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Contact lenses and watersports

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GreenRider
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Re: Contact lenses and watersports

Postby GreenRider » Mon Jul 26, 2010 12:14 pm

So this bacteria only gets in your eye if you are wearing lenses? Seems kinda weird to me

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Re: Contact lenses and watersports

Postby jakemoore » Mon Jul 26, 2010 1:02 pm

So this bacteria only gets in your eye if you are wearing lenses? Seems kinda weird to me
Acanthamoeba is actually a protozoan, not a bacteria. But yes contact lenses dramatically increase your chance of getting a corneal ulcer, whether by amoeba, fungi or bacteria. The issue is repeated microscopic trauma to the corneal epithelium along with formation of a biofilm on the contact lens. After contact lenses, the next most common cause of corneal ulcers is trauma, e.g. a corneal abrasion. There are very few bacteria that can penetrate an intact corneal epithelium, but that is possible too.
kidsan wrote: I therefore like to take a broader spectrum of opinions and it is interesting to see how many people on this thread (and a similar one on another forum) who have been kiting for many years and have not had problems.

That said, the risk of permanent damage is a real one and maybe it is advisable, in freshwater lakes particularly, to take more precautions.
Ron Burgandy is absolutely on the money here. The absolute risks are not very high, e.g. somewhere between 1 in 10000 to 20000 contact lenses will develop a serious vision threatening complication every year. Abusing contact lenses vastly increases your chance of being that one. And yes, the outcomes can be devastating.

Kidsan, based on the relatively low numbers your Kiteforum sample might not be expected to have the power to detect even one adverse event. However in my office, in Corpus Christi, TX, I will see 5-6 corneal ulcers a year and I know the other physicians here see the same.

If I needed to have my vision corrected on the water and I was a candidate I would strongly consider laser vision correction. In 2010 we have come to the point where all-laser LASIK can be debated to be safer than contacts. So certainly I would steer contact lens abusers towards laser vision correction.

If the laser is not an option and you refuse glasses, I would only consider daily disposable contacts, but realize you are only removing the repeated exposure to a biofilm on the contacts, the microscopic trauma to the corneal epithelium is still there. Just some food for thought next time the E.coli count is up at the local beach.

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Re: Contact lenses and watersports

Postby kidsan » Mon Jul 26, 2010 5:19 pm

Thanks for that full reply Jake.
I think that one thing to consider is that i currently live in an area where the sea is relatively clean...i.e. the Atlantic coast of Africa but maybe things are a different matter back in europe.

Another factor is that though laser correction does seem a good option to replace lenses, i am now at an age (44) where it is no longer recommended.

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Re: Contact lenses and watersports

Postby edt » Mon Jul 26, 2010 8:09 pm

ron burgundy wrote:Your optician is referring to a condition called acanthamoeba keratitis. Swimming in freshwater lakes while wearing contact lenses places you at risk for this infection. Acanthamoeba infections are extremely difficult to treat and often result in permanent corneal scarring and vision loss. As an eye surgeon I have seen the outcomes of this infection and they are unfortunate to say the least.
you're an eye surgeon so you should know that there are less than 200 cases of acanthamoeba keratitis per year. It is EXTREMELY rare.

I think it's safe to say that it's a lot more important to wear a helmet and sunblock than to worry about your contact lenses in fresh water.

Thousands of people die to skin cancer and head trama per year.

I don't think there has been single case of a kiter getting acanthamoeba keratitis this year, but several have died to head trama and nearly 100% of the kiters are at risk for skin cancer. There's a tendency not to use sunblock.

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Re: Contact lenses and watersports

Postby kidsan » Mon Jul 26, 2010 9:55 pm

edt wrote:
you're an eye surgeon so you should know that there are less than 200 cases of acanthamoeba keratitis per year. It is EXTREMELY rare.

If so, this is exactly what i was referring to, the over-reaction by medical experts.

I do actually wear a helmet and use sun-block. I am probably more likely to die driving to the beach... :-?

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Re: Contact lenses and watersports

Postby jakemoore » Tue Jul 27, 2010 5:23 am

Good points edt and kidsan, but it is important to realize that the problem is greater than acanthamoeba. In the United States alone there are about 4000 cases of infectious keratitis that result in loss of 2 lines of vision or more from contact lenses each year. Where I live, we have some lakes are teeming with amoeba, but they are closed to swimming and water sports. I have not yet seen an amoebic keratitis here, but we do have an unusually high rate of Fusarium, and we see plenty of Pseudomonas. I lost an eye to Fusarium in the first quarter this year. (Note to Ron Jeremy, this was agriculture, not contaminated solution)

Daily disposable contact lenses cost about $1 each, while a 1 month lens costs about $5-10. Risking blindness as well as loss or damage to a $5 lens rather than disposing a $1 lens is penny wise and pound foolish IMHO. Furthermore, this is a little different than the helmet/sunscreen/safety glasses/board-shorts argument because you are already using contact lenses. There is no possible way to argue for inconvenience, discomfort or worry about looking uncool because there is only a change in the type and brand of this accessory you are already using, rather than the presence or absence of it. The only disadvantage to a daily disposable contact is the $1 you lose.

Regarding LASIK: My oldest LASIK patient is 62 and she is absolutely stoked with her uncorrected 20/15 distance J2 near vision with a mild blended vision procedure. There is room for ophthalmologists to debate LASIK vs clear lens exchange as a surgery of choice an older patient and it is very rare to find somebody who is an ideal candidate in their 60's. We talked about her options. She made the choice with realistic expectations in mind. Now she is happy with the outcome. I find many of the doctors poo-pooing LASIK exclusively sell glasses or contact lenses. But don't take my advise! Take Ron Jeremy's advice to seek medical opinions in person from a licensed professional who has examined you and who you trust to help you make an unbiased decision and can offer all of the options.

Jake

DISCLAIMER: The contents of my posts on Kiteforum (Content), are for presented for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Kiteforum Site!

If you think you may have a medical emergency, call your doctor or 911 immediately. JakeMoore does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site. Reliance on any information provided by Kiteforum or its users and visitors solely at your own risk.

In the context of a fiduciary professional relationship JakeMoore does not recommend any form of contact lens wear for use during water sports.

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Re: Contact lenses and watersports

Postby Laughingman » Tue Jul 27, 2010 3:20 pm

Jake, I can't read this, do I need reading glasses?

jakemoore wrote: DISCLAIMER: The contents of my posts on Kiteforum (Content), are for presented for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Kiteforum Site!

If you think you may have a medical emergency, call your doctor or 911 immediately. JakeMoore does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site. Reliance on any information provided by Kiteforum or its users and visitors solely at your own risk.

In the context of a fiduciary professional relationship JakeMoore does not recommend any form of contact lens wear for use during water sports.


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