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Spockie
medicine forum addict
Joined: 24 Dec 2005
Posts: 50
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 Posted: Thu May 18, 2006 11:17 am Post subject:
will acuvvue oasys or advance 2 be okay for swimming?
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will acuvvue oasys or advance 2 be okay for swimming?
i would like some contacts for swimming in the ocean |
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doctor_my_eye@msn.com
medicine forum Guru Wannabe
Joined: 24 May 2005
Posts: 150
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| Posted: Thu May 18, 2006 1:11 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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Salt water shrinks all soft contacts. Soft lenses are between 1/3 and
2/3 water, and that water content is needed for the lens to hold its
shape. Our "normal" tears are like normal saline, and have a little
bit of salt in them. When we cry an emotional tear, the salt content
is much higher. This is why soft contacts hurt more and misbehave when
you have been crying over the loss of a loved one, etc. Also, there is
an infection risk. Ocean water grows many microbes, plus your lenses
will stick like glue to your corneas.
Buy a really airtight goggle if you swim in soft contacts, and throw
them away after each swim. If you are nearsighted and don't have a lot
of astigmatism there are ready-made swim goggles with minus lenses in
them from -1.00 to -6.00. They retail for about 35 bucks and they are
worth every penny! |
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doctor_my_eye@msn.com
medicine forum Guru Wannabe
Joined: 24 May 2005
Posts: 150
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LarryDoc
medicine forum Guru Wannabe
Joined: 29 Apr 2005
Posts: 262
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| Posted: Thu May 18, 2006 5:14 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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In article <Xns97C72BADF2F67spockieverizonnet@199.45.49.11>,
Spockie Hendrick <spockie@verizon.net> wrote:
| Quote: | will acuvvue oasys or advance 2 be okay for swimming?
i would like some contacts for swimming in the ocean
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IMHO, silicone lenses provide a certain degree of safety for those who
swim with lenses on the eye. They tend to not dehydrate in hypertonic
saline ocean water as much as other materials and therefore less likely
to adhere to the cornea. They are also less likely to harbor
pathogens--bacteria and viruses that are found (sadly at intolerable
levels in some places) in ocean water.
Lenses that have been exposed to ocean and even swimming pool water
should not *ever* *ever* be slept in without prior cleaning and
disinfection. For extra safety, remove lenses following swimming and
disinfect them prior to re-use. For even better safety, use daily
disposable lenses and toss them (not in the ocean) after your swim.
The "official" rule is: do not swim with contact on. The safest route is
to use prescription swim goggles. But if you must, follow the guidelines
above.
LB, O.D. |
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William Stacy
medicine forum Guru
Joined: 01 May 2005
Posts: 1177
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| Posted: Thu May 18, 2006 5:38 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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doctor_my_eye@msn.com wrote:
| Quote: | When we cry an emotional tear, the salt content
is much higher.
Really? I always thought the major lacrimals secreted a lower salinity |
than that of the normal precorneal film.
Where does all that salt come from? If it's stored up in the lacrimal
gland, it must deplete with continued crying, no?
| Quote: | This is why soft contacts hurt more and misbehave when
you have been crying over the loss of a loved one, etc.
I thought it was because of just the opposite, more dilute salinity in |
the cry tears causing the cornea and contacts to take on too much fluid
and swell.
| Quote: | Also, there is
an infection risk. Ocean water grows many microbes, plus your lenses
will stick like glue to your corneas.
Infection risk in the ocean is pretty low. The high salinity there is |
strongly anti-microbial.
Like glue? I would think low water lenses (like modern silicone based
ones) are less prone to osmotic dehydration, and unless swimming under
the surface with eyes open, not a big factor.
| Quote: | Buy a really airtight goggle if you swim in soft contacts, and throw
them away after each swim.
