Week 5 - Contact lenses for sport Flashcards
Benefits of cls:
• ** wider field of view **
• ** Less minification/magnification** -
• Less adaptation may be required -
• Greater stability
• ** Enhanced depth perception**
• Fewer aberrations
• Fewer reflections
• Not affected by fogging up or rain
• Less susceptible to dirt
• Allow protective eyewear or sunglasses to be worn
• Protect against peripheral and obliquely incident UV
• Low risk of damage to lens during wear (soft lenses)
• ** Disposability viable**
Considerations:
• Alot Px may be children
• Communication
• Px required, make sure px involved
• Length of time playing sport
• Environment which played
• General physical demands of sport
• Appropriate material + wear time
• Modify criteria to be sport specific
• Visual skills must improve + remain consistent
• Be cautious about fitting/refitting athlete
Material - SCL
• Soft CLs material of choice
• Tend to move less compared to RGP’s > less likely dislodged
• Dust debris trapped under RGP lens result in corneal damage
• For CL dryness or dehydration use:
- Thicker, high water; thin, low water; or SiHy CLs
Material - RGP’s
• Excellent visual acuity
• Lens loss more likely
• Avoid with:
- dynamic sports
- high-risk sports
- contact sports
• Large TD
• Steeper fit required so not dislodged
• Dispense spare pair
Daily Disposable
• Dependent on prescription and availability of lens material
• Potential for lens contamination and handling problems reduced with daily lens
• Allows for single use
• Particularly suited to part-time wear
• Convenient (no solutions, spare lenses readily available, relatively inexpensive etc)
2 weekly/monthly
• Dependent on prescription and availability of lens material
• Potential for lens contamination
• Need to think about hygiene
• Cost when lost
Toric Lenses
• Spherical contact lenses for patients with astigmatism to ~0.75-1.0
• Toric contact lenses with astigmatism of 1.00D or above
• Optimum correction vital in many sports
• May be worth fitting toric lenses at lower levels of astigmatism to maximise VA
Ortho-K Lenses: what
• Individually designed RGP lenses are worn overnight
• Removed in daytime
• Alteration in corneal curvature reduces myopia and some forms of astigmatism
• May be an option for those athletes unable to tolerate modern contact lenses/prohibited from wearing them
Ortho-K lenses: limitations
• Limited Rx range addressable…
Will be covered in its own lecture
• Infection risk similar to other modalities
• Who would this be good for?
- No worries about glasses or lenses being knocked off/out
- No need to have spare lenses or solution nearby
- Sports where lenses could be more risky or more likely to be knocked out like boxing or rugby
Acuvue Oasys Transition lenses
• “reduce haloes and starbursts at night”
• “help your vision recover from bright light up to 5 seconds faster”
• “squint less, see more”
• All compared to standard Oasys lenses.
Not replacement for sunglasses, but useful when sunglasses cannot be worn!
Dk levels:
• Dk and Dk/t are important
D
• Low Dk/t = less oxygen to the anterior surface
• Duration of the sporting activity needs to be taken into consideration to v hypoxia
• Low Dk/t lenses may be unsuitable for use at high altitudes due to reduced corneal oxygenation
• Silicone hydrogels are advisable for skiing and mountaineering
Prescription:
• Maximise VA
• Correct all myopic & significant hyperopic refractive errors
• Correct anisometropia ≥ 0.50 D
• Correct astigmatism > 0.50 D with toric or RGP lenses? (different factors to consider)
Endurance events:
• Mountaineering
• Ocean racing
• Rally driving
EW lenses may be the best solution
Racquet Sports:
• Squash and badminton
• Eye protection!!
• Serious eye injuries can occur from the ball, racket and opponent
• Soft CL should be the lens of choice - good stability and centration
Contact sports:
• Football, rugby, boxing, martial arts etc.
• RGP CL are not recommended for contact sports as these can fracture in the eye or dislodge on impact
• Soft CL should be the lens of choice - good stability and centration
• Sweat entering the eyes may cause stinging and discomfort? Why?
Boxing:
• Research shows a boxer has a 20% chance of a retinal detachment and a 95% chance of a retinal tear after 75 bouts!
• Some organisations do not allow boxing participants to wear contact lenses or spectacles.
• UK amateur boxing says soft lenses allowed
• In karate, soft contact lenses are the only contact lenses of choice.
Running
• Environmental factors such as changes in air velocity and temperature = ocular dryness
• Dynamic sport - requires extra stability of SCL to provide minimal movement on blinking
• For long-distance and marathon runners, protection from dust/debris also an issue -> protective eyewear
• UV
Cycling:
• Problems with dust and flying debris, causing eye irritation
• 1 airflow may cause dryness
• Silicone hydrogel CL best option
• If choosing CL as mode of correction, protective spectacles are also advisable
• UV protection
• Polarised lenses can be useful when cycling on wet surfaces
Shooting:
• CL provide good peripheral vision
• SCL are the lens of choice for shooters due to windy conditions making RGPs uncomfortable
• Movement of lenses on blinking may impede performance
• Difference in tear quality/quantity pre and post training due to decrease in blink rate
• High water content hydrogel lenses should therefore be avoided and low water content hydrogel / silicone hydrogel prescribed
Sub-aquatic sports
• A sudden decrease in atmospheric pressure e.g. while resurfacing after diving, causes bubbles to form in the body, including the eve,
• Contact lenses (especially RGPS) are a contraindication in these conditions
• Small bubbles observed in tear film when wearing ROPS can result in corneal damage
• Better with a prescription diving mask
Water sports advice
• Avoid rigid lenses
• Fit larger diameter lenses
• Consider thicker lenses
• Consider spherical lenses for toric patients
• Recommend disposable lenses
• Carry spare lenses
• Eye rinse upon leaving water
• Remove, clean and disinfect lenses promptly
• Consider goggles
CL Loss in water sports
• High-impact sports (e.g. water skiing) most affected but.
- in a study of 119 water skiing trials, no CLs were lost (76% fully submerged)1
- blink reflex may be protective; sea water may cause CLs to tighten’
• When fitting, ensure CLs remain in place with a strong blink
- consider DD CLs or Ortho-K
• Goggles an option - caution with high impact!
Risk of infection in water sports:
• MK is a significant concern, especially Acanthomeba sp.
- also… Staphylococcus,
- Pseudomonas sp,
- & other amoebae
• Recommend DD CLs & protective goggles
- change (or clean) CLs immediately after event
- sunglasses may help in some sports (e.g. sailing)
• Patient education is crucial!
Motor sports
• The Motor Sports Association UK (body responsible for medical standards in most UK motor sports) recommends:
• Spectacles should be fitted with ‘shatterproof lenses’
• SCL can be worn for motor cycling but under a full face visor or goggle
• RGP contact lenses not advised
