contact lens care
Protection from Pollen
BY MICHAEL A. WARD, MMSC, FAAO

Spring is a time of renewal. Songbirds sing their loudest and most eloquent songs to mark their territory and to attract a mate. Flowers emerge from bulbs through the cool, damp soil that has slowly prepared since fall to present a kaleidoscope of colors to brighten our days. Grasses awaken from their dormancy to claim their space in the yard. Trees sprout new growth to repair the traumas from winter storms. Ah, the joys of spring.

Trees are spring's first large-scale producers of buds, flowers and pollens. Grasses, molds and weeds follow as the season advances. Pollens blur the vision of our contact lens-wearing patients.

All About Pollen

Pollens affect contact lens wearers in multiple ways. Pollens are both physical and immunologic irritants, affecting roughly 10 percent to 20 percent of the population, with even greater percentages in the warmer and humid climes. As carbon dioxide concentrations increase, so do the number of pollens and other allergens in our environment.

A Harvard Medical School study (2002) found that ragweed grown in an atmosphere that contains double the current carbon dioxide levels produced 61 percent more pollen. Regrettably, experts expect atmospheric carbon dioxide levels to double over the next 50 years.

The greatest tree-generated physical irritant is the bi-lobed, vesiculated pine pollen, which feels like aerated sand to contact lens-wearing patients. Allergic rhinitis that has associated allergic conjunctivitis is the main immunologic consequence to seasonal tree pollens. Expectedly, contact lens wear can prove challenging in this environment.

Tips for Contact Lens Wearers

Following are some pointers that should make wearing contact lenses more bearable when the pollen count is high:

Physical barriers Wear goggles or close-to-the-face fit sunglasses when outside. Keep home and automobile windows closed.

Air cleaners High efficiency air filters and electrostatic air cleaners can remove pollen and dust to improve air quality in central air conditioning systems. Replace filters regularly.

Eye drops Frequent use of low-viscosity, preservative-free artificial tears help to dilute and rinse out tear film irritants. In-eye contact lens cleaners such as Blink-N-Clean (AMO) or Clerz Plus (Alcon) may also help.

Pharmaceuticals Systemic antihistamines can help alleviate allergic symptoms, but may lead to ocular dryness. Patients should use topical decongestants sparingly to avoid vascular rebound. Mast cell stabilizers are helpful if you prescribe them proactively before symptoms occur. Combination drops such as azelastine HCl ophthalmic solution 0.05% (Optivar, MedPointe Healthcare, Inc.), olopatadine HCl ophthalmic solution 0.1% (Patanol, Alcon) and epinastine HCl ophthalmic solution 0.05% (Elestat, Inspire Pharmaceuticals/Allergan) seem to offer the greatest relief of allergic symptoms by combining the immediate antihistaminic relief with the prolonged effect of mast cell stabilizers.

Lens care products Ignore the "no rub" product labeling. Instruct patients to rub and rinse their lenses upon removal to decrease the accumulation of debris on the lens surfaces. If you suspect a solution-related hypersensitivity or toxicity, then change to peroxide disinfection to eliminate possible preservative sensitivities.

Miscellaneous Washing face and hands often with cold water can relieve symptoms. (Cold compresses help to relieve ocular itching.) Instruct patients to replace their lenses more frequently and to avoid wearing them in severe pollen conditions.

Mr. Ward is an instructor in ophthalmology at Emory University School of Medicine and Director, Emory Contact Lens Service.