I don't think so, unless you happen to swim into a plume of recently |
released marine mammal excrement.
w.stacy, o.d. |
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Dr. Leukoma
medicine forum Guru
Joined: 30 Apr 2005
Posts: 1283
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| Posted: Thu May 18, 2006 5:43 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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LarryDoc wrote:
| Quote: |
IMHO, silicone lenses provide a certain degree of safety for those who
swim with lenses on the eye. They tend to not dehydrate in hypertonic
saline ocean water as much as other materials and therefore less likely
to adhere to the cornea. They are also less likely to harbor
pathogens--bacteria and viruses that are found (sadly at intolerable
levels in some places) in ocean water.
|
Studies show that acanthamoeba has a prediliction for attachment to
silicone-hydrogel lenses. What this means in terms of infection is not
clear at this time. However, I would not want to be wearing a lens
that had attracted thousands of little amoebic organisms from swimming.
DrG |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Thu May 18, 2006 6:21 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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Doctor_my_Eyes wrote:
| Quote: | Buy a really airtight goggle if you swim in soft contacts, and throw
them away after each swim.
|
Bill Stacy replied:
| Quote: | I don't think so, unless you happen to swim into a plume of recently
released marine mammal excrement.
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Candidly ... not so much since Otis reduced his posting frequeny here
 |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Thu May 18, 2006 6:23 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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On 18 May 2006 10:43:01 -0700, "Dr. Leukoma" <drg@leukoma.com> wrote:
| Quote: |
LarryDoc wrote:
IMHO, silicone lenses provide a certain degree of safety for those who
swim with lenses on the eye. They tend to not dehydrate in hypertonic
saline ocean water as much as other materials and therefore less likely
to adhere to the cornea. They are also less likely to harbor
pathogens--bacteria and viruses that are found (sadly at intolerable
levels in some places) in ocean water.
Studies show that acanthamoeba has a prediliction for attachment to
silicone-hydrogel lenses. What this means in terms of infection is not
clear at this time. However, I would not want to be wearing a lens
that had attracted thousands of little amoebic organisms from swimming.
|
Mmmmm. Data.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16360208&dopt=Abstract
OR: http://tinyurl.com/p5mvj
Attachment of Acanthamoeba to first- and second-generation silicone
hydrogel contact lenses.
Beattie TK, Tomlinson A, McFadyen AK.
Department of Vision Sciences, Glasgow Caledonian University, Glasgow,
Scotland, United Kingdom. t.k.beattie@gcal.ac.uk
PURPOSE: To investigate the attachment of Acanthamoeba to first- and
second-generation silicone hydrogel contact lenses, and to determine
if patient wear or the presence of a bacterial biofilm coating affects
attachment characteristics. DESIGN: Experimental study. PARTICIPANTS
AND CONTROLS: Attachment to the silicone hydrogel lenses was compared
with that to a conventional hydrogel control lens. Sixteen replicates
(n = 16) were carried out for unworn, worn, and biofilm-coated lenses
of each type. METHODS: Unworn, worn, and Pseudomonas aeruginosa
biofilm-coated first-generation (lotrafilcon A) and second-generation
(galyfilcon A) silicone hydrogel and conventional hydrogel (etafilcon
A) lens quarters were incubated for 90 minutes in suspensions of
plate-cultured Acanthamoeba castellanii trophozoites. MAIN OUTCOME
MEASURES: Trophozoites attached to one surface of each lens quarter
were counted by direct light microscopy. Logarithmic transformation of
data allowed the use of parametric analysis of variance for
statistical analysis. RESULTS: Attachment of Acanthamoeba was affected
significantly by lens material type (P<0.001), with higher numbers of
trophozoites attaching to the first-generation lotrafilcon A silicone
hydrogel lens, compared with the second-generation galyfilcon A lens
and the conventional hydrogel lens. Attachments to the latter 2 lenses
did not differ significantly from each other (P = 0.126). Patient wear
and the presence of a bacterial biofilm had no significant effect on
attachment to the lotrafilcon A lens (P = 0.426) but did significantly
increase attachment to the galyfilcon A (P<0.001) and the etafilcon A
(P = 0.009) lenses; attachment to the latter 2 lenses was still
significantly less than that found with the first-generation silicone
hydrogel (P<0.001). CONCLUSIONS: Acanthamoeba demonstrated a
significantly greater affinity for the first-generation silicone
hydrogel lens as compared with the second-generation silicone hydrogel
and the conventional hydrogel. If exposed to Acanthamoeba (e.g., when
showering or swimming, through noncontinuous wear and ineffective lens
care regimes), first-generation silicone hydrogel lenses may promote a
greater risk of Acanthamoeba infection due to the enhanced attachment
characteristics of this lens material. However, prospective studies in
patients are required to determine if these experimental results are
clinically significant. |
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retinula@hotmail.com
medicine forum beginner
Joined: 14 Nov 2005
Posts: 44
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| Posted: Thu May 18, 2006 9:10 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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nice find on the abstract Neil! new information for me!
