In a recent report published in Pediatrics, showed that the most frequently injured body part due to medical device complications was the eye.  The study showed the most frequent diagnosis were corneal abrasions, conjunctivitis, and hemorrhage.  Eye pain, bacterial infections, and corneal ulcers have also been implicated in misuse of contact lenses and some of these can lead to permanent vision loss or even blindness.  Most of the problems due to contact lens wear was due to improper use, poor hygiene, and misuse of the lenses.  “Contact lenses are great alternative to glasses in kids, however kids and their parents have to be reminded that serious eye injuries can occur if they are misused,” states M Farooq Ashraf MD, Atlanta LASIK surgeon of the Atlanta Vision Institute.  He advises to have a proper contact lens fitting, not to sleep with the contact lenses, have proper hygiene when handling the contacts, and never swim with the contacts in.

Greater than 40,000 eye injuries from sports occur each year requiring a visit to the local Emergency Room, according to the U.S Consumer Product Safety Commission.  The good news is that most of these injuries can be treated acutely with no permanent damage to the eye.  Sports like basketball may lead to injuries in which the eye gets poked by fingers or elbows.  High velocity injuries can lead to permanent damage.  These include injuries in which the eye is struck by a fist, baseball, golf ball, or a hockey puck.  Repeat trauma to the eye may also lead to permanent damage.  An example of this would be Sugar Ray Leonard sustaining multiple retinal detachments over many years of sustained blows to the eyes.  Sustained head trauma from boxing, rugby, or football may lead to brain damage of which may result in dementia.  This leads to a situation in which the eye and visual acuity may be normal, however the patient may not be able to interrupt the images or words that he or she sees.  Dr Ashraf notes that it is very important to obtain an eye exam after any eye injury by an ophthalmologist since certain injuries may lead to eye damage many years after the injury.  For example, severe blunt trauma to the eye may lead to small tears in the retina or cause glaucoma.  These conditions may manifest many years after the initial injury and the patient usually is asymptomatic.  Unfortunately by the time the patient notices changes in his vision, it may be too late.  In a recent study it was noted that 66-76% of boxers have signs of ocular trauma.  The key finding in this study was these boxers were completely asymptomatic.  If left unchecked, some may develop glaucoma and potentially become blind.

Lady Gaga’s wider-than-life eyes in her “Bad Romance” video has fueled the latest craze for teenagers.  This look is re-created through the use of “circle” contact lenses.  These colored soft contact lenses are slightly larger than normal, they not only cover the cornea but extend out to the white part of the eye.  Many consumers have been getting these lenses illegally through the internet without a prescription.  This has prompted the American Academy of Ophthalmology to issue a statement about the dangers of these lenses.  They note that  buying any decorative lenses, including circle lenses, without a prescription is illegal.  Any type of contact lens is a medical device that requires a prescription, proper fitting by an eye care professional and a commitment to proper care by the consumer. Inflammation and pain can occur from improperly fitted, over-the-counter lenses and can lead to more serious problems including corneal abrasions and blinding infections.   Dr Ashraf, medical director of the Atlanta Vision Institute, notes that these lenses can be safe and effective when used properly.  This requires a contact lens fitting by your eye care professional and proper care by the individual.

Visual performance in normal eyes can be affected by macular pigments such as lutein and zeaxanthin.  In a study published in the Journal of Food Science in December 2009, the investigators reported that these carotenoids can help to stave off glare and quicken the time a person’s eyes recover after being exposed to blinding flashes, such as oncoming headlights.  According to the lead author Billy Hammond PhD, professor of neuroscience at the University of Georgia, these two carotenoids play a role in how fast the brain processes information.  He also noted that people vary dramatically in how much of these pigments they have.  Dr Hammond notes that carotenoids are going to play an important role in the maturation of the visual system in babies and may play a crucial role in cognitive function also.  “The retina is a neural tissue and reflects neural tissue in other parts of the body like the brain,” he said.  This may play a role in future research in diseases such as Alzheimer’s.  Dr Ashraf of the Atlanta Vision Institute adds, “that by supplementing your diet with these carotenoids may not only help with prevention of macular degeneration but may also improve cognitive function.”

Investigators in a Vancouver research institute noticed a 15% increased risk of cataract formation in patients taking Selective Seratonin Reuptake Inhibitors (SSRI).  The researchers assessed data for nearly 19,000 people age 65 or older, all of whom also had cardiovascular disease. Their records were compared to about 190,000 controls.  The effect was strongest for three SSRIs: Luvox, Effexor, and Paxil.  The etiology maybe based on the fact that the crystalline lens has seratonin receptors and excess seratonin in the eye may the lens cloudy thereby leading to cataract formation.  Dr Ashraf, Medical Director of the Atlanta  Vision Institute, comments that patients currently or in the process of starting on oral SSRI antidepressant therapy may consider this minor risk of cataract formation.

