Contact Lens Practice Pearls
What Is This Stuff on My Contact Lens?
By John Mark Jackson, OD, MS, FAAO
One of my students came to me recently with a contact lens problem. She noticed whitish deposits on her lenses within a few days of opening a new pair. The deposits were easy to see with the naked eye. Even her friends had noticed them while talking to her. (To be fair, her friends were also optometry students, so they had an advantage.) The deposits were interfering with her vision, too, as they often ended up over her pupil.
I looked at her lenses with the slit lamp and saw the deposit shown in Figure 1. It had a glistening appearance and didn't look like a jelly bump or other typical deposit. She removed the lens, and I tried to clean it with an extra-strength cleaner. Some of the deposit came off but not all of it.
Figure 1: Contact lens deposit, presumably from makeup.
I asked her the usual history questions: Have you changed brands of lenses? Have you changed any of your hygiene habits? Are you using new soaps or lotions? New makeup? New contact lens solution? Are you rubbing your lenses or just tossing in solution? Do you have seasonal allergies?
She was compliant with lens care (rubbing, rinsing, storing in fresh solution) and did not think she had changed any products recently. She had been wearing this brand of lens for some time before this problem occurred. I asked her to go home and double check to make sure she hadn't changed any products.
Once home, she realized she had, indeed, changed her eyeliner within the last month. She changed back to the old product, and the lens deposits went away.
Looks Can Be Deceiving
This case was interesting to me because I presume the lens deposits were from her eyeliner, but the deposits looked nothing like eyeliner. They were white, not black. Obviously, cosmetics contain a variety of chemicals, so something besides the pigment was depositing, which made me first think it was lotion or foundation. As I learned, looks can be deceiving, so make sure your patients look at all of the products they use when searching for the culprit.
Also, be sure to share these instructions with patients who wear cosmetics and contact lenses:• Apply lenses before applying cosmetics
• Avoid oil-based makeup and removers
• Close eyes tightly when using hairspray
• Replace products frequently, especially mascara and eyeliner, to avoid infection.
My student told me the name of her eyeliner, but I was unable to determine from the manufacturer's website if it was oil-based or if it was contact lens-compatible. Tyler's Quarterly devotes a page to contact lens-compatible makeup and is a great resource for the busy practice. I have consulted Tyler's countless times over the years when I suspected a patient was using an incompatible product.
As always, patient education is the key to successful contact lens wear. Be sure to let your patients know that not all products are OK to use with their contact lenses. CLS
Dr. Jackson is an associate professor at Southern College of Optometry, where he works in the Advanced Contact Lens Service, teaches courses in contact lenses and performs clinical research. You can reach him at firstname.lastname@example.org.