Lenses made of special materials that are attached to the front surface of the cornea to correct the refractive errors of the eye are generally called “contact lenses”. These lenses are placed on the front surface of the cornea and correct the refractive error of the eye thanks to their optical refractors, allowing clearer vision.

Nowadays, appearance and the discomfort of wearing glasses are the main reasons for using contact lenses. People who do sports activities, work hard or do not want to wear glasses prefer to use contact lenses.

Wearing contact lenses is necessary for people to obtain the best quality of vision, especially for those who wear high-prescription glasses, have a high prescription difference between the two eyes, and have irregular and high astigmatism. Not only these people, but also anyone who does not want to wear glasses and has suitable eye structures can use contact lenses.

Nowadays, many types of contact lenses have become available thanks to people’s needs and developing technology. Although they have many names and shapes, contact lenses can generally be examined under four main headings.

soft contact lenses

gas permeable lenses

hard contact lenses

Custom made contact lenses

Soft Contact Lenses

These are lenses designed to completely cover the cornea and iris layers of the eye and to cover 1-2 mm more at the edge of the iris. Due to their soft structure, they fit snugly on the cornea and do not cause discomfort to the user. Depending on their oxygen permeability and water content, they can remain in the eye for a long time. They do not harm the eyes if used correctly, but if care is not taken, allergic problems may occur, as with all lenses. There are many subgroups of soft contact lenses. Soft lenses other than toric contact lenses are used to correct myopic and hypermetropic refractive errors, and they have little corrective effect on astigmatism.

Classic Long-Term (Conventional) Contact Lenses:

These are contact lenses that can be used daily or for long periods of time and have a lifespan of 3-12 months. Although they have a long life, the deposits on them can cause allergic symptoms and problems in terms of eye health.

Myopic or hyperopic plain clear lenses

Myopic or hyperopic colored lenses: These are soft contact lenses, with or without prescription, used to make the iris color of the eye look different.

Toric (astigmatic) transparent lenses: They are specially produced soft contact lenses used to correct astigmatism as well as myopic or hypermetropic refractive errors.

Toric (with astigmatism) colored lenses

Multifocal (near-far use) clear lenses: These are lenses used for near vision impairment. It helps in correcting far and near refractive error.

Planned Change Lenses:

The lenses used in these lenses are replaced at certain intervals, minimizing deposits and related problems on the lens surface. Today, it is widely used all over the world and is preferred by doctors and people with refractive errors. Lenses can remain in the eye for a long time, depending on the doctor’s advice and material properties. They are lenses that are easy to find and maintain with a wide range of production parameters.

Monthly Planned Change Lenses

It is produced to be used for 30 days. It can remain in the eye for 1-30 days, depending on the doctor’s advice and lens material properties.

Myopic or hyperopic plain clear lenses

Myopic or hyperopic colored lenses

Toric (with astigmatism) clear lenses

Multifocal (near-far use) clear lenses

Progressive (near-far use) transparent lenses: These are lenses with a balanced distribution of near and far numbers used in near vision impairment. It helps in correcting far and near refractive error.

Weekly Planned Change Lenses

It is produced to be used for 7 days, and can remain in the eye for 1-7 days according to the doctor’s recommendation.

Myopic or hyperopic plain clear lenses

Daily (Disposable) Lenses

These are lenses that can be used for 1 day and then thrown away.

Myopic or hyperopic plain clear lenses

Gas Permeable Contact Lenses

They have characteristics between hard and soft lenses. It has oxygen permeability properties. It is attached to the corneal surface on the eye, and tears may occur between the lens and the cornea. They do not cause allergic problems and can correct astigmatism to a large extent due to their lens structure. It can be preferred in people with allergic eye structures, astigmatism, and young patients. The adaptation period is longer than soft lenses. They are easy to maintain and durable lenses.

Hard Contact Lenses

It is produced from a material called PMMA, and it has low oxygen and liquid permeability properties. It is not widely used today

Custom Made Contact Lenses

These are lenses produced according to people’s eye problems.