wouldn't one expect that overnight hydrogen peroxide treatment (e.g.
ClearCare) might appropriatedly disinfect SiHy lenses that were worn
for swimming? i usually recommend that but i admittedly haven't seen
any proof that it actually works (for bacteria, acanthamoeba, and other
organisms). anyone know or have an opinion?
==========
Neil Brooks wrote:
| Quote: | On 18 May 2006 10:43:01 -0700, "Dr. Leukoma" <drg@leukoma.com> wrote:
LarryDoc wrote:
IMHO, silicone lenses provide a certain degree of safety for those who
swim with lenses on the eye. They tend to not dehydrate in hypertonic
saline ocean water as much as other materials and therefore less likely
to adhere to the cornea. They are also less likely to harbor
pathogens--bacteria and viruses that are found (sadly at intolerable
levels in some places) in ocean water.
Studies show that acanthamoeba has a prediliction for attachment to
silicone-hydrogel lenses. What this means in terms of infection is not
clear at this time. However, I would not want to be wearing a lens
that had attracted thousands of little amoebic organisms from swimming.
Mmmmm. Data.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16360208&dopt=Abstract
OR: http://tinyurl.com/p5mvj
Attachment of Acanthamoeba to first- and second-generation silicone
hydrogel contact lenses.
Beattie TK, Tomlinson A, McFadyen AK.
Department of Vision Sciences, Glasgow Caledonian University, Glasgow,
Scotland, United Kingdom. t.k.beattie@gcal.ac.uk
PURPOSE: To investigate the attachment of Acanthamoeba to first- and
second-generation silicone hydrogel contact lenses, and to determine
if patient wear or the presence of a bacterial biofilm coating affects
attachment characteristics. DESIGN: Experimental study. PARTICIPANTS
AND CONTROLS: Attachment to the silicone hydrogel lenses was compared
with that to a conventional hydrogel control lens. Sixteen replicates
(n = 16) were carried out for unworn, worn, and biofilm-coated lenses
of each type. METHODS: Unworn, worn, and Pseudomonas aeruginosa
biofilm-coated first-generation (lotrafilcon A) and second-generation
(galyfilcon A) silicone hydrogel and conventional hydrogel (etafilcon
A) lens quarters were incubated for 90 minutes in suspensions of
plate-cultured Acanthamoeba castellanii trophozoites. MAIN OUTCOME
MEASURES: Trophozoites attached to one surface of each lens quarter
were counted by direct light microscopy. Logarithmic transformation of
data allowed the use of parametric analysis of variance for
statistical analysis. RESULTS: Attachment of Acanthamoeba was affected
significantly by lens material type (P<0.001), with higher numbers of
trophozoites attaching to the first-generation lotrafilcon A silicone
hydrogel lens, compared with the second-generation galyfilcon A lens
and the conventional hydrogel lens. Attachments to the latter 2 lenses
did not differ significantly from each other (P = 0.126). Patient wear
and the presence of a bacterial biofilm had no significant effect on
attachment to the lotrafilcon A lens (P = 0.426) but did significantly
increase attachment to the galyfilcon A (P<0.001) and the etafilcon A
(P = 0.009) lenses; attachment to the latter 2 lenses was still
significantly less than that found with the first-generation silicone
hydrogel (P<0.001). CONCLUSIONS: Acanthamoeba demonstrated a
significantly greater affinity for the first-generation silicone
hydrogel lens as compared with the second-generation silicone hydrogel
and the conventional hydrogel. If exposed to Acanthamoeba (e.g., when
showering or swimming, through noncontinuous wear and ineffective lens
care regimes), first-generation silicone hydrogel lenses may promote a
greater risk of Acanthamoeba infection due to the enhanced attachment
characteristics of this lens material. However, prospective studies in
patients are required to determine if these experimental results are
clinically significant. |
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Dr. Leukoma
medicine forum Guru
Joined: 30 Apr 2005
Posts: 1283
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| Posted: Thu May 18, 2006 9:45 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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retinula@hotmail.com wrote:
| Quote: | nice find on the abstract Neil! new information for me!
