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Blinded after applying contact lenses with wet hands

243 points| sohkamyung | 9 years ago |bbc.com | reply

222 comments

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[+] piptastic|9 years ago|reply
I had acanthamoeba in 2001.

You pretty much have to have a corneal abrasion (scratch) before introducing the eye to water. It's not something you're going to get randomly from taking a shower or swimming. However, wearing contacts regularly for the last twenty years, I tend to get an abrasion once every two years or so. I'm extra careful during these times..

In 2001, there were about 7 cases in the US per year. It took me 6 months of excruciating pain and three eye doctors just to diagnose it. Luckily the third doctor really knew what he was doing. He diagnosed it in about 2-3 visits, snuck me some non-FDA approved drops with chlorine in them, and got rid of the infection.

I had to do a corneal transplant and still can't see very well out of it - cloudy with an astigmatism too large to correct.

Here's a good resource: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972779/

[+] reenw|9 years ago|reply
Hello pietistic, I'm the person in the piece, I hope you don't mind my responding to you directly. I'm sorry you had AK, and I hope you're doing better now. Just to be clear, swimming in contact lenses is an incontrovertible risk factor for AK- several studies have proved this. Moorfields Eye Hospital are also concluding a case control study which will also identify showering in contact lenses is a risk factor. Here's professor John Dart from Moorfields Eye Hospital talking about these risk factors https://www.youtube.com/watch?v=neUYomeUkYM. Any questions let me know. thanks!
[+] falcolas|9 years ago|reply
Anecdotally, I agree: it can't be that easy. I've worn contacts for most of my life (including while doing competitive swimming, showering, etc), and recently (3 years ago) got into scleral lenses (which included instructions from my optometrist to rinse these contacts in cold water to rid them of preservatives). If the formula really was "tap water and mis-care of contact lenses induces eye infection", I would have been blind before I could vote.

Maybe I'm just that lucky. A shame my lottery tickets disagree.

[+] jacquesm|9 years ago|reply
I've had one due to dropping some stucco into my eye when working on a ceiling, before I realized what happened my eye had rotated causing some pretty deep scratches. Both extremely painful and took surprisingly long to heal.
[+] karmacoda|9 years ago|reply
I tried contacts twice, a few years apart. On both occasions, a few weeks in, I ended up sitting in front of an opthalmologist having had what seems to have been a corneal abrasion from the contact lens. The opthalmologist couldn't find anything wrong, and I can only guess that maybe a dry eye caused the lens to stick to both the ball and lid, then moving the lid yanked the lens and in turn the ball. Seriously sharp pain and eye streaming.
[+] nashequilibrium|9 years ago|reply
This is scary, I have 1 month disposables but use them for 1-3 months, I always insert them with wet hands, I shower with them on most days, I swim at the gym with them but use goggles. I've been doing this for the last 14yrs, time to change my habits!

If I understand correctly, you have to have an open wound for this to occur?

[+] bonafidehan|9 years ago|reply
How can you tell that you have a corneal abrasion?
[+] PhasmaFelis|9 years ago|reply
> snuck me some non-FDA approved drops with chlorine in them

Yikes! I mean, that'd do it, but yikes.

I wonder how much chlorine it takes. Would swimming in the local pool with your eyes open help count as treatment? Probably not, the article says it's "common in tap water, sea water and swimming pools." Still.

[+] plainOldText|9 years ago|reply
1. Person suffers a loss or misfortune.

2. Person decides to dedicate resources to educate and prevent the misfortune from happening to somebody else.

I think these people should get more recognition; it is a proof of their commitment to our society and to the well-being of their fellow humans. Much appreciated!

[+] roel_v|9 years ago|reply
I don't quite see it that way. More often than not, it's

1. Person suffers a loss or misfortune.

2. Person makes widely inaccurate extrapolations on the actual danger, without seeing the broad implications or consequences by scaring people into woefully uninformed behavior, under the guise of 'but look! it happened to me! It'll happen to you!'.

Case in point from the media last week: ticks and Lyme disease. Some woman on the news on a personal crusade against Lyme because she contracted it when she was 13 and it caused major issues in her 20's. Sucks for her, of course, and some sort of public awareness about checking for ticks when you've been out in nature is good; but her message was hysterical. Our local equivalent of the CDC basically says 'we have basic awareness campaigns, but we don't want to scare people from going outside, because the benefits outweigh the risks'. And then you have one person who has her 15 minutes of fame, spreading massive misinformation about risks to a general population that isn't capable of understanding the concept a normal distribution curve, let alone make an assessment on an epidemiological risk.

