Dry Eyes and Contact Lenses

Hi there,

Today I will be sharing with you my experience with Dry Eye Syndrome and the lenses I'm currently experimenting with! 

Dry Eye Syndrome: 

Not sure how many of you can identify with this relatively troublesome issue, but incidence of Dry Eye Syndrome has been reported to be between 7% to as high as 33% in certain populations. Symptoms include scratchy eye feeling, stinging pains, eye muscle strains, and eye fatigue. 

In addition to dry eyes, I sustained an eye strain on my right eye during upper Secondary due to late nights and lots of Digital Media usage. Since then, my right eye has been especially symptomatic of dryness and strains related to dryness. 

Dry Eye Syndrome may not be a life-threatening problem, but it has affected my life in many ways, including pushing me away from desk-bound work. My eyes would be "burnt out" just after a good 8 hours of facing the computer screen. I'm thankful that desk-bound work was never on my cards anyways.

Options for good vision:

Possessing extremely high myopia, I've always worn specs and am incapable of functioning without it. In the mornings, sometimes, I need help searching for my eye-wear due to poor vision. Due to high degree, my lenses have also always been rather thick, and my glasses a tad bulky. So in university, I tried on my first pair of contact lenses. It was a pair of soft lenses designed to be disposable on a yearly basis. Over time, I moved on to Acuvue biweekly soft lenses, and then to Acuvue Moist dailies. 

However, I would often sustain eye strains on my right eye (my dominant eye). The doctor said I have oily eyelids (think acne on the eyes) and that my tear evaporation was much faster than the normal person. Even though I wasn't told to discontinue contact lens usage, I have personally done so for the past year and a half. I've only worn my dailies on special occasions like Chinese New Year, with a frequency of once a month.

Effects of Dry Eyes & the search for Cures: 

Scleral veins can become quite noticeable due to eye strains, and they can even become permanent, persisting for months without signs of fading. Wanting to resolve the problem, I did some online research, and started taking mega doses of Taurine, touted to be good for eye whitening. Taurine also supposedly has a very high toxicity threshold and I took note to not go beyond that threshold. However, that didn't remove the redness from my eye whites. 

Moving on, I started taking a homeopathy herb called Arnica Montana, also known to be good for eye whitening. Once again, the effects I had wanted didn't show. Simultaneously, I've visited Traditional Chinese doctors and Homeopaths alike to alleviate my Dry Eye Syndrome. So far, none of these have proven successful. Western doctors merely prescribed me with non-preservative eye drops to drip into my eyes whenever discomfort occurs, but I was dissatisfied as this did not solve the root problem. I've been armed with a whole box of eye drops in my house ever since. Meanwhile, I've also been taking fish oil supplements regularly to lubricate my eyes. 

Rigid Gas Permeable contact lenses: 

While doing lots of online reading, I chanced upon this product called Rigid Gas Permeable contact lenses. These lenses are very small, tinier than the circumference of your pupil, unlike soft lenses. Due to their small size, they move about in your eyes quite a lot when blinking, as your eyelids tend to push the edges of the lenses about when opening and closing. RGP lenses are arguably healthier for the eyes as their small circumference allow for more oxygen transmission to the corneas. Also, their constant movement help spread tear film evenly about your eyes. Importantly, as these lenses do not contain water and do not require it to retain their shape, they do not draw moisture from your eyes, and may be more suitable for dry eyes compared to soft lenses.  

However, these lenses are not very popular with people as they come with their own set of problems, such as more initial discomfort as compared to soft lenses. People I've spoken to, with knowledge of these little-known lenses, were very averse to me trying them out. "Why don't you stick to soft lenses? There are many brands out there for you to try." "RGP lenses are extremely uncomfortable." "You sure about this?" But my main concern was really about not straining my eyes further with soft lenses that compete with my corneas for moisture. Comfort was sideline. So I adamantly acted on my decision to try out RGPs.

I was referred to Dr Lim Li at the National Eye Care center to check my suitability for these lenses. Unlike soft lenses, hard lenses are prescribed rather than merely bought over the shelf. A few nerve-wrecking tests later, Dr Lim Li gave me the pleasant news that I could try them out. However, she did suggest for me to try out soft lenses or even LASIK surgery beforehand. She stressed the discomfort of hard lenses and alleged that many who have tried hard lenses before eventually revert to the much more comfortable soft lenses. Generally, only people with severe eye disorders who are barred from using soft lenses try out RGPs. To be honest, I have contemplated undergoing LASIK before especially because peers around me have sweared by it, parading that it was one of the best decisions of their lives. However, LASIK can be a temporary rather than permanent solution to myopia, as regression of eyesight may occur, requiring enhancement surgeries, until surgeries no longer become an option due to thinness of the corneas. Furthermore, they are known to potentially instigate further eye dryness. 

