Contact Lens Care & Compliance
Spring Has Sprung, and So Have the Allergies
BY MICHAEL A. WARD, MMSC, FAAO
It is 71° in February in Atlanta, and we are enjoying a very welcome change from our unusually cold winter and notorious ice storms. Although still technically winter, spring’s annual renewal is approaching with its wondrous scents, warmth, and pollen-laden air as exemplified by my sniffles and itchy eyes. So, it is time for my annual column on how to help contact lens wearers cope with seasonal allergies.
Trees contribute the majority of the pollens in spring, with flowers, grasses, weeds, and molds following into the fall. Of all allergy sufferers in the United States, approximately 75% are allergic to ragweed, 50% are allergic to grasses, and 10% are allergic to trees. Approximately one in four people who have allergic rhinitis also have asthma. Pollen grains come in a wide variety of shapes and sizes, and they can land on our clothes, skin, and hair as well as in our eyes and lungs, where pollens may initiate a rhinitis, conjunctivitis, or bronchitis (Medicinenet.com).
Following is some general advice (Ward, 2013). You should not wear shoes indoors. Keep auto and house windows closed; high-efficiency (HEPA) air filters and electrostatic air purifiers can remove approximately 99% of allergens in central air conditioning systems (www.air-purifiers-america.com). Replace air filters regularly and more often when pollen counts are high.
Wear a mask if working outdoors during high-pollen conditions. Shower immediately after outdoor exposure to remove pollens from clothes, hair, and skin. Cold compresses can help relieve ocular itching. Wear goggles or close-fitting sunglasses when outside during high pollen counts.
Keep room humidity below 50 percent to inhibit mold growth. Molds (multiple types of fungi that grow in filaments and reproduce by forming spores), dust mites, and animal dander can cause allergic reactions.
Contact Lens Care
To start, shorten the replacement interval for soft contact lenses. Single-use lenses are preferred, which allow wearers to throw away the contact lenses—along with the allergens—every day. Reusable lens wearers should consider the following:
• Instruct patients to rub and thoroughly rinse their lenses upon removal (don’t wait until the next day) to decrease the accumulation of debris and contaminants on lens surfaces and in the storage case.
• Change to preservative-free peroxide disinfection systems such as Clear Care (Alcon) or PeroxiClear (Bausch + Lomb) if multipurpose solution sensitivity is suspected.
• Frequent use of low-viscosity, preservative-free artificial tears such as Refresh Plus (Allergan), Blink (Abbott Medical Optics), Systane (Alcon), or TheraTears (Advanced Vision Research) help to dilute and rinse out irritants.
• Any ocular medication dosing should be before and/or after contact lens wear.
Corneal GP lens wearers face additional challenges during high- pollen seasons. Pollen becomes a physical as well as an immunologic irritant. Besides avoidance and wearing goggles, placing a high-oxygen silicone hydrogel daily wear lens under the GP in a tandem/piggyback fashion can considerably limit the “gotcha” foreign body episodes—but instruct patients to not allow GP lens care products to contact soft lenses. A great option for those needing GP lenses is a scleral GP, which creates a barrier from environmental contamination. CLS
For references, please visit www.clspectrum.com/references.asp and click on document #221.
Mr. Ward is an instructor in ophthalmology at Emory University School of Medicine and Director, Emory Contact Lens Service. He is also a consultant or advisor to Alcon and B+L. You can reach him at firstname.lastname@example.org.