[+] DanBC|9 years ago|reply
For other examples in healthcare see:

James Titcombe who has been campaigning around maternity safety, particularly culture of midwives, after his child died. He used to work in nuclear safety, he now works in patient safety. https://twitter.com/JamesTitcombe?lang=en

Martin Bromiley, who campaigns around clinical human factors after his wife died. He uses his knowledge of airline style investigation. https://twitter.com/MartinBromiley?lang=en

And the @NHS twitter account features a range of different clinicians, patients, and carers. https://www.england.nhs.uk/atnhs/curator-archive/irenie-ekke...

[+] copperx|9 years ago|reply
Just a reminder that step 2 has happened in the form of books since the invention of the printing press. Read non-technical stuff as much as you can.
[+] aaron695|9 years ago|reply
Person doesn't care.

It happens to them, suddenly they do care, now they are a great person?

Person is not an expert in the field but they educate people about it? Now they are a worse person quite frankly.

What you describe is exactly why part of current society is so toxic.

Lucky we have people who do care about issues that are real and serious (not just what they are invested in) and do fight and educate. But sometimes I think they are losing to the people above.

Nothing in particular about OP case.

[+] zimablue|9 years ago|reply
The only thing I can contribute to this is my experience of one-eyedness. I think people are probably more afraid of it than they should be, having had eyesight in two eyes till I was early twenties I can remember the difference. In terms of your daily life it's almost no impact, there are three things that for me are important.

Reduced spatial awareness on the bad side (duh), so you'll be slightly more likely to stumble a bit or bump into something and seem clumsy

Certain sports are much harder and you pretty much couldn't compete in them - almost any sport involving a ball. However this leaves lots of sports and I was fairly successful in grappling sports afterwards

Low level fear - I don't have a spare and being actually blind is obviously orders of magnitude more impact on your life.

[+] jmcdiesel|9 years ago|reply
I had a friend who was only sighted in one eye... his only problems were no ball sports (like you) and depth perception made parking his big ass crown victoria harder than it should have been...
[+] dimillian|9 years ago|reply
It's amazing you mention that, I have amblyopia, but I actually learnt about that name into my late twenties. I always had a lazy eye (had an operation when I was 4, but did nothing...), so that lazy eye never properly developed, it hava a vision of like 2/10. It only see the left far side, very blurry, so I have an almost 100% field of view, but that's about it.

It never bother me, except what you talked about, is some very particular tasks, some task like filling a glass of water can be challenging as I have no parallax, so no real depth of field. Sometimes I can't tell if your glass is right under my jug or not. Sports with ball, forget it, ping-pong and badminton was just impossible for me in high-school/college. Bumping into things happen often, and no 3D movies for me, also VR is a lot less appealing and immersive :(

[+] rhcom2|9 years ago|reply
My father was born with only one working eye. The only time it ever comes up is if you try to get his attention on his "bad" side and that we always avoid 3D movies.
[+] jameslk|9 years ago|reply
As a former contact lens wearer, infections like these, amongst a lot of other reasons, are why I chose PRK (laser eye surgery). Statistically, there's a higher chance of infection with wearing contacts than there is with receiving laser eye surgery[0]. I paid about $3k and came out with better vision than I had with glasses/contacts. The only negative side effects I've noticed are slight starbursts around lights at night, but its never been a problem and now I rarely notice it.

I would also recommend PRK over LASIK because LASIK requires permanent flaps to be cut on the surface of your eyes. This can sometimes lead to some nasty accidents with the flap being damaged in certain cases. PRK has been around a lot longer and requires wearing bandages over the eyes for a couple of weeks, which is why LASIK became more popular for a while (i.e. the flaps act as bandages). But now they can provide contact bandages for PRK where you aren't blind and useless for weeks making LASIK less desirable.

0. http://www.webmd.com/content/article/128/117072.htm

[+] tsukaisute|9 years ago|reply
I'm a contact lens wearer for about a couple of decades, and never had a problem. However, contacts are not for everyone. I have seen friends:

- Pick up a dropped contact lens from the floor, blow on it, and put it on

- Take it out/put it in without any hand washing

- Rinse contacts with tap water

- Reuse the same lens for weeks just because

What I do:

- Wash hands before handling

- Rinse fingers with contact/saline solution for a couple of seconds

- Use daily disposables and do not reuse them

- If I drop a lens, I just grab a new one.

It's hard to make decisions based on this unfortunate story without understanding that person's hygiene/lens wearing habits, personal health history, and so on.

YMMV.

[+] alatkins|9 years ago|reply
As a contact lens wearer for almost 20 years, I wasn't aware of this. I regularly swim and shower with lenses in my eyes.

I'd really like to understand what role the lenses play in the infection occurring. Presumably an eye without a lens could also get the infection from a water source?

[+] unculture|9 years ago|reply
I happen to know Irenie personally. One of the things that she's done to help others in the wake of her illness is to get together with other patients and medical practitioners at Moorfields Eye Hospital to write a pamphlet with information about Acanthamoeba Keratitis. It has information about the condition in easy to understand language.

