Original Article
Awareness of Contact Lens Care among
Medical Students
Hijab Ijaz, Rida Ijaz, Naeem Rustam
Pak J Ophthalmol 2017, Vol. 33, No. 2
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See
end of article for authors
affiliations …..……………………….. Correspondence
to: Hijab Ijaz Department:
Department of Optometry and Orthoptics, Fatima Memorial Hospital College of
Medicine & Dentistry, Lahore. E-mail: hijabijaz@hotmail.com |
Purpose: To determine the awareness of
contact lens care among medical students. Study Design: Cross sectional study. Place and Duration of Study: Fatima
Memorial Hospital College of Medicine and Dentistry, Lahore over a period of
four months since 1st August 2012 to 30th November
2012. Materials and Method: Data
was collected through a self-design questionnaire from 100 medical students
of Fatima Memorial Hospital College of Medicine and Dentistry, Lahore.
Questionnaires were distributed among those who used contact lenses presently
or in the past. Questions were asked about contact lens hygiene and complications
related contact lens usage. Gender, visual acuity and contact lens fitting
etc. were independent variables. Students related to other professions and
those who had eye problems but did not use contact lenses were excluded. Results: In this study there were total
100 medical students whose ages ranging between 18-23 years and majority of
them were females 96% (96); most of the students occasionally 57% (57) used
contact lenses; awareness about contact lens solution was found in 96% (96)
of students. However students have little awareness regarding contact lens
case cleaning and use of enzymatic cleaner 68% (68) did never used enzymatic
cleaner. The complications occurred in 69% (69) students with the use of
contact lens. Conclusion: Majority of the medical
students were aware about the most of the cleaning and hygienic steps of
contact lens care but majority of them were unaware about contact lens case
cleaning and use of enzymatic cleaner therefore they faced eye problems. Keywords: Awareness, contact lens, care,
medical students. |
Contact
lenses are thin optical corrective lenses worn on the eye, resting on the
surface of the cornea. Contact lenses are becoming popular in young generation
specially students of school and colleges1.
Care and maintenance of contact lens is one
of the most important aspects. It can influence the outcomes of contact lens
wearers and contentment with their lenses2. Non-compliance is a
major issue in contact lens wearers and it is seen in various aspects of
contact lens wear and care3,4. It has been estimated that
approximately 140 million people were using contact lenses worldwide in 20055.
Use of contact lenses is increasing day by day yet people are not fully aware
about various merits and demerits of contact lenses1.
Ignorance of contact
lens care leads to a serious ocular health problems for example dry eyes, giant
papillary conjunctivitis, corneal edema, corneal ulcer, keratitis, corneal
warpage and neovascularization.1 Ocular health education especially
knowledge in the correct and careful practice regarding contact lens wear can
prevent complication resulting from wearer’s inappropriate behavior6.
The wearer’s attitude and knowledge relating to contact lens care including
cleaning, disinfection, protein removal, keeping of solutions for a longer
period, hygiene of hands and lens cases, a period of wear exceeding the
recommended one, and the lack of regular eye assessment, have been proposed as
the main causes of complications7. Medical students having studied
the basic physiology and anatomy of the eye are expected to have better
knowledge about contact lens care compared to students studying other subjects.
This study was undertaken to determine
the awareness of contact lens care among medical students.
MATERIALS AND METHODS
This was a cross sectional descriptive study. The
study was conducted in 4 months since 1st August 2012 to 30th
November 2012. Helsinki (2008) principles were followed to conduct the study.
After taking ethical approval from the institution data was collected and it
was only for research purpose. After taking consent data was collected through
a self-design questionnaire at Fatima Memorial Hospital College of Medicine and
Dentistry, Lahore from 100 medical students of those who used contact lenses
currently or ever had tried in the past. Questions were asked about contact lens duration, type, hygiene and
complication related contact lens usage. Gender, visual acuity and
contact lens fitting etc. are independent variables. Students related to other professions
and those who had eye problems but did not use contact lenses were excluded.
After collection of data it was entered and analyzed by using SPSS 19.
RESULTS
In this study data was collected from 100
patients in which 96 (96%) were females and 4 (4%) were males. Currently 69
(69%) were using contact lens and 31
(31%) had tried them in the past. Eight students (25.8%) stopped using contact
lens because it was difficult to wear, 9 (29%) discontinued as they were fed up
to wear contact lens because it needs proper care and they cannot maintain
appropriate care, and 14 (45.2%) terminated their use due to its complications
they faced. The patients who wore Rigid Gas Permeable lens (RGP) or soft
contact lenses presently or in the past were 2 (2%) and 98 (98%) respectively.