wouldn't one expect that overnight hydrogen peroxide treatment (e.g.
ClearCare) might appropriatedly disinfect SiHy lenses that were worn
for swimming? i usually recommend that but i admittedly haven't seen
any proof that it actually works (for bacteria, acanthamoeba, and other
organisms). anyone know or have an opinion?
|
Actually, I'm glad you asked. Some 15 or so years ago, during THE
acanthamoeba scare, I remember receiving an advisory from the
University of Texas Southwestern Medical Center about appropriate lens
disinfection. The advisory recommended a minimum 6 hour soak in 3%
hydrogen peroxide to kill the acanthamoeba trophozoa and spores.
Unfortunately, with commercially available hydrogen peroxide systems,
the concentration begins to drop immediately as soon as the peroxide
comes into contact with the catalyst.
However, the Optifree solution with Aldox also kills acanthamoeba
spores following a 6 hour exposure.
DrG |
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CatmanX
medicine forum Guru
Joined: 17 May 2005
Posts: 367
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| Posted: Thu May 18, 2006 9:46 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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The better option would be to buy a set of dailies and use them. Once
you get to waist depth, squint your eyes a bit and splash some water on
the lenses. This will tighten them and stop them from coming off.
I have a few ocean swimmers and triathletes as patients and this is the
procedure we use. Discard the lenses after swimming.\
dr grant |
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Neil Brooks
medicine forum Guru
Joined: 24 Mar 2005
Posts: 1148
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| Posted: Thu May 18, 2006 9:58 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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On 18 May 2006 14:45:12 -0700, "Dr. Leukoma" <drg@leukoma.com> wrote:
| Quote: |
retinula@hotmail.com wrote:
nice find on the abstract Neil! new information for me!
wouldn't one expect that overnight hydrogen peroxide treatment (e.g.
ClearCare) might appropriatedly disinfect SiHy lenses that were worn
for swimming? i usually recommend that but i admittedly haven't seen
any proof that it actually works (for bacteria, acanthamoeba, and other
organisms). anyone know or have an opinion?
Actually, I'm glad you asked. Some 15 or so years ago, during THE
acanthamoeba scare, I remember receiving an advisory from the
University of Texas Southwestern Medical Center about appropriate lens
disinfection. The advisory recommended a minimum 6 hour soak in 3%
hydrogen peroxide to kill the acanthamoeba trophozoa and spores.
Unfortunately, with commercially available hydrogen peroxide systems,
the concentration begins to drop immediately as soon as the peroxide
comes into contact with the catalyst.
However, the Optifree solution with Aldox also kills acanthamoeba
spores following a 6 hour exposure.
|
After the Renu MoistureLoc thing, I got smart/silly/scared/wise and
bought the PuriLens system (no financial interest, blah, blah, blah).