RGPs are undeniably hard work. Besides having spent hundreds on expensive eye tests, and being due for more follow-ups (every few months to a year), I spent hours learning how to put on and remove these hard plastics. Initially, you might feel dizzy and disoriented because the bopping of the lenses on your eyes may cause vision to "bounce". Also, you might feel these lenses with your eyelids every time you blink. Dust and minute particles also supposedly get trapped under these lenses easily, causing pain and possible scratches on the cornea. Hence, I was advised to and have bought myself a pair of polarized shades. Purchased my sunglasses at a steal of $200 at Sunglass Hut where there was a 20% discount going on for polarized shades. Had initially eyed the Ray-Bans but was told the lenses were too flashy for formal wear, so I stuck to a classy dark pair by Coach. This pair of sunglasses serves to protect my eyes against dust particles while in the open, and reduce eye strain from glares. Doesn't hurt that they add a touch of coolness to almost any getup. :) 

My experience with RGPs: 

Uncomfortable? Yes, because they are constantly moving about in your eyes. However, it isn't to the point of excruciating pain. 

RGPs can feel pretty dry on the eyes, to be honest, which was why I puzzled over why they are supposedly better for eye health compared to soft lenses. However, if eye dryness with RGPs start out at quotient of 7/10, it only progresses on to an 8/10 over the course of hours. Compare this with eye dryness with soft lenses. If the quotient starts out at 5/10, it quickly progresses to a 10/10, for people with moderate to severe Dry Eye Syndrome like me. 

RGPs cannot be worn for 8 hours straight on the first day; they require progressive adjustment to. I was made to wear my lenses for 2 hours on the first day, progressing to 3 hours the next day, so on so forth, until I can wear them everyday for long periods of time. So far, I've tried 6 hours, but my eyes got pretty uncomfortable, so I am contemplating to rest my eyes for a day before resuming the progressive adjustment phase. 

One thing I'm really glad about is that RGPs are relatively easy to put on, and are removed similarly painlessly with a small suction device you purchase from Optical shops. They can also be removed quite easily using a two-finger approach. This lessens my aversion to wearing them. However, like all contact lenses, they require "high maintenance" of a few minutes per day cleaning them. Solutions needed are the Cleaning solution, Saline solution, and Conditioning solution. 

My worst experience with RGPs so far is the temporary visiual blurriness while wearing spectacles, associated with temporary alteration of the shape of the corneas. This is supposedly okay, and thankfully, isn't expected to last. 

Pros vs Cons of RGPs: 

Pros:

• Provides the sharpest vision for people with astigmatism
• Durable (lasts 2 to 3 years)
• Helps reduce deterioration in Myopia (surprising huh)
• Safe improvement in corneal health
• Allegedly better for dry eyes compared to soft lenses (due to tear circulation beneath the lenses, and the lenses not drying out)

Cons

• Not suitable for wear during sports
• More uncomfortable and longer time to adjust, compared to soft lenses
• Easily traps dust and small particles under lenses
• Requires more delicate care (as these can break)

Good Alternatives to RGPs (for dry eyes): 

If RGPs don't work out for your Dry Eye Syndrome, fret not. Options aren't exhausted yet! 

There are 2 kinds of contact lenses that I want to introduce you to (I've read up a lot, remember?). 

These are 1. Scleral lenses, and 2. Silicone Hydrogel lenses. 

Scleral contact lenses are a large type of lenses that rest on the sclera (eye whites) and create tear-filled vaults over the cornea. They are designed to treat a variety of eye conditions, many which do not respond well to other treatments, one of which is severe Dry Eye Syndrome. :) The space between the corneas and the back surface of the lenses act as fluid reservoirs to provide comfort to Dry Eye sufferers who otherwise could not tolerate contact lens wear. I'm not sure which doctors in Singapore specialize in issuing these kinds of lenses, though, but you could check them out if you are interested! 

Silicone Hydrogel contact lenses are advanced soft lenses that possess more oxygen permeability than usual, and enable up to six times more oxygen to reach the cornea, resulting in better overall eye health. Because they also contain less water than regular soft lenses, they are less prone to dehydration. Some of these lenses have also been touted to be wearable for days on end. Preliminary research has shown effectiveness of Silicone Hydrogels on a group of Dry Eye Syndrome sufferers. Sounds worthy of a shot, so far, isn't it? :)  

Hope this post helps some of you who have been seeking out alternatives to spectacles for your dry eyes! 

Till next time,

Meng Yee <3