Pigy-Back Lenses

These are contact lenses with a partially hard lens in the middle and a soft lens on the edges, which are used in keratoconus disease and irregular high astigmatism.

Prosthetic Lenses

These are lenses used for aesthetic and treatment purposes in iris problems.

Lens Care

Care of soft conventional hand lenses

Every time you take your lenses off, be sure to clean them according to the properties of the care solution you use. In some solutions, when you remove it, mechanical cleaning is done by holding it in your hand and dropping a few drops of the solution. In some solutions, mechanical cleaning is not required; due to the characteristics of the solution, simply leaving it in overnight is sufficient.

For these types of lenses, lens protein cleaning must be done once every 15 days.

If lens wear is to be discontinued in any way, the solution in which it is stored should be changed once a week. Normal cleaning procedures should be carried out before reuse.

Between 6-12 months, a doctor’s check-up should be made and if the lenses are worn, they should be replaced. Maintenance of planned replacement lenses.

Every time you take your lenses out, be sure to clean them according to the properties of the care solution we use. In some solutions, mechanical cleaning is done by taking it in your hand and dropping a few drops of the solution. In some solutions, mechanical cleaning is not required; due to the characteristics of the solution, simply leaving it in overnight is sufficient.

If lens wear is to be discontinued in any way, the solution in which it is stored should be changed once a week. Normal cleaning procedures should be carried out before reuse.

Lenses should not be used beyond the anticipated usage period (30 days, 1 week). Maintenance of gas permeable lenses

Every time you take your lenses out, be sure to clean them according to the properties of the care solution we use. In some solutions, when we remove it, mechanical cleaning is done by taking it in your hand and dropping a few drops of the solution. In some solutions, mechanical cleaning is not required; due to the characteristics of the solution, simply leaving it in overnight is sufficient.

For these types of lenses, lens protein cleaning must be done once every 15 days.

If lens wear is to be discontinued in any way, the stored solution should be changed once a week. Normal cleaning procedures should be carried out before reuse.

A doctor’s check-up should be done every 6-12 months, and if the lenses are worn, they should be replaced.

Features You Should Look For in Your Contact Lenses

It should be able to correct the refractive error completely or to the best possible level.

It should not damage the physiological structure of the eye or create pathological changes.

Oxygen permeability must be high

Must be able to use for long periods of time during the day and at night if necessary.

It should be easy to use and maintain

Any debris that may form on the surface should be easily cleaned.

It should not cause eye discomfort

To Use Your Contact Lenses Healthily and to Avoid Harming Your Eyes

Contact lenses must be worn and used under the supervision of a doctor.

Attention should be paid to the use, cleaning and maintenance of lenses.

Checks and replacement should be made when necessary.

Lens wearing times should be as long as your doctor deems appropriate for you.

If you experience even the slightest discomfort in your eyes and lenses, see your doctor. Remember, if a small problem is neglected, it can lead to bigger problems.

•It is necessary to comply with the recommended usage and care rules to protect your eye health.

What are the situations that require contact lens removal?

Lenses should be removed if they cause itching, burning or stinging in the eye, the feeling of having something in the eye, excessive watering, unusual eye discharge or redness, blurred vision, a rainbow or halo around objects, or if the lenses cause more discomfort than when they were first worn. If the discomfort or sensation disappears when you remove the lens, you should examine the lens closely to check for damage, dirt or foreign objects. If there is damage, the lens should be thrown away and a new lens should be used. If there is dirt or foreign objects, it should be cleaned. If the problem persists despite these, consult your doctor immediately. The complaints mentioned here may be a sign of any infection or a more serious condition.

Is there an age group where contact lenses cannot be worn?

No, it can be fitted even to babies a few days old after cataract surgery. When implanted for refractive error correction, middle school and childhood may be a good time to start. Decreased tears may be a problem after the age of 40.

Do contact lenses get stuck in the back of the eye?

No, the pocket that appears when you pull down the lower eyelid is actually on the upper eyelid as well. So it’s a dead end. However, sometimes the lens can fold and get stuck in these pockets, in which case it can be easily removed from the eye.

