A 19-year-old female who was new to GP wear presented to the office on the advice of her mother who was an GP patient of ours for several years. The patient had been fitted elsewhere since she was away at college and found the other practice much more conveniently located. She had been struggling with poor vision since she had been fit 2 months prior and both she and her mother were frustrated since excellent vision was her main reason for being fit with GP lenses. She had returned to the practice that had fit her several times, but each time the answer was the same, “that was the best the vision would be.”

We were happy to work with this young woman and began our exam.

K’s:

• 43.00 @ 180 / 43.50 @ 90
• 43.00 @ 180 / 43.75@ 90

Rx:

• -2.50 -0.50 x 180
• -2.00 -0.50 x 180

Lens parameters:

• 43.25 -2.75 9.2
• 43.25 -2.25 9.2
• Fluorosilicone acrylate lens material

VA:

• 20 / 25
• 20 / 30

Wearing time typically 8 hours daily. On today’s visit it was at 5 hours.

Slit lamp exam showed well-fit lenses that moved well on the eye. However, the surface of the lenses was extremely coated with a thick oily substance.

Care of the lenses was then discussed in detail and it was determined that the patient was taking proper care of her lenses, cleaning them upon removal, storing them in fresh solution and inserting them without rinsing them in tap water the next morning. Enzyme tablets had been started after the patient complained about vision but they did not seem to help.

The next topic of discussion was the use of non-contact lens related products. While the deposits had the look something quite greasy, everything that could possibly come in contact with the lenses was discussed: hairspray, shampoo, conditioner, hand lotion, sunscreen, make-up, make-up remover. The patient denied using any of these products inappropriately. The patient’s hygiene “schedule” was next discussed. As she walked her way through her day, she admitted to using Vaseline around her eyes every evening to remove extra make-up that didn’t come off with soap and water and to reduce those “little fine lines” (she was 19! It must have been preventative…). She had assumed that since the lenses were out, this wouldn’t pose a problem.

The lenses were thoroughly cleaned with an alcohol-based cleaner and reinserted. The patient was able to see quite well until the lenses began to coat up once again. We then had a thorough discussion of the use of some of these seemingly harmless products and reinforced the point that everything that comes in contact with the lids and lashes can play a role in the success of contact lens wear, regardless of whether the lenses are in place or not. It is extremely vital that the practitioner discuss every aspect of care that can possibly play a role in the patient’s success. It is important that we take steps to avoid having “beauty become the beast.”