Contact lenses

Question

My daughter would like some contact lenses and I do not know if it is safe.

Answer

Dear parent thank you very much for your question regarding the use of contact lenses in your child with CF.
Having initially checked some CF chat forums anecdotally people with CF report variable success with contact lens use.
Anyone who has an underlying medical condition has to be extra careful when using contact lenses. Vitamin A deficiency, Type I & II Diabetes and poor respiratory health can all impact on ocular health and are all more likely in people with CF.
In studies adults with CF have been shown to have reduced tear film stability and also to have some signs of ocular surface inflammation. The same has not been shown in children with CF. Tear film stability is also reduced in people with vitamin A deficiency so it would be extremely important to maintain normal vitamin A levels.
Problems with tear film stability and vitamin A deficiency may lead to an increased incidence of dry eye and make contact lenses more uncomfortable to wear. Therefore it may be better for people with CF to use silicone hydrogel contact lenses rather than standard hydrogel lenses to improve comfort and they maybe better with daily disposables compared with extended wear contact lenses.
Microbial keratitis(bacterial infection of the cornea) is an infrequent but important complication of contact lens wear and of note the commonest bacteria identified causing this condition is Pseudomonas aeruginosa. However there is evidence to suggest that CF may be protective against eye infections with PA with CF mice being almost resistant to developing PA keratitis. (1)
Generally it is important for anyone using contact lenses to follow good practice guidelines and more so in people with any underlying medical conditions. Some of the most important include:
• Regular check ups
• Good hand hygiene
• Good compliance with advised wearing times, cleaning & maintenance
• Prompt review if any concerns regarding painful or red eye
Full standard guidelines for the care of contact lenses including dos and don’ts/contact lens wear in children and what to do if problems arise are freely available on the British Contact Lens Association website. (2)
Dr Laura Jenkins, MB BCh MRCPCH, Paediatric CF Associate Specialist.
Acknowledgement to Dr Katharine Evans PhD BSc(Hons) MCOptom , School of Optometry & Vision Sciences, Cardiff University for assistance with answering this question.
1. Cystic Fibrosis Transmembrane Conductance Regulator-Mediated Corneal Epithelial Cell Ingestion of Pseudomonas aeruginosa Is a Key component in the Pathogenesis of experimental Murine Keratits Tanweer S. Zaidi, Jeffery Lyczak, Michael Preston and Gerald b Pier Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts. Infection and Immunity Vol. 67, No.3 Mar 1999
2. www.bcla.org.uk

Best wishes

Laura Jenkins

03.07.2012

The answer is edited by: Prof Stuart Elborn