Can eye drops be instilled into the eye while using contact lenses?

However, eye drops that do not contain preservatives can be instilled. Other drops can only be instilled after the lens is removed from the eye.

Do contact lenses cause problems during pregnancy?

If you are using lenses for the first time, the adaptation period may be problematic, but if you have used lenses before, problems such as stinging may rarely occur due to the change in the curvature radius of the cornea. Contact lenses do not have any negative effects on the baby.

Is it possible to swim with contact lenses?

Yes, it can be entered, but since it is known that significant pollution in pool and sea waters, and especially viruses and parasites that have been shown to exist in pools, can cause serious infections, it is recommended to wear swimming goggles that do not leak water over the lenses, and never sleep with lenses used while swimming.

Can you sleep with contact lenses?

The contact lens is worn on a very valuable layer of the eye, which we call the cornea, which can be considered as the window through which we look at the world. We know that the cornea needs the oxygen of the air the most and is nourished by it. The cornea receives oxygen directly from the air during the day and from the capillaries on the back of the eyelids during sleep at night, since the eyelids are closed. However, compared to the amount of oxygen in the air, the oxygen provided by the capillaries behind the valve is approximately one-fifth less. That’s why there is already a malnutrition at night. If you use lenses as a second obstacle preventing oxygen from passing to the cornea at night, the cornea will remain even more oxygen deprived. The most important problem that this situation will create is that the cornea becomes susceptible to infection. The oxygen permeability parameters of contact lenses are known as Dk/L or Dk/T. Today, it is known that contact lenses will not disrupt corneal nutrition no matter how much oxygen they allow. This critical figure is Dk/L= 125. The Dk/L value of most soft lenses is lower than this figure, but silicone-hydrogel lenses produced in recent years have Dk/L rates up to 175. With these lenses, it is possible to use these lenses under the supervision of an Ophthalmologist without removing them at night for up to 30 days without any problems.

Who performs Contact Lens examination and application?

Law No. 1219 grants this authority only to ophthalmologists.

In cases where the transparent layer of the eye is excessively curved forward (keratoconus), the ophthalmologist first recommends contact lens examination and application to the patient who does not benefit from spectacle lenses and whose vision cannot be improved. After obtaining the patient’s consent, he begins medical procedures.

Patients can choose contact lenses to compensate for vision defects. In addition to these contact lenses for optical purposes, only ophthalmologists can apply contact lenses used for treatment purposes to the eyes of their patients.

Colored contact lenses are used for aesthetic or medical purposes. The same medical procedures are applied to these contact lenses.

A contact lens is a foreign object that is placed on the transparent layer of the eye. It requires medical monitoring, care and discipline.

Patients should not obtain contact lenses randomly from the market. Contact lenses distributed for promotional purposes should not be relied upon. It should not be forgotten that contact lenses applied without medical supervision may cause eye diseases leading to blindness. If the examination is not performed by an ophthalmologist, it cannot be understood whether the eye has sufficient prerequisites for the use of contact lenses.

Can a feeling of dryness in the eyes occur due to contact lenses?

It is another common situation. It should not be forgotten that soft contact lenses contain water and should not dry out. In other words, it must be in an environment where it can constantly be fed with water. This requirement is provided by tears when the lens is in the eye, and by the solution in which it is stored when it is outside the eye. There is a thin pool called the tear film layer in front of our eyes, which means it is not exposed to the outside world. The contact lens, in a way, floats in this pool. If the depth of this pool decreases, the contact of the lens with the cornea, the outer surface of the eye, increases and a sinking sensation occurs.

Reasons; 1) Lack of tears (especially in women, situations related to age or accompanied by rheumatic diseases) 2) Situations that increase attention, such as computer use, and thus reduce the number of blinking, causing tears to evaporate away from the surface of the eye. 3) Air conditioners, radiators or dry climates, which remove tears from the eye. 4) Contact lenses with high water content, which use more tears 5) Various eye diseases that cause tear imbalance in the eye (Eyelash root diseases (Blepharitis), etc.)

