Contact Lens Care & Compliance
Makeup and Scleral GP Lenses
BY SUSAN J. GROMACKI, OD, MS, FAAO
Much has been written about cosmetics and contact lenses (Weisbarth and Henderson, 2005; Bennett and Wagner, 2005; Sindt, 2013; Ward, 2013). Makeup can adhere to both soft and GP contact lenses, resulting in compromised vision, comfort, and ocular health. In addition, the reemergence of scleral GP contact lenses has brought new challenges regarding cosmetics and contact lenses.
Makeup Debris in the Tear Reservoir
Scleral lenses are fitted to vault the cornea, providing between 100 to 500 microns of central clearance. In addition, they rest on the conjunctiva/sclera with minimal movement and tear exchange. Unlike a small corneal lens, whose movement and size may allow under-lens debris to be flushed out with a few blinks, makeup trapped beneath a scleral lens remains there all day—or until the lens is removed, cleaned, refilled with nonpreserved solution, and reapplied. This can cause decreased vision, ocular irritation, lens deposition, discomfort, and, if the cosmetics are contaminated, microbial keratitis.
The best way to eliminate this is to instruct patients to apply makeup after applying their contact lenses (Weisbarth and Henderson, 2005; Bennett and Wagner, 2005; Sindt, 2013; Ward, 2013). Any makeup remaining on the hands can transfer to the lenses, depositing their surfaces and potentially entering their matrixes. Be sure that your patients apply eyeliner only to the outer (not the inner) eyelid margin. Educate patients about removing contact lenses prior to makeup at the end of the lens-wearing day. And, if some residual makeup remains on the eyelids or lashes, verify your patients’ proficiency with lens application so that none of those cosmetics enter the eye.
Soft or small-diameter GP lens wearers who use mascara will have an adjustment to make when switching to scleral lenses. Because scleral lenses are 2X to 5X thicker compared to their previous modality and have greater tear clearance, they protrude more, increasing the likelihood that the mascara wand touches the front surface of the contact lens (Figure 1).
Figure 1. Makeup from a mascara wand adhered to the front surface of a scleral GP contact lens.
If patients are unable to revise their mascara application technique and are adept at lens application (i.e., does not touch the lens to the lashes), then an exception may be made. That is, patients may apply their mascara (but no other types of makeup) prior to application their contact lenses.
Makeup deposits are typically too dense to be removed with a typical GP daily cleaner. Sometimes an extra-strength cleaner, such as Boston Laboratory Cleaner (Bausch + Lomb), or an alcohol-based cleaner, such as Sereine Extra-Strength Daily Cleaner (Optikem International), Walgreens Extra Strength Daily Cleaner (Optikem International), Lens Fresh (Orion Vision Group), or Sof/Pro2 Extra-Strength Daily Cleaner (Lobob Laboratories) (Gromacki, 2013) may be strong enough to remove the heavy makeup deposition. If not, a quick polishing with an in-office modification unit will clear the lens in no time. If all else fails, you can order a new contact lens for the patient.
As with all contact lens modalities, it is important that scleral lens patients wash their hands before handling their lenses and refrain from using soaps containing perfumes or lotions. CLS
For references, please visit www.clspectrum.com/references.asp and click on document #220.
Dr. Gromacki is a diplomate in the American Academy of Optometry’s Section on Cornea, Contact Lenses and Refractive Technologies and practices in Chevy Chase, Md.