A dangerous drinking game called “vodka eyeballing” is attracting public attention on YouTube. People need to be aware that anyone who pours vodka directly into his eye risks damaging the surface epithelial cells–often causing pain and infection.  The cornea is the clear outer part of the eye that focuses light and provides much of the optical power. Depending on the amount of alcohol and length of time it is in contact with the eye, epithelial cell loss could result in corneal ulcers or scarring, not to mention a great deal of pain. And if endothelial cells die off, vision recovery would be uncertain. “Eyeballers” do not even get a “quick high” as claimed, because the volume of vodka absorbed by the conjunctiva and cornea is too small to have that effect.

The American Academy of Ophthalmology and Atlanta LASIK surgeon Dr Ashraf strongly advises the public not to engage in “vodka eyeballing.”

Click Here to view Dr. Ashraf’s recent news interview about Vodka Eyeballing.

Caffeine may be effective in protecting the lens against damage that could lead to the formation of cataracts according to a study presented at the 2010 Annual Meeting of the Association for Research in Vision and Ophthalmology.

Researchers from the University of Maryland School of Medicine in Baltimore, MD hypothesized that caffeine may inhibit the intraocular generation of reactive oxygen species in the lens and consequent damage to the tissue.

The team studied the oxyradical effects in vitro by incubating mice lenses in medium exposed UVA in the presence of kynurenine with and without caffeine. In vivo studies were conducted in rats by incorporating caffeine with galactose in their diet. In both cases, caffeine was found to be effective in protecting the lens against damage.

As reported in the abstract, “These effects of caffeine have not been reported before and are hence considered highly interesting in view of its relatively high content in widely consumed beverages.” Additional research to determine the pharmacological significance of this study is underway.

Scientists have developed a new formula that combines a potent antibiotic and an anti-inflammatory drug into nano sized particles.  This new formulation is advantagous because more of the drug can penetrate the eye and stay in the eye longer.  This is especially important in the treatment of bacterial keratitis, a condition in which bacteria attack the corneal stroma and can result in severe vision loss. Current treatment requires frequent use  of topical antibiotics - one drop every 5 minutes to start and then more drops every 15-30 minutes for up to 3 days - and daily use of anti-inflammatory drugs. This intensive treatment regimen is difficult for patients to follow.

Howida Kamal Ibrahim and colleagues in a study in Molecular Pharmaceutics, a bi-monthly journal describe the development of a new two-in-one formula that combines the antibiotic and anti-inflammatory drug into a single medication. The eye drops contain nano-sized particles - each about 1/50,000th the width of a human hair - of an antibiotic (gatifloxacin) and an anti-inflammatory drug (prednisolone) coated with a substance that keeps the medicine in the eye longer. In tests with lab animals, the drops delivered five times more medication to the eye and it remained there three times longer than existing medicine, the scientists say.
Article: “Mucoadhesive Nanoparticles as Carrier Systems for Prolonged Ocular Delivery of Gatifloxacin/Prednisolone Bitherapy”

According to the Contact Lens In Pediatrics (CLIP) study, the first clinical investigation to compare children under 12 years of age and teens using silicone hydrogel contact lenses, researchers report that children as young as eight years old who need refractive error correction are as capable as teenagers at wearing and caring for soft contact lenses.

Doctors will typically evaluate a child’s maturity and level of parental support in deciding whether a child is ready for contact lenses.  “Contact lenses often provide a more convenient mode of vision correction for the young and as long as the child is mature to put in the lens and adhere to strict hygiene standands, there should be no reason why any child cannot wear contact lenses” states Dr Ashraf, medical director of the Atlanta Vision Institute.  He adds that, “proper hygiene includes washing hands prior to insertion or removal of the lenses, no swimming with the contacts in, and no sleeping with the contacts in the eye.”

Overexposure to the sun can wreak havoc on your eyes. Sun damage can cause or has been implicated in conditions such as photokeratitis (sunburn to the cornea), pterygium (tissue growth on the whites of eyes that can block vision), and skin cancer on the eyelids, and has been implicated in the development of cataracts and possibly macular degeneration as well.

Chronic exposure to sunlight causes skin damage as well as accelerating damage to ocular tissues states Dr Ashraf of the Atlanta Vision Institute. He states, “the simplest solution to harmful UV rays is to wear the proper sunglasses”.  Any protective eyewear should have side shield protection or wrap around the eye so light cannot enter the eye from side reflections.

Proper UV eye protection should include the following:

- Check the UV protection level. UV and sunglass protection is desirable year round, and should also be used during daylight hours, even through cloudiness and haze. Your sunglasses should provide more than 95 percent UV protection.

- Check the lens tint. Most people believe that darker sunglasses provide better protection against the sun but that is not true. The lens tint should block 80 percent of transmissible light, but no more than 90 percent to 92 percent of light; neutral gray, amber, brown or green are good colors to choose from.

- Make sure they block all of the light. Choose sunglasses that wrap all the way around the temples, and/or wear a hat with a three-inch brim that can block the sunlight from overhead.

- Wear shades over your contact lenses. People who wear contact lenses that offer UV protection should still wear sunglasses. Sunglasses are helpful for preventing the drying effect most contact lens wearers get, which is caused by warm wind.

- Buy shades for your children. For the greatest protection, consider providing UV-protected sunglasses for your children, and remember that the eyes of very small infants should always be shaded from direct exposure to the sun.