Published: 19 July 2021

It's the summer and one of the most common questions eye doctors are asked is, “Is it safe to swim in my contact lenses?” The answer we give is “NO!" Do millions of people swim with their contact lenses? The answer is “Yes, they do, but it is NOT a recommended activity.’’ There are several reasons why, ranging from comfort issues to others that are far more sinister and potentially blinding. The first reason not to swim with contacts in is that the pH and buffering of your tears is not the same as plain water, and certainly not that of ocean or pool water. Contact lenses, especially soft ones, are designed to do best in pH and buffers of solutions that mimic your natural tear film. This pH difference is often why after you swim in a chlorinated pool your eyes tend to redden, burn or blur. When pool water or another water source mixes with your tears, the pH rapidly changes and there is a mini-chemical reaction occurring on the surface of your eye. Now if you add a contact lens to this mix, it prolongs the chemical mixing that occurs. The actual contact lens will often swell due to the pH and buffer changes that are occurring and this swelling results in blurred vision. When a contact lens swells it often tightens its fit onto your eye, causing discomfort or even pain. This is usually temporary until the volume of tears surpasses the volume of foreign water and the tears take over and the contact lens returns to its normal thickness, but the discomfort and blurring can last several minutes. The second reason for not wearing your contacts swimming is that you can lose your lenses under water. Contact lenses adhere to your eyes via a principle called capillary attraction, which happens when two surfaces are held together by a thin layer of liquid. When a contact lens is placed on your eye it is the tears that hold it there more than anything else. Now if you go into a large body of water--like a pool, ocean, etc.--there is more water outside of your eye than the little layer between the contact and your eye and your contact lens floats out. This can result in either a dislocated contact lens under an eyelid or a lost contact lens. Since most people wear disposable lenses it may not be a big deal, but if they were the only pair of lenses you wore to the beach and your sunglasses are not prescription, you could have a difficult ride back home. The final and most important reason not to wear contacts while swimming is infection. There are many different types of waterborne bacteria, viruses, fungi, and microorganisms. Some may result in the typical types of conjunctivitis that are easily treated with antibiotics. But as with any infection, you will have to stop wearing your contact lenses while you are being treated. The two most difficult types of infections to treat are fungal infections and microorganisms/protozoans, and treatment options are limited. Fungal infections are notoriously difficult to treat and tend to require very long treatment times; these infections can lead to corneal scarring and sometimes permanently decreased vision. The most dangerous type of infection is called Acanthamoeba. This is a protozoa commonly found in soil and fresh water. If you happen to contract Acanthamoeba the infection commonly results in a painful eye, can ultimately cause blindness, and the only course of treatment if that happens is to consider a corneal transplant. The incidents of this infection are quite low – but you don’t want to be the person who contracts it because you swam in your contacts. To avoid infection risks, organizations like the American Optometric Association (AOA), American Academy of Ophthalmology (AAO), and even the US Food and Drug Administration (FDA) recommend against swimming in any type of pool, lake, ocean or other body of water while wearing contacts. So with all those authorities advising against swimming with contact lenses, what are you options? First, if your vision is not too bad, you should swim without your contact lenses and wear prescription sunglasses while on the beach. Second, if your prescription is significant, they do make prescription swim goggles that can be worn while swimming. Then once you have stopped swimming, switch over to prescription sunglasses for relaxing afterwards or consider putting your contact lenses in after you have done your laps. One bright spot on the horizon for those who absolutely MUST swim in their contact lenses is that with the ever-growing use of daily disposable contact lenses, swimming in contacts is safer than for those who wear extended wear two-week or monthly lenses. While there is still risk for potentially sight-threatening infections, those who dispose of their contacts after swimming see this risk decrease dramatically. Please use extreme caution if you need to swim in contact lenses. For avid swimmers who have high prescriptions and cannot use prescription goggles, daily disposables are a must. However, most people do just fine with not wearing contacts at all while in the water. Article contributed by Dr. Jonathan Gerard

Published: 23 June 2021

Have you ever felt a twitching sensation in your eye? Were you sure everyone was looking at you because of it? Worried that it was the beginning of a big problem? Relax, it’s not likely to be a big deal. Most of the time it is not even visible to other people. First, it’s almost never your actual eyeball that is twitching; it’s your eyelid muscle. Actual eye twitching is fairly rare and your vision would be pretty blurry if that's what was really happening. The eyelid has a muscle in it that closes the eyelid and that muscle has a very high concentration of nerve innervation. Because of that dense nerve tissue in the eyelid, anything that makes your nervous system a little hyped up or off kilter can result in the eyelid twitching. What are some of the risk factors for eyelid twitching? Fatigue Not getting enough sleep can result in your nervous system not performing at its best and one of the results of that may include twitching of your eyelid. If you are getting frequent eyelid twitching, try to make sure you are getting the proper amount of sleep. Caffeine Too much caffeine can certainly overexcite your nervous system and result in frequent eyelid twitching. If eyelid twitching is becoming something you experience frequently, it might be time to cut down your caffeine intake. While coffee tends to be the biggest offender, caffeine does come in other flavors. Tea, cola soda, and chocolate are the easy ones that come immediately to mind. Other items that you don’t think of as much: ice cream (especially chocolate or coffee flavors), de-caffeinated coffee (still has some caffeine), power or energy bars, non-cola soft drinks (Mountain Dew, Dr. Pepper, some root beers) and some OTC pain relievers (Excedrin Migraine, Midol Complete, and Anacin). Stress This is a hard one to quantify but if I ask most people who come to me with a complaint of eyelid twitching if they are under more stress than usual the answer is almost always, YES. This is not an easy thing to mitigate. You may need to seek some help from your internist or psychiatrist or you could try some home remedies like long baths or whatever helps you relax. Dry Eyes One of the first things I tell people suffering from eyelid twitching is to use a lubrication drop in their eye. Anything that irritates your eye may result in eyelid twitching and an OTC lubricating drop in the eye might decrease the eyelid twitching. It is certainly worth a try. What if the twitching won’t go away? Could it be anything more serious? There is a condition called essential blepharospasm that could cause frequent twitching of the eyelid. In this condition you don’t just feel the lid twitching, but the entire eye starts closing involuntarily like you are trying to wink at someone. This can start to interfere with your normal daily life and can make things like driving and reading difficult to do. If the lid closing gets that significant, the main treatment for it is Botox injection to weaken the muscle that closes the eyelids. This stops the lid twitching very effectively, but it often needs to be repeated every 3 or 4 months. Most of the time, eyelid twitching just goes away on its own as mysteriously as it came. If you experience twitching that doesn’t go away, try making some of the modifications I mention above and if that doesn’t work you should schedule an exam. Article contributed by Dr. Brian Wnorowski, M.D.