that
    patients who insist on swimming in contact lenses avail themselves of
    daily disposables so that the lenses can be thrown away. There is also
    the role of hypoxia and corneal integrity, and extended wear may also
    enter the mix as a risk factor. You can only go so far to warn people.

    DrG
     
    Dr. Leukoma, May 23, 2006
    #17
  18. I doubt a study is needed on the disinfecting properties of strong
    saline the sea as compared to the exceedingly weak salines of tears
    and/or ophthalmic solutions, or even saline swimming pools (which are
    also of the "normal" saline variety). Certainly if it were not the case,
    the oceans would be teeming with all kinds of bacteria, which they are
    not. Normal saline is under 1%, sea water is at least 3.5% salt.

    Here's a quote from:

    http://141.150.157.117:8080/prokPUB/chaphtm/004/04_04.htm

    "High salt concentrations represent a special case of low water
    activity. Sea water (aw = 0.98) is not tolerated by the majority of
    bacteria living in soil and in fresh water. Ecosystems containing salt
    (sodium chloride) at saturating concentrations are inhabited by only a
    few organisms."

    w.stacy, o.d.
     
    William Stacy, May 23, 2006
    #18
  19. Spockie Hendrick

    Dr. Leukoma Guest

    I am talking about acanthamoeba, not bacteria. Just Google on the
    search terms of acanthamoeba and salt water and see how many hits you
    get. Quite a few (I didn't count).

    DrG
     
    Dr. Leukoma, May 24, 2006
    #19
  20. Of course they grow very well in NORMAL saline, and the tons of articles
    are mostly about normal saline, not brine. I'm sure they can survive up
    to a certain amount of salinity, but I'm just betting they don't do well
    in the open ocean.

    w.stacy, o.d.
     
    William Stacy, May 24, 2006
    #20
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