Not-So-Extended-Wear Lenses; Risk to Children From Aerosols
Confirming what some eye care specialists have said for years, extended wear contact lenses should be worn for only seven days, not 30 as previously advised, according to a manufacturers’ recommendation submitted to the Food and Drug Administration.
The recommendation, issued Friday by the Contact Lens Institute in Washington, is based on studies showing that shorter wearing times reduce the risk of infections and other complications, said Glen Bradley, institute chairman.
For the past few years, many eye care practitioners have recommended that extended wear lenses be removed for disinfecting and cleaning about once a week or even more frequently.
Ideally, extended wear contact lenses should be worn for a maximum of seven days, stated one leading manufacturer, Bausch & Lomb, in a letter to practitioners last week. Earlier this year, the institute made the same recommendation to eye care practitioners who should determine wearing schedules for patients on an individual basis, Bradley said.
“There’s nothing magic about seven days,” noted Patrick Yoshinaga, director of contact lens services at USC Estelle Doheny Eye Institute. He reviews the risks of extended wear lenses with each patient and prescribes wearing times on a case by case basis.
Effects of Aerosol on Children
Deodorants, room fresheners, and other household aerosol sprays can cause lung deposits 10 times greater in infants and children than in adults, warns a UC Irvine air pollution expert.
Small children are much more susceptible to many inhaled agents, said Robert Phalen, a professor of community and environmental medicine and director of the university’s Air Pollution Health Effects Laboratory. The findings are based on computer modeling studies corroborated by disease pattern studies of children, he said.
Because of their smaller airways, newborns and children are more efficient at gathering pollutants from the air, and they also take in more air per pound of body weight than adults, he said.
Further complicating the problem, children often display fewer symptoms than adults to pollution exposure, said Dr. Henry Gong, a UCLA associate professor of medicine and director of the UCLA Environmental Exposure Laboratory. When exposed to ozone and other pollutants, children complain less even though they may be feeling the effects, he said.
When using aerosol products, experts advise: Always have good ventilation, limit other pollutants (such as cigarette smoke and pet dander) and consider the use of electronic air cleaners. And don’t use aerosol products around newborns.
Doctor’s Say-So Helps Quitters
A growing number of experts agree: stern words from a doctor or other health-care professional can be an effective strategy for discouraging smoking.
As many as 12 million Americans would quit smoking if their doctors urged them to and reinforced their efforts, U.S. Surgeon General C. Everett Koop said last week. He joins the National Cancer Institute and the American Cancer Society in recommending such a strategy.
The effectiveness of physician intervention was also demonstrated by a recent USC study. Told to quit smoking by their doctors, two-thirds of 5,000 subjects either did so or cut down significantly. “A great deal of research has been done on the process of quitting, on which methods are effective,” said Dr. Kaye Kilburn, the study’s principal researcher and a Ralph Edgington professor of medicine .”Our hypothesis was that what’s needed most is strong motivation.”
In the USC study, physicians pointed out adverse effects of smoking while reviewing chest X-rays with study participants. Nurse practitioners commented on wheezes or diminished breath sounds, explaining they are characteristic signs of smoking.
Senior Psychotherapy
Older people who seek psychotherapy should anticipate as much success as younger patients--and maybe even more--according to a new USC study.
Meanwhile, Texas researchers say older men and women who want to discuss intimate issues might be best served by a younger therapist.
In his studies, USC associate professor of gerontology and psychology Robert Knight found that older clients did well in therapy even with longstanding problems. Comparing a group of 125 senior clients (average age, 72), and more than 1,200 younger clients (18 to 60), Knight found the seniors showed more improvement, as measured by therapists’ assessments.
Acknowledging that further studies are needed to confirm his findings, Knight believes his study “dispels the notion that problems in later life are intrinsic to the aging process and we’re helpless to do much about them. While younger clients may still be identifying their strengths and successes, older clients have a base of lifetime experience and can draw on their strengths and successes, he added.
In another study, conducted at the University of North Texas, researchers found that peer counseling--often recommended for older clients--is not always best. In a survey of 96 subjects with a mean age of 69, Bert Hayslip, a professor of developmental psychology, found they preferred to discuss intimate problems--such as marital discord--with younger counselors because they were less likely to feel “judged.” However, they preferred to discuss less intimate problems, such as time management, with counselors their own age.
