When disposable contact lenses hit the U.S. market two years ago, they seemed a godsend for busy, or lazy, consumers. No more cleaning, disinfecting or soaking lenses. Just toss 'em after a week of continuous wear. A half million people, according to industry estimates, bought them.
In theory, the new disposable lenses stay cleaner than the conventional extended-wear lenses, thus reducing the risks of eye ulcers and other painful complications.
But now come the horror stories. One 22-year-old Los Angeles woman scrupulously cleaned her disposable lenses every other day and discarded them weekly. Still, UCLA doctors reported in this month's American Journal of Ophthalmology, she suffered ulcers of the cornea (the transparent covering of the eye ball) in both eyes. Another patient who wore disposable lenses continuously for three weeks, three times longer than the maximum wearing time usually recommended, had such severe corneal ulcers his vision will never be restored to 20/20.
In the last few months, several medical journals have published reports of complications such as pain, redness and loss of vision, sometimes even in wearers who faithfully discard the lenses after a week.
Problems arise with any continuous wear, regardless of whether lenses are trashed or cleaned. The risk of microbial keratitis (corneal inflammation), for instance, is five times greater with extended-wear contact lenses than daily wear lenses, Harvard researchers found in a Contact Lens Institute study expected to be published soon in a major medical journal.
"Disposable lenses may not be as safe as believed," concludes Dr. William T. Parker, a San Diego ophthalmologist who says he reported the first case of corneal ulcer associated with disposable lens wear earlier this year in an ophthalmology journal.
Not everyone agrees. Says Contract Lens Institute spokeswoman Colleen Puckett, the keratitis risk is small for both types of lenses.
Even some objective experts consider the journal reports isolated, worst-case scenarios, not reflections of general use. "I've seen virtually no problems (with disposables)," says Dr. Fred H. Dubick, a Burbank optometrist who fits one in six of his contact lens patients with disposables. If patients are fit by a professional eye care specialist and follow recommendations on wearing schedules and follow-up care, they "should not have any problems," he says.
However, both advocates and opponents of disposable contact lens wear agree on at least two points:
--Patients who wear the lenses continuously for more than one week are asking for trouble.
--"The minute wearers have any redness or pain, they should see their eye doctor immediately," Parker says. "By immediately, I mean that same day."