According to the mode of wear 2 (2%) were
using disposable lenses, 67(67%) wore their lenses daily and 31 (31%) were extended
wearers. Six (8.7%) were using contact lens for less than 6 months, 20 (29%)
for 6 months to 1 year, 17 (24.6%) were using from 1 to 5 years and 26 (37.7%)
were for more than 5 years. 43 (43%) daily wore their contact lenses and 57 (57%)
used them occasionally.
On average 56 (56%) were wearing less than
8 hours per day while 44 (44%) used them for more than 8 hours per day. 42
(42%) students were using contact lens for their refractive error, 31 (31%) for
cosmetic problems, 22 (22%) for convenience while 5 (5%) were using lenses for
other reasons. 91 (91%) removed contact lens before going to sleep, 4 (4%)
removed after overnight, 3 (3%) after one week, 2 (2%) were removing after
fortnight.
Frequency of hand
washing (p-value=0.668) was 89% before handling contact lens. Only a small
number of students 2 (2%) never cleaned their lenses others cleaned them either
before or after wear, weekly or monthly (p-value=0.305). Mostly students 96
(96%) were using contact lens solution as cleaning material (p-value=0.207).
When question was asked about contact lens case cleaning only 7 (7%) student
never cleaned them while only few 4 (4%) students knew about enzymatic cleaning
once a week (p-value=0.223) as shown in table.
Table: Contact Lens Use.
|
|
Male |
Female |
|
|
|
Gender |
4 (4%) |
96 (96%) |
|
|
|
|
Current user |
Past User |
|
|
|
Contact
Lens Wear |
69 (69%) |
31 (31%) |
|
|
|
|
<6 months |
6 months to 1 year |
1 to 5 year |
>5 year |
|
Duration
of contact lens wear of current user |
6 (8.7%) |
20 (29%) |
17 (24.6%) |
26 (37.7%) |
|
|
Rigid
gas permeable |
Soft contact lenses |
|
|
|
Type
of contact lenses use |
2 (2%) |
98 (98%) |
|
|
|
|
Daily wear |
Extended wear |
Disposable |
|
|
Mode
of wear |
67 (67%) |
31 (31%) |
2 (2%) |
|
|
|
Daily |
Occasionally |
|
|
|
Use
contact lenses |
43 (43%) |
57 (57%) |
|
|
|
|
<8hours |
8-12hours |
>12 hours |
|
|
Hours
per day wearing contact lenses |
56 (56%) |
33 (33%) |
11 (11%) |
|
|
|
Refractive |
Cosmetic |
Convenience |
Others |
|
Reason
of using contact lens |
42 (42%) |
31 (31%) |
22 (22%) |
5 (5%) |
Table: Knowledge about contact lens hygiene.
|
|
Yes |
No |
|
|
|
Hand washing before using contact lens |
89
(89%) |
11
(11%) |
|
|
|
|
Before going to sleep |
After overnight |
After one week |
After fortnight |
|
Remove contact lenses |
91 (91%) |
4
(4%) |
3
(3%) |
2
(2%) |
|
|
Before or after wear |
Weekly |
Once a month |
Never |
|
Contact lens cleaning |
69
(69%) |
20
(20%) |
9
(9%) |
2
(2%) |
|
|
Once a week |
Once a month |
Off & on |
Never |
|
Contact lens case cleaning |
37
(37%) |
19
(19%) |
37
(37%) |
7
(7%) |
|
|
Lens solution |
Tap Water |
|
|
|
Cleaning material |
96
(96%) |
4
(4%) |
|
|
|
|
Yes |
No |
|
|
|
Knowledge about renewal of contact lens every 3 months |
52
(52%) |
48
(48%) |
|
|
|
|
Once a week |
Once a month |
Off & on |
Never |
|
Enzyme cleaner use |
4
(4%) |
13
(13%) |
15
(15%) |
68
(68%) |
The patients who were
using contact lenses 69% of them may had problems with its use while 31 (31%)
students had no problem with contact lens usage.
DISCUSSION
It is very important that the medical
students have knowledge about contact lens wear, hygiene, care and
complications. Many people prefer contact lenses
over glasses for cosmetic reasons. Broadly contact lens are classified in hard
and soft lenses.8 Soft contact lenses are usually more comfortable
to wear, but they also tear more easily than hard contact lenses.
In the present study 96% of the students used
contact lenses were females. Among them 69.8% (67) females were using contact
lenses currently whilst 30.2% (29) had tried them in the past. 97.9% (94) females
were soft contact lens users. The study conducted in Malaya, Karachi and Brazil,
females were most frequent users of contact lens respectively (87.6%, 92.6%,
69.2%). They were using them for refractive error or cosmetically4,7,9.
