Eye-catching, but hardly purrrfect

By Dr Eddy Bajrovic*

You may have seen them worn in nightclubs or at parties – colourful contact lenses. Cat’s eyes, snake eyes, all-white zombie eyes… the variety is endless.
Scores of websites offer these cheap, one-size-fits-all coloured contacts.
While they may seem harmless – a bit of eye-catching fun – the sale of contact lenses without a prescription is illegal in most Australian states.
But, illegal or prescribed, using contact lens can result in serious infections – even blindness in rare cases – if they’re not inserted, cleaned, or stored correctly and hygienically.
Contact lenses are actually medical devices. Although they’re a discrete substitute for spectacles, the important difference is that they come into direct contact with your eyes.
Ask anyone who currently wears contacts (or has worn them in the past). They’ll tell you that contacts can be just as problematic as they are convenient – especially during a trip overseas.

 Cornea-copia of eye infections

Contacts increase the risk of keratitis. Keratitis can occur from prolonged wearing of contacts or when germs – bacterial, viral, parasitic, or fungal – invade the eye and inflame the cornea, the clear dome that sits over the iris (the coloured part of the eye). This is called microbial keratitis.
Early eye irritation can indicate a more serious condition, such as some form of keratitis or a corneal ulcer, an open sore in the outer layer of the cornea caused by an infection.
There are 4 main types of microbial keratitis that can cause serious damage to the eyes.
BACTERIA: Such as Staphylococcus aureus (including drug-resistant MRSA) and Pseudmonas aeruginosa, transferred from the skin or from water via contacts. Cause – Using rigid lenses to correct near sightedness, not washing lenses or cases correctly, storing or washing lenses in unsterile water, or sharing lenses. Treatment –prescription antibiotic eye drops.
PARASITES: Acanthamoeba keratitis can lead to vision loss, even blindness. It is caused by an amoeba called Acanthamoeba, a single-celled organism. While relatively rare, contact lens wear is behind the majority Acanthamoeba infections. Cause – Using tap water to wash lenses or to dilute lens solution, wearing lenses in a hot tub or spa, or eye trauma. Treatment – Prescription eye medications. Because Acanthamoeba infections are often difficult to treat, early diagnosis is important.
VIRUS: Oral herpes virus (HSV-1) can be transferred from herpes blisters or sores to the eyes. Cause – Rubbing the eye after touching a blister or sore. Treatment – Antiviral therapy (topical or oral).
FUNGUS: Fusarium keratitis, Aspergillus and Candida are among the principal fungal infections linked contact lens use. Cause – fungal infections can be caused by diluting lens solution with tap water or by eye trauma from thorns or sticks. Contact lens solutions have had to be withdrawn from sale in the past after they were found to be contaminated by a fungus. Treatment – antifungal eye drops and oral medications. People with an eye disease or a weakened immune system are at higher risk of more severe infection.

Danger signs to look for

The early tell-tale signs of possible keratitis infection are:
- Discomfort or swelling
- Red or ‘blood shot’ eyes
- Decreased, blurry, or lost vision
- Pain in or around the eyes (with the contacts in or out)
- Pain when looking at lights (light sensitivity)
- A discharge or unusually watery eyes
- Itching, burning or a grit-in-the-eye sensation
If you experience any symptoms of eye irritation or infection:
- Remove your lenses immediately and do NOT put them back in
- Contact your optometrist immediately
- Take the lenses with you – they may help to determine what caused your symptoms

Tap water is NEVER the solution

For contact lens wearers, the single biggest cause of eye infections is washing or storing lenses in tap water.
Which brings me to a golden rule of healthy travel: NEVER DRINK WATER FROM A TAP without first boiling or treating it effectively, particularly in a developing country.
But, it’s so easy to forget these rules. Countless travellers have fallen ill after putting a glass or their tooth brush under a tap without thinking twice.
It’s the reason why I’m less than enthusiastic about travellers relying solely on contacts overseas.
My advice is: Use them sparingly - if at all. Rely on your spectacles instead.
The last thing you want is to have your trip ruined because you need medical treatment in a foreign country for an otherwise completely avoidable eye infection.

Avoid contact with germs

To reduce your chances of infection when using contact lenses whilst travelling:
- Remove lenses if there is pain, redness, or irritation.
- Wash your hands well with soap and water before changing lenses.
- Clean lenses and cases well with a reputable cleaning solution.
- Never expose your contact lenses to water: tap, bottled, distilled, lake or ocean water. Never use non-sterile water (distilled water, tap water or homemade saline solution).
- Do not top up cleaning solution with tap water.
- Avoid showering, swimming, or using a hot tub with contacts without first talking to your optometrist.
- Do not wear lenses overnight unless prescribed.
- Do not share lenses.
- Speak to your optometrist about tips for wearing contact lenses on long haul flights. The air in the plane cabin is dry and can cause irritation. Always carry a pair of prescription spectacles to wear if needed.
- Follow up with an eye doctor regularly and if there is a problem.
And, finally, don’t mess with coloured contacts. Your eyes are perfect just as they are.

* Dr Bajrovic is the Medical Director of Travelvax Australia.

Get more expert advice for a healthy holiday by calling Travelvax Australia’s free travel health advisory service on 1300 360 164. You can also book a pre-departure medical consultation and obtain vaccines and travel medications at a Travelvax clinic near you. Find out more online and follow us on Facebook.