prescribing for presbyopia
Traveling With Contact Lenses
BY TIMOTHY B. EDRINGTON, OD, MS, FAAO, & JULIE A. SCHORNACK, OD, MED, FAAO
For some patients, the onset of presbyopia comes at a time of increased discretionary disposable income and frequent journeys to domestic and exotic locales. Keep in mind that traveling brings its own set of considerations with regard to contact lens wear.
Advise patients traveling abroad to pack their spectacles, sunglasses and additional contact lenses and lens care solutions. If departing by air from the United States, patients can currently carry only up to 3-ounce containers of solutions on board the airplane. These sizes would need to be enclosed in see-through plastic bags. Patients must pack larger bottles of solution and additional bottles in their checked luggage. Keep in mind that the availability of lens care products varies from country to country.
Copies of current spectacle and contact lens prescriptions are beneficial, especially if an extended stay is planned. You can also access the American Academy of Optometry's Web site at www.aao.org and search by country under Fellows to recommend an eyecare practitioner in the area to provide emergency eye care.
Up in the Air
Many contact lens wearers experience discomfort and increased lens dryness during flights. This results from forced air and low humidity on commercial aircraft. Symptoms tend to be more prevalent for presbyopic patients.
If symptoms are mild or the flight is short, rewetting drops will probably help reduce the symptoms. For flights longer than two hours, we recommend that patients consider wearing their updated spectacles for the most comfortable in-flight experience.
At the Destination
Consider prescribing daily disposable lenses for traveling as an adjunct to regular lens wear. Daily disposables are now available in sphere, toric and multifocal designs. We should never under-estimate the value that patients place on this type of convenience.
For destinations that include water activities, educate patients regarding the safety of contact lens wear. We don't recommend lens wear during water activities because of the possibility of eye injuries or infections such as Acanthamoeba keratitis. But if patients insist on wearing lenses, consider daily disposables.
If daily disposables aren't a viable option due to prescription restrictions, instruct patients about fastidious lens care and disinfection routines as well as lens removal following water activities. We recommend rubbing the lens for optimal disinfection activity.
Educate patients as to when they may resume lens wear after water activities. Instruct them to not wear the lenses until disinfection is complete and to not sleep in their lenses that evening. Ideally, patients would not wear contact lenses for the remainder of the day. If that's not feasible, they could wear a different pair of new or disinfected lenses. Educate patients about warning signs and symptoms of corneal infection.
Advise all contact lens patients to have a pair of quality sunglasses to protect them from ultraviolet insult. Discuss the value of polarized lenses outdoors and especially on and in the water. Advise contact lens patients to keep sunscreen away from their eyes. Contamination of lenses with sunscreen could spoil the lenses and is also uncomfortable and may cause redness and superficial corneal staining. The waterproof elements in some sunscreens can wreak havoc on comfort and vision with contact lenses.
Travel and contact lenses can co-exist with just a little planning and adequate supplies. Make sure patients are well equipped and educated as they travel so that no lens-related issue spoils a much anticipated vacation. CLS
Dr. Edrington is a professor at the Southern California College of Optometry. E-mail him at firstname.lastname@example.org. Dr. Schornack is the associate dean of Clinical Education and serves in the Cornea and Contact Lens Service at the Southern California College of Optometry.