Symptoms; 1) Feeling like the contact lens is a foreign object, especially towards the evening 2) Redness 3) Feeling of dryness in the eyes 4) Eye fatigue, heavy eyelids 5) Feeling of sleepiness

Suggestion; 1) Using artificial tear drops that do not contain preservatives that damage the lens, at a dose determined by the Ophthalmologist while the lens is on the eye. 2) Changing the contact lens to a lens with lower water content. 3) Avoiding environments with intense air conditioning, cigarette smoke and low humidity.

Can Contact Lenses cause corneal infection (keratitis/corneal ulcer)?

It is the most important contact lens complication. Nowadays, with the introduction of monthly breakthrough lenses and increasing the oxygen permeability of lenses, it has become a very rare problem.

Reasons;

1) Improper lens care and lens use (It is extremely important that the solutions used are recommended especially by the Ophthalmologist)

2) Excessive use of lenses with insufficient oxygen permeability at night (this is the most common reason)

3) Especially using monthly change lenses for more than their due date

4) Do not use lenses when suffering from microbial diseases such as conjunctivitis and stye.

5) Use of lenses during diseases where body resistance is excessively weakened (Cancer, Diabetes, etc.)

Symptoms;

1) Pain, stinging, watering

2) Significant redness in the whites of the eyes

3) Light sensitivity (especially light coming from the window, or eye pain when suddenly going into a bright environment)

4) Swelling on the lids

5) Burr and runoff

Suggestion; 1) Stop using contact lenses immediately 2) See an Ophthalmologist immediately

What are the advantages and disadvantages of contact lenses?

Advantages of contact lenses

Contact lenses have optical advantages for some people, as well as cosmetic benefits and the convenience of not wearing glasses.

In cases of high-grade refractive errors, contact lenses reduce visual impairments in the peripheral parts due to their small diameter and thickness, as well as correction directly over the eye.

The glasses given to those who have lost their lenses in one eye due to surgery or injury are difficult for the patient to use because they produce excessive magnification. The magnification factor in contact lenses is much less than that of spectacle lenses and can be tolerated by the patient. Thus, the patient becomes able to use both eyes.

Patients with keratoconus or irregular corneas due to another cause, whose vision cannot be corrected at all with glasses, often achieve good vision with contact lenses.

Contact lenses also have advantages for athletes and people with special work needs.

Disadvantages of contact lenses

They are a little more costly than glasses. However, thanks to the development of technology, more affordable contact lenses are being introduced to the market.

There is a certain period of adaptation for those who are new to using it. This period is less in those using soft lenses and longer in those using hard lenses (1 week-1 month).

When using contact lenses, it is necessary to pay close attention to cleanliness. Some eye health problems, which will be explained later, may occur in contact lens wearers. Sometimes there are times when lenses cannot be used and it may be necessary to use glasses at these times.

For what purposes are contact lenses used?

1. The most common purpose is to correct refractive errors. Their use for this purpose constitutes an alternative to the use of glasses and the correction of refractive errors by surgical methods and laser. Refractive errors that can be corrected with contact lenses; Myopia (The refractive power of the eye is higher than normal), Hypermetropia (The refractive power of the eye is lower than normal), Astigmatism

(Inequality in the refractive power of the eye in different quadrants), Presbyopia (Age-related loss of near vision). While contact lenses can provide complete correction in the first three of these 4 problems, their usefulness is limited in presbyopia. In addition, contact lenses are used to provide vision to patients, especially infants, who have lost their lens organs due to reasons such as cataracts or trauma, but who cannot have an intraocular lens surgically implanted, called ‘Aphakia’. Another area of ​​use is ‘Anisometropia’. This means a significant difference between the refractive errors of both eyes. The use of glasses is very problematic or impossible in patients with more than 2 diopters of different refractive error between the two eyes. In these patients, the problem is solved with contact lenses.

2. Therapeutic contact lens use: In many eye surface diseases, contact lenses are used to accelerate the healing period or relieve pain.

3. Cosmetic use: They are used to change eye color and provide an aesthetic appearance in patients who do not have an iris layer (the colored part of the eye) or whose eye surface appears white due to injury/surgery.

