Acantha-what? Eliminating Contact Lens Use is Your Best Defense

Acanthamoeba keratitis. 

A dreaded word in the eye doctor community and one that just made the local news as a “Woman nearly loses sight in one eye after wearing contacts in shower and pool1.” This rare but aggressive painful infection of the cornea, the transparent outer covering of the eye, which usually causes scarring and, if undiagnosed and untreated, can lead to blindness.  In the most severe cases, a corneal transplant is necessary. It is caused by a microscopic, free-living amoeba that’s commonly found in water and soil. In fact, any kind of water exposure while wearing soft contacts puts a person at risk1.   Cleaning your contacts in contact lens solution after swimming offers no help.  The Federal Drug Administration (FDA) does not require that lens solutions be Acanthamoeba resistant so disinfecting them after exposure to water will not kill the organism if it is present.

In the United States, 85% of those that contract Acanthamoeba Keratitis are contact lens wearers.  Researchers have begun to explore other possibilities outside this most common risk factor. Because Acanthamoeba is a waterborne pathogen, newer theories involve local water supply contamination.  Recent changes in the United States Environmental Protection Agency (EPA Guidelines) regarding the chemical makeup and strength of water disinfection products may have a direct correlation to the proliferation of Acanthamoeba in certain geographic areas.  In order to reduce the number of byproducts in the water after the purification process, the EPA made changes to the concentrations and procedures which may not effectively kill this bacteria and other microorganisms3.

Acanthamoeba are also resistant to killing by freezing, desiccation, several varieties of antimicrobial agents, and levels of chlorine that are routinely used to disinfect drinking water, swimming pools and hot tubs.

While there are a lot of safety measures to take to reduce your risk, the best one is to avoid wearing contact lenses all together – especially when taking a bath, shower, or swimming.  In fact, why even bother with hassle and cost of contact lenses and glasses when there is a safe and effective alternative:  LASIK

LASIK has been proven to be safer than long-term contact lens wear. In the most recent international LASIK vs. Contact Lens study conducted by the Cornea Research Foundation of America, the self-reported rates of eye infections, abrasions, and corneal ulcers were over twice as high using contact lenses as compared to having LASIK.  LASIK is also considered the safest, most successful and most studied elective procedure in the world. It has the highest patient satisfaction rate, and it has continually improved over the last two decades.2

Do you doubt the safety of the LASIK procedure?  Consider the fact that both Navy and Marine service personnel were offered laser vision correction to aid in clinical research to study the procedure’s performance in challenging operational environments.

In one study, 99% of the 330 U.S. Naval aviators who had LASIK overwhelmingly reported they would recommend the procedure to another pilot4. This praise coming from highly skilled aviators that can land on aircraft carriers at night or perform extreme aeronautical evasive procedures at Mach speeds is quite a recommendation.  In fact, these pilots performed better after LASIK than before the treatment.

The interest in vision correction surgery to achieve exceptional and operational vision in service personnel was so high that the Army created a night vision simulator to test target detection and identification skills in military exercises to study LASIK outcomes. Using the simulator, those treated with laser vision correction procedures reported being as good or better at target detection and identification in night combat environments compared to their abilities with glasses or contacts. The Air Force began its own studies with LASIK, specifically using femtosecond technology to create a flap.  In 2007, LASIK was approved for all USAF personnel, including for aviators flying high-performance aircraft. 

The Armed Forces’ approach to vision correction surgery has been systematically, evidence-based, and operationally focused.   In fact, after these environmental studies were released by the military, NASA approved LASIK for the first time to astronauts.  This was the first time NASA allowed astronauts to have any form of refractive surgery.  That should provide comfort to many that may be nervous about the efficacy and safety of the procedure. 

References

1. https://www.nbcnews.com/news/amp/ncna1030876

2.  https://www.healio.com/ophthalmology/refractive-surgery/news/online/%7Bf1714ae6-80fb-4d6a-b661-5b6d029bd89c%7D/lasik-called-safest-most-successful-elective-procedure-in-the-world

3. https://www.preventblindness.org/acanthamoeba-keratitis-and-contact-lenses

4. https://www.ncbi.nlm.nih.gov/pubmed/23664357

This post is contributed by Dr. Robert Dinga, who oversees the clinical operations of 58 national LasikPlus vision centers while providing strategic vision, optometric leadership, and clinical mentoring

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