question about contacts

[erinlins]

Dr. G,

My opthomologist said that I would be able to wear lenses even though I have dry eye. Do you have any suggestions on what lenses? He suggests one day acuvue moist but I think night and day might be better b/c of the oxygen levels.

My only concern is that I have blood vessels all around my eyes. They are not protruding into my cornea however. Is this just resulting from my dry eye or should I be worried that the contacts are causing new blood vessels to form.

Thank you!

[DrG]

I am more inclined to use a silicone-hydrogel lens under those circumstances. The problem with a conventional hydrogel such as a one day Acuvue is that they dry out and the oxygen permeability drops. With a silicone-hydrogel, the oxygen permeability is inversely related to the water content. The Focus Night and Day has the lowest water content of any soft lens. Those lenses are great for keeping the blood vessels around the cornea from becoming dilated. I have never seen a case of corneal pannus (blood vessels) develop from the use of that lens, and typically they reverse pannus caused by other lenses.

I had an adolescent patient who presented with pannus so severe that I thought I was seeing things. She had this sea-fan shaped growth of vessels in both eyes that had grown within two millimeters of her visual axis. Her problem is that she sleeps with her eyes open, and was wearing conventional hydrogel lenses. With silicone-hydrogels, the pannus is barely visible, and has not grown. She also uses a sleep mask now.