4. Orthokeratology: Orthokeratology is the temporary correction of refractive error by shaping the cornea with specially designed contact lenses. Today, it is most commonly applied to correct myopia below approximately -5.0 D. Although it is not a new method, it has gained popularity and been developed over the last 10 years with the introduction of advanced corneal surface measurement methods and high oxygen permeable rigid lenses. In this method, unlike classical contact lens application, contact lenses produced/selected to suit the patient according to the corneal topography are worn at night during sleep and removed during the day. Although the lenses begin to be effective after the first night, the full effect is reached within 1 week to 1 month, depending on the degree of refractive error. When the use of lenses is stopped, the refractive error will return after a while. Although it has been suggested that the progression of myopia in children can be stopped with orthokeratology, this claim has not yet been scientifically proven. This special application should only be performed under the supervision and control of a ‘Contact Lens’ specialist Ophthalmologist.

What are contact lenses and their types?

What are contact lenses?

Contact lenses are prostheses that can be placed on the outer surface of the eye, such as the cornea and sclera, and can be used to correct refractive errors or treat some eye diseases. In recent years, contact lens technology has advanced greatly and new designs and materials have been developed that make lenses easier to use and extend their lifespan.

What are the types of contact lenses?

There are basically two types of lenses today. These are gas permeable hard lenses and soft lenses. Soft lenses are mostly used, except for a few cases where gas permeable hard lenses are required.

Gas permeable hard lenses: They are called this because they allow a high rate of oxygen to pass into the eye. These lenses, which require a certain amount of getting used to when used because their presence is felt when they are first put on the eye, are actually more durable than soft lenses. Since they do not take the shape of the cornea, they are especially preferred in cases such as high astigmatism and keratoconus. In Keratoconus disease, which is a progressive sharpening of the cornea starting from adolescence, no other method can provide the quality of vision provided by these lenses, and gas permeable hard lenses can be successfully applied in 93-97% of these cases.

Soft lenses: 1-day-lasting lenses used daily, 1-month-lasting lenses used daily, 1-year-lasting lenses used daily, 1-week-lasting lenses used for 1 week, 1-month-lasting lenses used for 1 month, therapeutic lenses used for the treatment of some eye diseases, There are many different types such as bifocal/multifocal lenses and colored lenses. They are very comfortable to use. Most lenses used to correct refractive error in the eye are colorless and do not change the appearance when placed on the eye. As long as they are worn, they correct the defect and provide a clear image.

How should contact lens application be done?

The more parallel the contact lens is positioned on the cornea, the more patient comfort increases and problems are minimized. This process is called “fitting” in contactology. During this procedure, in addition to biomicroscopic examination of the eye, the ophthalmologist first measures the curvature radius of the cornea (keratometry), measures the front and back surfaces of the cornea with ‘computerized corneal topography’, determines the contact lens parameters that will fit that cornea, that eye, and determines the contact lens parameters that will fit that cornea and that eye. determines the contact lens parameter. Contact lenses have parameters that determine their surface properties such as material, overall diameter, curvature radius, diopter power, central thickness, water content, ionic or non-ionic nature. When deciding on these parameters, the doctor evaluates various features of the patient’s eye. For example, one may choose one lens for a patient with low tears, another for a patient with allergies, another for a patient with different eyelid tension, and another for a patient living in a dry climate. The fitting process is of vital importance for the patient and must be repeated at least once a year, even in successful lens wearers. The fit examination involves ensuring that the contact lens, which has many fit measurements, fits the patient like a custom-made dress.

The high quality of the contact lens is an important prerequisite. However, the adaptation of this quality contact lens to the eye is at least as important as this quality. This compliance examination is also among the duties and responsibilities of the ophthalmologist. The ophthalmologist also educates the patient on the care and insertion and removal of contact lenses. After determining the contact lens that is suitable for the patient, contact lens care is explained in detail, and before delivery, the patient is taught how to put on and remove the contact lens, leaving no question marks. The importance of regular check-ups is stated and it is recommended to come if there is even the slightest redness, burrs or blurred vision.

