T.R. is a 44-year-old highway worker who presented to our office complaining of a burning and scratchy feeling in his right eye. He has long noticed a “grayish spot” on the eye but with no discomfort. T.R has a 15 year history of daily wear soft contact lens wear but admits to not being to an eyecare professional for “several years.” He also says he has never worn sunglasses. The examination reveals a pterygium, with inflammation, at the temporal limbus of the right eye with 3 to 4mm of corneal encroachment. Due to the advanced nature of the pterygium, the patient is referred for surgical excision. Though this is an extreme case, it demonstrates the need for eyecare providers to stress the importance of quality sunwear to all our patients who spend time outdoors.
Each year consumers spend millions of dollars on the purchase of products to protect their skin from the harmful effects of the sun. The sunscreen industry, along with the medical community, has done an excellent job of consumer education over the past several years. Much less effective, however, has been the ability to convince consumers of the benefits of quality sunwear in protecting their eyes from the sun’s harmful rays.
A tremendous opportunity exists for eyecare professionals among contact lens wearers. There are currently about 35 million Americans who where contact lenses and many do not wear quality sunwear when outdoors. This is often due to a lack of understanding because they have never been properly educated on the importance of protecting their eyes. The initial contact lens fitting is the perfect time to make patients aware of the concerns of ultraviolet light relative to the development of cataracts and macular degeneration. Most importantly, the patient should be educated that, even in the case of UV blocking contact lenses, the most common ocular effects of sun exposure persist. These include the development of pingueculae, pterygia and benign and malignant skin cancers of the lids.
Proper patient education can be done in many ways. Of course the most effective is the one-on-one counseling that should occur with every patient. – Carmen F. Castellano, OD, F.A.A.O.
Carmen Castellano is in a private group practice in St. Louis, Mo. specializing in contact lens care. He is a diplomate in the Cornea and Contact Lens Section of the American Academy of Optometry, a past president of the Heart of America Contact Lens Society and immediate past-chair of the American Optometric Association Contact Lens and Cornea Section.