Most of the medical students in our study using contact lens for more than 5
years were 37.7%. Among these 18 students (41.9%) were having more problems
with contact lenses which are consistent with results that found in both
previous researches4,7.
In our study 56 medical students (56%) wore
contact lenses for less than 8 hours and among them 56.7%experienced problems
with contact lenses. However the study conducted in India found that 88.6%
students had problems related to contact lens with P value 0.043 and concluded
that hours per daily wear related to use of contact lens10.
Contact lenses are used to treat refractive
error, keratoconus, anisometropia, nystagmus, unilateral aphakia and also use
for cosmetic and therapeutic purposes11. In our study most of the students 42% were
using contact lens for refractive purpose and 31% for cosmetic purposes while
in study held in Karachi contact lenses were used for refractive errors in 67.23% patients and for cosmetic purposes in 43.8%
patients in the study of Malaya4,7.
The purpose of lens care system is to
maintain comfort, provide good vision, maintain eye health, and maintain lens
hydration and parameter stability.12 Care for contact lenses is
dependent on the type of contact lenses and solution recommended by your eye
care professional13. In particular, including a "rub and rinse"
step in the lens cleaning process, minimizing contact with water while wearing
contact lenses and replacing the lens case frequently can help reduce the risk
of infection14. Contact
lenses must also be safely stored in solution until they are next worn15.
Nine percent (9) students
did not remove their lenses before going to sleep and among them 10.5% (7)
faced problems. However 13.20% and 13.50% students did not remove their lenses
before going to sleep in the
studies of Malaya and Karachi respectively4,7.
In our study hand washing is not related
with contact lens problems. 89% (89) of medical students wash their hands
before handling of contact lenses while students who did not wash their hands
was slightly higher 11% (11) from another study in Karachi in which 7.7% did
not wash their hands4.
98% (98) of students claimed that they
cleaned their lenses amongst them before/ after wear 69% (69), weekly 20% (20) and
monthly 9% (9). However remaining 2% (2) did not clean them ever. Among 98% who
cleaned their lenses 70.4% (69) experienced an eye problems related to contact
lens. On the other hand Muneer et al reported that 94.2% of students cleaned
their lenses while 5.8% did not and 84.3% of students cleaned their lenses
reported by Tajunisah
et al4,7.
Contact lens solution are used to clean,
disinfect and rinse the lens. Multipurpose solution most commonly use now a
days.16 In this study 96% (96) students claimed that they were using
contact lens solution as cleaning material and 4% (4) using tap water. Whereas
in the study of Giri, P.A., Chavan,
W.M., Phalke et al. 79.31% used lens solution and 20.69% did not1.
Contact
lenses can adversely affect most of the anterior ocular structures.17 Patient using contact lenses often suffer from red eye,
itching, and scratchiness. 18 69%
(69) of medical students in our study reported that they were suffered from an eye
problems associated with contact lens wear in which red eyes 18% (18) and
discomfort 15% (15) with contact lenses were most prevalent; While in previous
studies redness and irritation were found to be the most frequent complaint4,7.
Adverse effects due to
contact lens wear can be acute or chronic in nature and can span the range from
a mere annoyance to a disabling condition that results in permanent ocular
damage or loss of the eye19. In our study 45% of
student’s claimed that contact lens is not harmful which is slightly different
from study by Muneer et al in which 58.1% patients said that it is not
dangerous for use4.
Patient
education is of paramount importance and has been the gold standard for
decades. Recent findings however, suggest that recommendations amongst eye care
practitioners are highly variable necessitating more effective practitioner
educational programs to eliminate this ambiguity20.
CONCLUSION
This study shows that medical
students have significant knowledge about how to use contact lens but majority
of them lack proper awareness regarding enzymatic cleaning and contact lens
case cleaning which can led to serious eye problems. Therefore, the knowledge
and practice about contact lens care should be increased by appropriate
counseling.
Author’s Affiliation
Dr. Hijab Ijaz
Department: Department of Optometry and Orthoptics, Fatima
Memorial Hospital College of Medicine and Dentistry, Lahore.
Dr. Rida Ijaz
Department: Department of Optometry and Orthoptics, Fatima
Memorial Hospital College of Medicine and Dentistry, Lahore.
Dr. Naeem Rustam
Department: Department of Optometry and Orthoptics, Fatima
Memorial Hospital College of Medicine and Dentistry, Lahore.
Role of Authors
Dr. Hijab Ijaz
Study design, data collection, data analysis, manuscript drafting.
Dr. Rida Ijaz
Data collection, manuscript drafting
Dr. Naeem Rustam
Manuscript drafting, Revision data analysis
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