Article Date: 10/1/2006

contact lens management
Contact Lenses For Athletes

Challenging environments and duration of wear are issues for athletes.

BARBARA HORN, O.D.

Just two days before Olympic ice dancers Tanith Belbin and Ben Agosto headed off to Torino, Italy last winter, to win a silver medal for the United States, I fit them with new contact lenses. Ice skaters are particularly challenging as contact lens wearers because they spend so much time in an environment with dry, cold air and wind blowing in their faces. But the skaters' biggest complaints — dryness and end-of-day discomfort — are very common among athletes, whether they are Olympic-caliber or just weekend sports enthusiasts.

Dr. Horn (center) with Olympic skaters Tanith Belbin and Ben Agosto.

Considering special needs

Dry, windy conditions are common in sports ranging from skiing to soccer. Many outdoor sports also involve sun exposure and glare, which can cause eye strain in the short-term and contribute to UV-related disease in the long run. Additionally, athletes tend to wear their contact lenses for long hours through work or school and sporting activities, so they really need good oxygen permeability and a comfortable fit.

Then there's the "weekend warrior" contact lens wearer. Tanith Belbin falls into this category. She has a very mild prescription and only wears her lenses for competition and some practice sessions. She needs a lens that feels comfortable even though her eyes aren't accustomed to contact lenses.

Part-timers

In my clinical experience, wearing contact lenses only for sport is very common. Patients who are nearly emmetropic may not need visual correction most of the time, but they want optimum visual acuity to land a jump perfectly, or to hit the ball out of the park. Those with higher prescriptions may typically wear glasses, but find them unsafe and/or uncomfortable for sport. Often these patient wear contact lenses to obtain full peripheral vision with no frames in the way, and to eliminate the minification effect of glasses so the images they see on the court or field are the correct size, both of which are crucial to good performance. 

Whatever their reasons for occasional contact lens wear, athletic patients don't want their contact lenses to distract them. Like Belbin, their expectations of comfort during the short time they wear their lenses is very high.

Score with the right questions

Fitting Tips for Active Patients

Ask patients about the conditions under which they normally wear their lenses.
Ask patients how much time they spend outdoors or in "challenging" environments.
Ask patients what conditions may be unique to their sport regarding their contact lens needs.
Choose contact lenses with high oxygen permeability and UV-protection

In fitting any athlete with contact lenses, my top priorities include a material with good oxygen permeability, UV-protection, clear all-day vision and a good base curve for a comfortable fit. I chose Acuvue Oasys with Hydraclear Plus (Vistakon) for both Belbin and Agosto. The lens, which was designed for comfortable wear in dry environments, is made of silicone hydrogel material (sen-ofilcon A). It blocks more than 96% of UV-A rays and 99% of UV-B rays.

The lens base curve is 8.4mm, and has been compatible with every patient I've tried it on to date. I have found the power to be predictable with no additional prescription adjustments necessary other than standard vertex conversion. Although I do a trial lens over-refraction at each follow-up visit, I cannot recall a time when I needed to adjust the power precalculated from a patient's refraction.

You may have more athletes among your patient population than you realize. In general, it's valuable to ask about the conditions under which patients normally wear their lenses, including how often and how long they wear them, and how much time they spend outdoors or in challenging environments. Asking a few questions about lens wear habits may reveal that dryness and discomfort are problems, even though patients initially say their lenses are "okay."

I suggest rewetting drops for dryness and always recommend patients wear protective eye wear in the sun, but I also know that patients don't follow our recommendations all the time. Anything we can do to provide additional protection to keep their eyes healthy is important.

DR. HORN IS IN PRIVATE PRACTICE IN WASHINGTON, MICH. CONTACT HER AT (586) 992-3700 OR BARBARAHORNOD@COMCAST.NET.



Optometric Management, Issue: October 2006