December 7, 2008
Contact Lenses, Cancer,and Dry Eye: A Case History
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Cancer is always a devastating condition that has many affects on multiple organ systems. While most people are focused on the location of the lesions, their affects on other areas of the body can be equally disruptive.
A 70 year old, white, woman who has been a patient of mine for over 10 years has been treated for Breast and then Colon cancer. At first, the systemic medication seemed to have little affect on her eyes. After approximately 6 months of treatment she began complaining of dry eyes, decreased vision, and contact lens intolerance. In addition, she stated that her eye lids were red, crusty, and painful. At first, it appeared as though her eyes were a little dryer as a result of the cancer medications, and we advised lubricating drops as needed. When that did not decrease her symptoms, we added Lotemax which is a soft steroid which reduces inflammation and helps the dry eyes. Omega III was also recommended to increase tear production. This nice woman is a very compliant patient so when she returned with no improvement in her condition, we knew we had something else to deal with.
Careful lid evaluation determined that she had chronic Blepharitis which is an inflammation of the glands in the lid. Apparently, the cancer treatment had damaged the glands in her lids. This in turn caused a decrease in tear production and additional inflammation. Thus, the lid condition was the cause of the dry eye, pain and redness. Furthermore, this blurred her vision since the cornea was not moist. Also, the medication had caused her cataracts to develop.
Now that we had the correct cause of her symptoms we had to treat her. Contact lens wear is very difficult when the eyes are dry. The only answer is to wear Gas Permeable lenses that are resistant to dry conditions. So we fit her with a progressive aspheric lens which corrected her near and far vision, and did not cause discomfort with the dry eyes. She did use artificial tears occasionally, but had stable vision. In addition, we instructed her to use Tobradex ointment on her lids at bed time. This is a steroid/antibiotic combination which reduced the inflammation and killed any bacteria that may have set up shop in/on her lids. Furthermore, she cleaned her lid margins with diluted baby shampoo twice per day to remove any mucousy build up and debris that may have accumulated at the gland openings. This was followed by warm compresses to increase blood flow to the area.
After 3 weeks of this regimen she demonstrated noticeable improvement in comfort, lens wear and vision. As a long term treatment she must still clean the lids biweekly with the shampoo and occasionally use the ointment at bed time.
As long as the underlying cancerous condition exists she will not be perfectly comfortable, but our goal is to get her as happy as possible during this difficult time.
Tags: Contact Lenses
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Sad story - I hope every thing works out well for here. I to need to wear Gas Permeable Contact Lenses but not for the same reason. I have to wear them because of my occupation. I am a painter and the paint fumes get into the softer lenses.
I like the Fluoroperm. I see sharper and more clearly with gas permeable lenses than the soft.
Finding a small measure of comfort when going through something as horrible as cancer is very important. Gas permeable contact lenses are a great option.
Cancer touches nearly 1 in 3 Americans. There are myriad of issues it creates for the survivor. This post illustrates one of them as it relates to eye care and contact lenses in a real world case study.
What brand of eye drops are best to moisturize my eyes when I wear gas permeable contact lenses ?
I like to use TheraTears. I find it very soothing!
Thanks for the heads up. I will try Thera Tears and another brand to see what works best.
Don’t use old contact lens solution to moisturize your contact lenses or eyes. Not only can that be dangerous but also counter-productive. Get new lens solution every few months at longest.
When debris adds up at the glad openings I use a shot glass worth of hot water on my face cleansing rag. It loosens the debris around my eye and tends to wash it off. Learned protocol as a kid when dealing with conjunctivitis (aka pink eye).
We had a similar case study with a cancer patient. Salivary glands were impacted by treatment. We worked with her doctor and prescribed something to replace some of the moisture.
Post #8 I actually used to do the same thing until my wife put a little bit of granpas old cough medicine in the shot glass and man did my eyes burn after that one. So now I clean out my eyes with warm water cupped in my hands and put it on my cleansing rag.
I think I may ask my Dr about the Thera tears as I had never heard of them before coming to this blog.
Thera tears are popular for just this type of thing.
I never had an issue with dry eyes and contact lenses. I am thankful to my eye doctor who apparently prescribed the right kind of lens for my eyes.
Omega 3 did help with the moisture problem I had in my eyes. Not a cure all however.
How did this patient hold up after the 3 weeks ?
Omega 3 seems to be good for almost everything, is that the same as fish oil?
Gas Permeable lenses are fantastic for cases like this,
I’ve used Thera tears for about 5 months and love the results.
My mother uses Thera and has been trying to get me to do so for some time.
I think you meant to say your mother uses bifocal contact lenses post #19.