PMMA lens

[BusyLizzy]

Hello Peeps,

I've had a PMMA lens for the past year, since the other RGPs (including Aquasil) resulted in allergic reactions. (I am prone to eczema and other allergies).
So far so good...until irritation developed inside the upper lid.
I was advised to keep the lens out for 3 weeks, use sodium cromoglycate drops, then build up my wearing time again. Unfortunately this hasn't provided enough improvement.
I'm using Liquifilm (preserv-free) with the lens in, and it's tolerable, but not comfortable.

I wear the lens up to 6 hours a day (maximum advised). Also concerned that it deprives the cornea of oxygen.

The eye department tell me this is the best lens they can offer, since I'm least likely to be allergic to this than the others.
Is this just a money-saving option for them?
Are PMMA lenses not the cheapest option?
Are they thinking they can cut corners because they think I'm going to be allergic to the lens anyway?

I would welcome your advice, especially if you happen to be an optician.

[Ali Akay]

Hi Busy Lizzy
It's not quite true to say that you were "allergic" to gas permeable lenses. What actually happens is that protein from your tears builds up on the lens and it's this that causes the allergic reaction inside your lids. The way to control the problem is reducing the build up of protein and this needs to be tackled in more than one way:
1.Keep your lenses very clean with daily cleaning with Boston Advance or similar surfactant cleaner. Weekly deproteinising with enzyme tablets (I prefer Amiclair but can be hard to get hold of).
2.Replace lenses frequently before protein builds up on them sufficiently to cause the allergic reaction.
3.Change lens material to one that doesnt attract protein.This is obviously what the clinic has done, and PMMA is the best material for this, but, as you know, there are concerns about oxygen supply. Although PMMA raw material is by far the cheapest, most labs charge the same or even more to make a PMMA lens as they regard it as a "special". Hence I am sure they havent done it as a cost saving exercise as such, but, a better route might have been sticking with gas perms and replace them say every 3-6 months, but this would cost more, so there's some truth in cost saving I guess. It's often possible to use a low oxygen transmission material without too much problem, so I am wondering if they've tried various materials before considering PMMA.

You have to carry on with the drops 4 times a day for quite some time to keep the problem at bay, a few weeks isnt enough. If the reaction is particularly bad, often a short course of mild steroid drops (Prednisolone) helps to bring it under control, but obviously this has to be prescribed by an ophthalmologist rather then the contact lens practitioner.

I hope this helps.

[Andrew MacLean]

Thanks Ali

that has explained something that I always wondered about.

Lizzy; all the best.

Andrew

[GarethB]

What lens types have you tried already?

What other treatments for dry eye have you used?

In middle 2005 I had an allergic reaction to my RGP's and I used what was prescribed which worked at first, but then long term not. Then had dry eye problems so it was hard to say if the lens problem was due to allergic reaction or the dry eye problem. I have exzema too. I know many who have lens problems, but as long as they use preservative free solutions and use preservative free saline many lens reactions are removed.

For me what overcame the reaction was a ditry change away form caffeine, fizy drinks, cut down the chocolate bars. Now I drink at least 2 litres water per day, more dairy products (organic stuff), diet rich in natural rhiboflavin), no chemically made suplements and also use Systane eye drops twice per day.

Innitially the Systane was used every couple of hours to stop reactions to lenses, but once the diet was changed, over three months I could reduce the dropfrequency to twice per day. Tried cutting them out completly but no good, have bad reaction to my RGP lenss again.

I too have exzema and asthema. Exzema controlled by Johnsons pH balanced soaps most of the time and if that fails, Alpha Kiri oil does the trick. Asthema is controlled by breathing technique to relax the muscles controling breathing and being drug free for that helps too.

Hayfever used to get me more around the eyes than making me sneeze, but the diet and eye drops saw no signs of hayfever at all in 2006 and very little asthema and exzema problems too.

[BusyLizzy]

Thank you for your input.

I have had two different RGP lenses (don't know what they were), then Aquasil.

Currently the only solutions I can use are Total Care, which I rinse with green bottle Amo Lens Plus saline.
Choice of saline is also very important, as I react to most. I use Ultrazyme protein remover tablets religiously once a week.

I don't really have much caffeine at all in my diet. I have one cup of good quality tea a day, and don't drink coffee or coke. No fizzy drinks, either. However, I do treat myself to some chocolate and I have a glass of wine every evening.
Interesting that Gareth found increasing organic dairy products. I find dairy products aggravate eczema for me.
I also have endometriosis, so it is possible that in my case there is an immune/hormonal link which is responsible for inflammation. No-one actually knows for sure, but it is clear that endo, allergies and candida are linked.

I have some preservative-free Systane drops, so will give these a try instead of Liquifilm.
Should I use these before inserting the lens, or drop them onto the lens?

I may also try to see my ophthalmologist about prednisolone if things don't calm down in the next few weeks.

Thanks again for your advice.

[GarethB]

Lizzy,

Put the drops in before the lens otherwise you get a build of the the drops forming a foggy haze over it.

The drops then form a clear gel layer over the cornea and the eye lids.

You can use the drops as ofetn as you like according to the instructions I have, but best results I found are with the lenses removed.

Rgerading dairy products, there was a time I could only tolerate sheep or goats milk. It was not until I worked on a farm at age 14 that I started to be able to tolerate dairy products and I think that was due to the fact I had breakfast in the milking palour. Plug the cows in and start on a bowl of cereal while they were milked. The farmer suggested fresh milk straight from the udder rather than the process pasturised milk goes through. Cringed at first, thought of warm milk, bt it tasted a whole load better than the full fat stuff. Shame farmers are unable to sell this now. I do just have milk and occasionsal ice cream and it is always the full fat variety. Do not often have yoghurts or cheese, I think reaction to dairy products in some of us is down to the bacteria present in cheese and yoghurt. They are present in raw milk but not so concentrated if you know what I mean.

[Louise Pembroke]

Out of curiosity Gareth, the breathing technique you used for your asthma, was it Buteyko?
If so, how can that impact on allergy itself such as pollen or cat hair or inflammation due to a virus? When my lungs are inflammed, my peak flow is plummeting and the coughing incessant sadly only inhaled or oral steroids get it back under control.

[Anne B]

I don't think anyone should be encouraged to be drug free for there Asthma. It is a very serious condition and loads of people die from it every year.
I ALWAYS use my preventative inhaler and that keeps everything under control.

[Louise Pembroke]

I know what you mean Anne, but if I could be free of them I'd love to. I worry about osteoporosis and oral prednisolone plays havok with the hormones and makes me feel quite mad!

[Anne B]

You could ask for a calcuim supplement when you have to have Prednisolone (thats if you have enough breath to ask )
I took oral pred for about nine months a couple of years ago (for eczema) and i was lucky not to have any side effects, apart from turning into a human balloon i just got bigger and bigger.