The few studies I saw seemed to indicate pretty good efficacy against
most of the creepy-crawlies ... except ... of course ...
acanthamoeiba.
Not sure I really plan to be *that* careful or *that* meticulous, BUT
.... if I did swim in the ocean, I would likely use a "standard"
chemical method in addition.
So far, the PuriLens seems to do a heck of a job taking my potential
exhaustion/laziness out of the equation and maintaining at least a
high (if not ultimate) level of cleanliness and sterility.
The whole "15 minutes" thing, too ... neat.
Kind of wonder, by the way, whether a *second* 15-minute cycle would
be any more effective against acanthamoeba than just one go.....
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14722469&query_hl=13&itool=pubmed_docsum
OR: http://tinyurl.com/ord42
Disinfection capacity of PuriLens contact lens cleaning unit against
Acanthamoeba.
Hwang TS, Hyon JY, Song JK, Reviglio VE, Spahr HT, O'Brien TP.
Ocular Microbiology and Immunology Laboratory, The Wilmer Eye
Institute, Johns Hopkins University School of Medicine, 600 North
Wolfe Street, Woods 259, Baltimore, MD 21287-9121, USA.
PURPOSE: The PuriLens contact lens system is indicated for cleaning
and disinfection of soft (hydrophilic) contact lenses by means of
subsonic agitation to remove lens deposits and microorganisms, and
ultraviolet irradiation of the storage solution for disinfection. The
capacity of the PuriLens system to disinfect storage solutions
contaminated with known concentrations of Staphylococcus aureus,
Pseudomonas aeruginosa, and Acanthamoeba species was evaluated.
METHODS: An in vitro assessment of the antibacterial and antiparasitic
efficacy of the PuriLens system was performed. Separated batches of
the storage solution for the cleansing system were contaminated with
stock strains of S. aureus and P. aeruginosa. A comparison of the
microbiologic content was made between the solution before and after
the cycle. RESULTS: The PuriLens system effectively eradicated S.
aureus and P. aeruginosa organisms after a 15-minute cycle. However,
viable cysts of acanthamoeba were recovered in the solution after the
15-minute cycle. CONCLUSIONS: The PuriLens system is highly efficient
in protecting against contamination with common bacterial ocular
pathogens. Acanthamoeba cysts, however, can survive in the solution or
contact lens bath undergoing integrated subsonic debridement and
indirect ultraviolet light disinfection. Use of chemical disinfecting
solutions that contain agents such as chlorhexidine or other cationic
antiseptics may be advisable in conjunction with use of the PuriLens
device, especially in high-risk settings.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10946984&query_hl=13&itool=pubmed_docsum
OR: http://tinyurl.com/p82fk
Evaluation of the PuriLens contact lens care system: an automatic care
system incorporating UV disinfection and hydrodynamic shear cleaning.
Choate W, Fontana F, Potter J, Schachet J, Shaw R, Soulsby M, White E.
Department of Physiology and Biophysics, University of Arkansas for
Medical Sciences, Little Rock 72205, USA.