We should be careful about allergies that develop after contact lenses.

I would like to share two example cases that show how important ophthalmologist examination and follow-up is during contact lens use.

When a 19-year-old patient, who used contact lenses while doing sports, came for examination, a severe eye allergy was detected. He was recommended short-term (one week) drug treatment against allergies. The patient was specifically reminded not to use contact lenses and not to use medications for longer than a week.

The patient did not come to the control examination for which he was invited.

About five months later, he came with a complaint of decreased vision. During the examination, eye pressure had increased in both eyes due to the side effects of the medications, and visual disturbances occurred due to eye pressure. The patient stated that he never stopped using contact lenses in order not to fall behind in the team he played for, and in order to do this, he constantly used the medications recommended for a week.

The patient was advised to stop using contact lenses and stop allergy medications. This time, the patient’s eye pressure was reduced to normal with treatment.

It is not right to continue using contact lenses when eye health does not allow. Using eye medication continuously to use contact lenses even though it is not medically appropriate may also cause eye diseases.

How can I reduce the problems that may arise with contact lens wear?

THE IMPORTANCE OF CONTACT LENS EXAMINATION

A significant portion of traffic accidents are not due to the inadequacy of vehicles, but

Questions about whether contact lenses are dangerous to the eyes can be answered by making an analogy with driving.

The examination by an ophthalmologist to determine whether the eye has the minimum sanitary conditions for wearing a contact lens can be compared to the preliminary examination required to obtain a driver’s license. Minimal sanitary prerequisites are evident in both. The use of contact lenses in inadequate sanitary conditions may damage the eyes. Just like a person who does not have the prerequisites for obtaining a driver’s license has a very high probability of having an accident due to their medical inadequacies…

If the examination is not performed by an ophthalmologist, it cannot be understood whether the eye has sufficient prerequisites for the use of contact lenses.

The fit examination involves ensuring that the contact lens, which has many fit measurements, fits the patient like a custom-made dress.

The high quality of the contact lens is an important prerequisite. However, the adaptation of this quality contact lens to the eye is at least as important as this quality. This compliance examination is also among the duties and responsibilities of the ophthalmologist.

The prerequisites and conditions under which contact lenses will be used are also

Even if you buy the highest quality, most expensive car, if you do not learn the features of the car well or if you do not drive the car according to the rules, you are likely to have an accident.

Learning in which situations and how you can use your contact lenses in your living conditions, wearing them under these conditions, and taking care of your contact lenses with solutions suitable for the material of your lens for the recommended periods will minimize the possibility of complications.

As a result, the contact lens and the eye are a whole that works together. Each eye may have different characteristics that are not revealed unless a full examination is performed. It is the ophthalmologist’s duty to ensure that the contact lens fits the eye.

For uncomplicated contact lens use, the compatibility of the contact lens to the eye must be ensured, and the patient must use the contact lens under appropriate conditions and at the right time.

Is contact lens wear always safe? What are the mistakes and consequences of using contact lenses?

If you are looking for answers to the questions above, you can benefit from the scientific article summarized below, about two cases we encountered, treated and followed as an Ophthalmologist.

Patient 1

A 35-year-old female patient was admitted to the hospital with complaints of pain, watering and stinging in her right eye for a week. From his history, it was learned that he had been using soft toric contact lenses, which were put on in the morning and removed in the evening and renewed once a month, for 6 years due to myopic astigmatism, and that he made the following mistakes in usage and thought that could cause infection:

1-15 days ago, a piece of ice from a roof fell into his eye on the street, and he continued to wear his contact lenses.

2-He entered the sauna with his contact lenses.

3-During a holiday period, he slept without taking off his lenses for a few nights.

4-He took his lenses from a place without a doctor’s supervision and failed to check them.

During the eye examination and laboratory examination of the patient, it was determined that an ulcer was developing on the cornea and that this ulcer was caused by a rarely seen but very resistant microorganism called Akantomoeba. Despite all treatment efforts, the ulcer did not heal and caused a perforation in the cornea, and a corneal transplant surgery was performed. However, a second transplant was required as the new transplanted tissue was rejected by the body. Currently, the patient is under close monitoring and treatment due to a new rejection response that may occur.