Here it is:

http://www.moorfields.nhs.uk/sites/default/files/acanthamoeb...

[+] pinum|9 years ago|reply
I don't mean to be insensitive to reenw/others, but this thread has thoroughly validated my decision to stick with glasses.
[+] Insanity|9 years ago|reply
Yeah.. it's something I ponder every now and then. Been wearing contacts for 10 years, and never really had an issue with them.. But I know that if something was to happen I would feel a lot of regret.

It's a shame that headsets and glasses don't work together that well, and I hate the smudges that you get on glasses with a passion.

[+] gnulnx|9 years ago|reply
I've been wearing monthly contacts for 3 years now. I take them out each night and soak them in a 3% hydrogen peroxide solution (Clear Care), and dispose of them on the first of the month.

I highly value my sight, so I have a routine which makes me feel comfortable with sticking things in and touching my eyes twice a day. My optometrists have always told me to avoid using water, saliva, etc, to clean the lenses, and so I do.

1. Wash my hands with soap and water, and usually scrub my fingernails with a brush.

2. Grab a fresh paper towel and pat dry my hands to sop up the water. Rubbing my hands with the paper towel, in my opinion, could leave fragments which could transfer to my eye / behind the contact.

3. Open the contact container, pull out the right lens, close the contact container.

4. Insert the right lens.

5. Repeat step 3 with left lens.

6. Clean up the area with the paper towel from step 2.

I regularly (nearly every day) shower with the lenses in, though while I make an effort to avoid getting water in my eyes, splashes obviously happen. I've also spent weeks vacationing and swimming in the ocean with the lenses in.

It is my hope that by removing and disinfecting the lenses each night I can ward off infections while also minimizing inconvenience.

[+] Insanity|9 years ago|reply
I have been wearing lenses for 10 years now and swim regularly with my lenses in. I do wear swimming goggles but of course some water sometimes enters my eye - never had a problem because of it.

I had one eye infection in my life which happened right after going to the optometrist and having my eyes checked (they put a fluid into my eyes to dilate the pupil, after that putting my lens in seemed to irritate my eye and caused an infection somehow).

But one thing I can not do is shower with my lenses in. I have done it several times but it always makes me feel so uncomfortable, the feeling of my eyes becomes so annoying (I suppose due to essentially taking steaming hot showers, the rising water vapor or something irritates my eye).

[+] 0xfeba|9 years ago|reply
I do largely the same procedure. However, I open the container (both eyes at once), then wash and dry my hands. So the only thing my fingers touch after washing and drying is the contact solution and the contacts.
[+] enraged_camel|9 years ago|reply
My dad is an eye doctor and has too many of these types of horror stories. While contact lenses are amazing, the fact of the matter is that the general population is either too ignorant or too careless to use them responsibly. So lots of people get infections or worse.

Both my sister and I used to wear contacts, but we ended up getting LASIK done several years ago. Best decision of our lives.

[+] martyvis|9 years ago|reply
I've always been fearful of correcting my -7 short-sighted vision with anything other than spectacles. Probably started while I was working as an electrical engineer at a steelworks and being told of the risks of watching a high intensity electric arc from welding or a high voltage electric contact break and then inadvertantly peeling away your cornea removing a contact lens because of the fluid between the two drying out.
[+] test1235|9 years ago|reply
I have contact lens for my -8/-8.5. I've never been exposed to anything as intense as welding, but when my lens dried out from exposure to a bbq or bonfire, they're more likely to fall out of my eye than stick to it. The lens kinda goes brittle rather than shrinkwrap onto my eye.
[+] bello|9 years ago|reply
Wow. The article says that she was wearing daily disposables, which are supposed to be much safer. Did AK really settle within <24hrs time?
[+] wapz|9 years ago|reply
I really wonder this too. I've known people who used daily contacts but would leave them in for multiple days at a time (and one was a swimmer). I've swam a lot with my contacts before as I'm mostly blind without my contacts and don't want prescription goggles. This article makes me a little more reluctant to go swimming with contacts but I throw them out every night.
[+] anon263626|9 years ago|reply
Another more common eye(lid) problem people often give themselves is painful infections on the tip of the eyelids called styes. It's usually caused by someone rubbing their eyes with their hands because it's a double-whammy of cross-contaminating eyes/hands and it embeds surface bacteria into crypts of sebaceous glands.

Also, I heard from a contact wearer another painful accident is forgetting to rinse contacts with sterlie saline after they've been cleaned, that it burns pretty good. Nothing like losing your corneas, but still Pavlovian human monkey training.