PURPOSE: This study evaluates lens care using the PuriLens System, an
advanced way to clean and disinfect soft hydrophilic lenses using
subsonic agitation and UV radiation, respectively. METHODS: A
two-period crossover lens cleaning and safety investigation was
conducted using 80 patients. Disinfecting efficacy was tested in
accordance with standard FDA protocols. Lens compatibility was studied
with Group I and Group IV lenses during the equivalent of a 6-month
care regimen by measuring: lens power, base curve, wet diameter,
refractive index, clarity, and tint. Safety was evaluated through
slit-lamp findings, wearing time, comfort, and visual acuity. RESULTS:
The mean wearing time of patients in the study was 13.79 hours. No
slit lamp findings greater than grade 2 were noted. Visual acuity was
20/25 or better in 92.5% of examinations. None of the patients lost
more than two lines of acuity. Lens surface evaluation showed no
deposits (grade 0) to very slight deposits (grade 1) in 94.4% of
examinations. Lenses cleaned with the PuriLens System were cleaner by
a statistically significant margin (P=0.02) compared to lenses
digitally cleaned with a leading multi-purpose solution (ReNu, Bausch
& Lomb). Overall, neither the Group I nor Group IV lenses were
affected after 180 cleaning cycles. CONCLUSIONS: The PuriLens System
provides automatic lens care compliance, superior antimicrobial
efficacy, and eliminates the need for daily digital cleaning. |
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Anon E. Muss
medicine forum Guru Wannabe
Joined: 22 May 2006
Posts: 136
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| Posted: Mon May 22, 2006 10:23 pm Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
|
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On 18 May 2006 10:43:01 -0700, "Dr. Leukoma" <drg@leukoma.com> wrote:
| Quote: | Studies show that acanthamoeba has a prediliction for attachment to
silicone-hydrogel lenses.
|
In vitro or in vivo?
Most eye doctors will never see a case of acanthomeba keratitis in the
course of their entire career, so I think the risk is quite low.
Of course, not swimming in your contacts is safest, but does one want
to be a caricature of caution? |
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Dr. Leukoma
medicine forum Guru
Joined: 30 Apr 2005
Posts: 1283
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| Posted: Tue May 23, 2006 4:09 am Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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Anon E. Muss wrote:
| Quote: | On 18 May 2006 10:43:01 -0700, "Dr. Leukoma" <drg@leukoma.com> wrote:
Studies show that acanthamoeba has a prediliction for attachment to
silicone-hydrogel lenses.
In vitro or in vivo?
Most eye doctors will never see a case of acanthomeba keratitis in the
course of their entire career, so I think the risk is quite low.
|
True, but I saw four cases in a 6 month period two years ago.
| Quote: |
Of course, not swimming in your contacts is safest, but does one want
to be a caricature of caution?
|
You should speak to the mother who emailed me today about her
daughter's experience with acanthamoeba keratitis and 3 subsequent
corneal transplants. I'm pretty sure how she would answer your
question.
DrG |
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Anon E. Muss
medicine forum Guru Wannabe
Joined: 22 May 2006
Posts: 136
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| Posted: Tue May 23, 2006 4:55 am Post subject:
Re: will acuvvue oasys or advance 2 be okay for swimming?
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On 22 May 2006 21:09:14 -0700, "Dr. Leukoma" <drg@leukoma.com> wrote:
| Quote: | Anon E. Muss wrote:
On 18 May 2006 10:43:01 -0700, "Dr. Leukoma" <drg@leukoma.com> wrote:
Studies show that acanthamoeba has a prediliction for attachment to
silicone-hydrogel lenses.
In vitro or in vivo?
Most eye doctors will never see a case of acanthomeba keratitis in the
course of their entire career, so I think the risk is quite low.
True, but I saw four cases in a 6 month period two years ago.
|
Regardless, acanthamoeba keratitis is extremely rare -- especially if
you do not work in large University setting or major referral center.
Even more so since people stopped preparing their own saline with
water and tablets.
| Quote: | Of course, not swimming in your contacts is safest, but does one want
to be a caricature of caution?
You should speak to the mother who emailed me today about her
daughter's experience with acanthamoeba keratitis and 3 subsequent
corneal transplants. I'm pretty sure how she would answer your
question.
|
Regardless, the incidence of acanthamoebal keratitis is extremely low
(less than 1 in 1.6 MILLION!)
When I educate patients, I do NOT recommend people swim in their
lenses. But I give them the REALISTIC risk of developing an
infection. After that, patients make up their mind whether they
choose to swim in their lenses or not <-- informed consent.
As an OD, have no undue fear about personally swimming in my silicone
hydrogel contact lenses. The risk of severe injury by car accident or
cancer is much greater. Everyone has their comfort zone. |
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