“‘I sleep in my contacts all the time and I’ve never had a problem.’
As an eye doctor, I literally hear this daily. The pictures below show a referred case from the local urgent care, a subsequently cultured pseudomonas ulcer, and are the direct result of sleeping in contact lenses. Pseudomonas (bacteria) is an important cause of ocular morbidity and its opportunistic characteristics quickly lead to permanent blindness. This will be the 4th case of cultured pseudomonas that I’ve treated in my clinic.
The bacteria explosively eats away at the patient’s cornea in a matter of days leaving a soupy, white necrosis (dead tissue) in its wake. I was able to start this patient on fortified antibiotic drops around the clock and recently steroids to reduce permanent scarring.
While this patient’s eye continues to drastically improve from baseline, she will very likely exhibit some form of residual vision loss even after treatment.
To be very clear, I don’t ever recommend sleeping in any brand of SOFT contact lenses. The risks outweigh the benefits every time. It takes seconds to remove your contacts but a potential lifetime of irreversible damage if you choose to leave them in. People need to see these images and remind themselves/family/friends to also be aware of contact lens misuse.
That being said, I would like to briefly address some topics:
1. The eye appears green because of the fluorescein dye that is instilled in the eye. The dye pools in areas of corneal compromise, in this case the ulcer bed.
2. This case did not take ‘years’ to form. In fact, it took about 36 hours, as is characteristic of this strain of bacteria. This patient presented to urgent care on Tuesday afternoon and was noted to have a ‘small ulcer.’ I examined her the following day (photos above) with a massive ulcer and vision that was reduced to light perception only.
3. ‘The adoption and increasingly popular overnight use (or misuse) of [soft] extended wear contact lenses as a convenient method for correction of routine refractive errors has been associated with a dramatic increase in cases of microbial keratitis in eyes that are not otherwise predisposed to this condition.’ This is straight from the medical literature and is not debatable. Don’t sleep in SOFT contact lenses.
4. ‘I sleep in mine all the time and this has never happened ONCE!’ Do you think someone would go through this twice??
5. If you still are adamant about ignoring these well-documented warnings… you are potentially contributing to clinical research to discover better, more efficacious drugs/devices/surgeries to help out future cases. The medical literature bemoans these practices and continues to feature and headline these cases in their respected journals. Just please locate your nearest EYE doctor and put their # on speed dial.
6. ‘Ideally, contact lenses for overnight use should be prescribed [very] reluctantly (or [ideally] not at all), unless there are specific medical (e.g., arthritis) or functional (e.g., assignment to a combat zone) needs that justify the risk.’
7. The amount of Google Degrees and histrionic remarks on social media never lets you down! Personally, I will continue to adhere to evidence based medicine studies when treating all of my patients for the best possible outcomes.”
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