2. Patient

A 21-year-old female patient, studying at a university, applied with complaints of pain and stinging in her left eye for a day or two and bloodshot blood in the morning. He had been using soft contact lenses for 4 years, which were put on in the morning and removed in the evening and replaced once a month.

According to the information received from him, the following errors were detected regarding the use of contact lenses:

1- When the contact lenses run out, they get them without a doctor’s supervision,

2- Sometimes he doesn’t take his lenses off for a few days

3- He sometimes goes into the sea or the pool with his lenses.

4- He doesn’t take off his lenses while taking a bath.

During the eye examination, it was determined that an ulcer had developed on the cornea, similar to that of the first patient, and laboratory tests revealed that it was caused by the same microorganism. Again, despite all treatment efforts, the ulcer eventually expanded and caused vision loss despite corneal transplantation.

The purpose of presenting these two cases consecutively is to emphasize that they occur in connection with similar errors. There is no connection between the patients and there is no direct contagion.

Acantomoeba is a free-living amoeba and can be detected in soil, water (especially tap water), seawater, ice, vegetables and air. It has a disease-causing form and a cyst form. The cyst form is resistant to many protective factors and can survive for years in such environments.

In fact, a mild trauma often plays a role in the emergence of Acantomoeba keratitis. This may be in the form of wind-blown sand, dust, insect or vegetable-type materials, and is often associated with the use of contact lenses and the resulting minor abrasions. The epithelial integrity disrupted in this way allows microbes to settle and develop. In both cases presented, contact lens use, mild trauma and interaction with fountain or pool water are present and are compatible with the mode defined as the mode of transmission. Although the use of contact lenses under adverse conditions is one of the most important causes of Acantomoeba keratitis, it can also be seen in people who do not use lenses, who have been exposed to trauma and who have come into contact with tap water, lakes, pools or the sea containing large amounts of this amoeba, as well as in those who have undergone eye surgeries such as corneal transplantation and LASIK surgery.

Although it is frequently seen in those who use soft contact lenses, it can also occur in those who use hard lenses. The first proven Acantomoeba infection was reported in the USA in 1974, in a person using soft contact lenses. The same infection was detected in the USA between 1984 and 1987 in a large number of consecutive patients using soft contact lenses, and attention focused on the disinfection and use problems of soft contact lenses. In order to investigate the causes of this widespread infection, which is described as an epidemic, Contact Lens Associations of Ophthalmologists and American Academy of Ophalmology groups conducted a joint study and identified risk factors and initiated measures to be taken in this direction. These risk factors are; Less than recommended and careless disinfection, use of home-produced saline solutions, swimming in the pool and sea with contact lenses, and ineffective disinfection solutions still being sold in markets have been reported.

In our country, these factors, as seen in both patients, are not paying attention to the cleaning rules, swimming in the sea and the pool with contact lenses, taking a bath, selling contact lenses without control by people or companies that are not authorized to apply them, giving them as gifts under the name of promotion without a doctor’s control, “It occurs as routine checks are disrupted and contact lens users are not adequately informed.”

Two patients who purchased Contact Lenses without a doctor’s supervision

First patient: 19-year-old female patient,

He bought his non-prescription colored soft contact lenses from an optician without a doctor’s examination. Approximately a month later, when he applied with a feeling of bloodshot, watering and stinging in his eye, widespread edema was observed, especially in the upper part of the cornea. His eye improved with medical treatment.

Second patient: 20-year-old female patient,

He bought contact lenses from an optician without a doctor’s examination, just based on his glasses prescription. Approximately two months later, when he applied with the complaint of bloodshot and crusting, it was observed that corneal inflammation had developed in his eye. It was determined in the microbiological examination that this inflammation was caused by a microbe, and medical treatment was given accordingly. The situation is resolved, leaving a scar on the cornea.

You have read about the complications of two real patients who were taken without a doctor’s examination and control and developed due to inappropriate lenses.

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