[+] test1235|9 years ago|reply
Back in my monthlies days, I forgot to rinse on a couple of occasions. My God, the pain is excruciating. There's no waiting it out, and hoping your tears will clear the burning - I had to squirt saline from the bottle directly into my eye to flush it all away.
[+] djrogers|9 years ago|reply
Interesting that incidence of this appears to be a full order of magnitude higher in the UK than in the US (.2 per 10k vs 2 per 10k for contact wearers). Wonder if we treat our tap water more rigorously, use more chlorine in our pools, or are the contacts themselves different?

[1] https://www.hindawi.com/journals/joph/2013/670242/

[+] Underqualified|9 years ago|reply
As a European who has visited the US: you put a lot more chlorine in your tap water.

It smelled and and tasted like our swimming pool water to me.

Edit: and your swimming pool water had if course even more chlorine, much more then I'd expect to find in Europe.

[+] ufukbay|9 years ago|reply
I have worn monthly contact lenses for almost 9 years without problems and switched back to glasses couple months ago because my eyes got tired and itchy too fast in front of the computer at work (I'm a front end dev so I spent most of the day in front the computer screen).

I have to admit that I didn't know that contact lenses shouldn't come in contact with water and that it could lead to such disastrous effects which can even end in loss of eye sight. However the first time I was at an optician to figure out what kind of lenses I need, they explained me very carefully that I should -always- wash my hands and dry (and not touch anything else other than the lenses in between) them with a clean paper towel before putting in our taking out my lenses.

Furthermore never to reuse the cleansing liquid you put into the little boxes where you store your contact lenses. I strictly followed this procedure over the years without any problems but when I was at the eye specialist to get my glasses subscribed I told her that I never had any infections using contact lenses and she smiled and said that it's only a matter of time. This really got me thinking because I was planning on using daily contact lenses for when I do sports or go out. :(

[+] atis|9 years ago|reply
> I'm a front end dev so I spent most of the day in front the computer screen

I really love how that sentence implies something about backend devs :)

[+] tsukaisute|9 years ago|reply
Have you tried switching to daily disposables? Also, f.lux for computer work. Both have been very helpful here for what you describe.
[+] roystonvassey|9 years ago|reply
Wow! This article couldn't have come at a better time for me. I recently started wearing contacts so that it's easier when I work out. But, I also started showering after my workout with the lens on. While I thought I was being plain lazy, I had no clue I was exposing myself to such a big risk!

Thank you so much for posting this and thanks to the lady in the piece for spreading awareness about this!

[+] e12e|9 years ago|reply
I occasionally use dailies - for swimming. But your example, and some of the stuff online doesn't makes sense: the difference between showering wearing contacts and without is that the contacts scrape up the cornea, and that the natural washing of tears become less effective (lenses trap all sorts of stuff on the eye).

It sounds odd that if you throw away lenses after showering anyway - the risk would be different?

Sounds like if one has been wearing lenses for a few hours, one should take precautions with getting water in the eye - with or without lenses?

Also it appears, swimming with dailies - if one wears glasses before/after and throw away the dailies - should be reasonably safe from what I can gather?

Alternatively, it would seem a lot more people would be infected even not wearing lenses at all?

[+] fastball|9 years ago|reply
That's awful, but I'm not buying that she was:

A. wearing dailies for only a day at a time

B. didn't shower/swim with them

It is incredibly unlikely that a bacterial infection from tap water would be able to manifest itself on an otherwise healthy eye in less than 16(?) hours. The timeframe/exposure just doesn't add up for me.

[+] reenw|9 years ago|reply
Hello, I'm the person in this piece. I can confirm I was definitely only wearing dailies for single day then throwing them away. I didn't swim in them but I am not sure about showering. Just to be really clear- acanthamoeba is not a bacterium, it is a single celled organism - a type of amoeba. The infection can take hold in just a few hours, after a single exposure to water. I am happy to answer any other questions you have on this.
[+] caf|9 years ago|reply
So, I never dried my hands before handling my lenses - I'd wash them thoroughly, rinse them with tap water, then rinse my fingertips again with a little saline or lens cleaning solution. My intuition was that my hand towel was likely to be laden with bacteria - is this wrong?
[+] doktrin|9 years ago|reply
I have a similar usage pattern, and in the wake of this article I've been pondering how to safely dry my hands before handling contacts. Perhaps paper towels?
[+] jbmorgado|9 years ago|reply
It's pretty nice to see her reaction to all of this. Instead of grieving and going around writing blogs blaming people she instead actually set up a successful campaign and is working so that no more people suffer her fate.

Now, this is very refreshing and nice to see, she seems a great person.

[+] mungoid|9 years ago|reply
I dont think i have ever put contacts in with dry fingers. I always have them wet from faucet.

So thanks.. Thanks for adding one more very rare thing for me to be constantly afraid of.