Global Insight

Eef van der Worp, educator and researcher in optometry and contact lenses, is disrupting the industry with his digital content. With short yet insightful commentaries on eye care and contact lens topics, his discussions are extremely relevant during the current global COVID-19 pandemic. 

Quarantine-Myopia

In Dutch we have a saying: ‘Oost-West – Thuis-Best’ – meaning there is nothing quite like home. As an experienced ‘home-worker’ the pros and cons of working from home are not new to me. But the latter (the cons) become extra clear in the current home-quarantine situation. Or as one of my neighbors with small kids exclaimed yesterday: ‘If I could have explained my idea of personal hell before last week, then no sport to watch, no gym, no pub and 2 kids at home all day – comes pretty close to it’.

Parental Monitoring

In China, of all places the cradle of the alarming virus that is hitting us, the Clouclip has been developed. It is like exponential ‘parental monitoring’. The tiny little camera is attached to the child’s frame, while it monitors not just the hours (minutes) of outdoor play and the amount of sunlight but also monitors the exact near-activity distance. The parents get a report at the end of the day of the exact child’s activities. Potentially something to consider for all of us in home quarantine these days.

Clouclip

A study in China lets kids in a rural environment, in a provincial-village and in a metropole wear this Clouclip. It was clear that kids in the rural environment scored a lower number of near-work activity and more sunlight exposure than kids in the village. This was true more-over in the metropolitan. And – surprise – the amount of myopia was larger there than in the village and in the rural environment.

If we elongate this – to stay in myopic terms – to the current situation of ‘homeschooling’ our kids, then let’s claim two new terms: quarantine-myopia and homeschooling-myopia. Maybe they can be put on the shortlist of ‘word of the year award’ in the eyecare field. However, this could be a worry if our kids stay indoors all day. Having said that – we have to wait a little while before we can see the consequences of that in the long run.

Global Warming

I notice when speaking to parents of young-myopes, that the urgency of intervention is often not obvious to them. As long as we don’t feel the consequences directly, it is hard to take action apparently. Isn’t this like with global warming and our environment? Regarding myopia: see the article by Kate Gifford in Contact Lens & Anterior Eye: what risk is larger, one on acute problems due to contact lens wear (that can potentially slow down myopia progression) – or the chance on myopic retinopathy later in life?

Cor(o)nea-virus

Pretty much every news item these days is related to the topic ‘virus’. In our profession as eye care providers, we are typically mostly worried about cornea-viruses, but that is different now.

At War

While we seem to be at war with a virus in the world-wide pandemic, it is weird to realize we are at war with a non-living creature. Viruses are pretty much non-living packages of DNA; they cannot live outside of a living cell. So the virus invades our cells, uses it – and goes on to the next cell. It cannot survive without ‘us’ basically. That is why the transmission of this virus is mostly via a direct way – e.g. via droplets that are sneezed or coughed on to the next person directly.

No Extra Risk

When you think about contact lens safety and corneal infections, viruses are actually not the first ones on our minds. The reason is exactly what is described above: a virus cannot live outside the human body. Bacteria can, and Acanthamoeba (free-living protozoa) can too. So, if we have one or a few bacteria in our contact lens case with purified water then these ‘animals’ (literally, and by figure of speech) can reproduce dramatically fast. Rabbits have the name for it – but believe me, these micro-organisms are the world champions reproducing. You can see I miss my daily shot of sports coverage here, by the way.

Contact Lens Related?

That’s why we don’t see – relatively speaking – much more corneal virus infections in lens wearers compared to non-lens wearers. For bacterial infections, and even to a larger degree for Acanthamoeba infections, the opposite is true: these are more prevalent in contact lens wearers. The latter case (Acanthamoeba) is in fact almost exclusively to contact lens wearers. Not something to be proud of. This has to do with the involvement of tap water in the lens care regimen. If an Acanthamoeba trophozoite is present and the lens gets stored in tap water overnight, then these parasites can increase substantially in number so that the next morning when the lens is applied to the eye, millions of micro-organisms are introduced to the ocular surface. That is why the general rule, for any contact lens regimen including rigid corneal and scleral lenses, is: no tap water!

Defense

Normally the defense mechanism of the eye is pretty good, with the epithelium and Bowman’s layer as first lines of defense if intact. But the combination of a compromised anterior ocular surface, with an overload of micro-organisms… that is not a favorable one. But with viruses, we typically don’t have the overload of overnight growth as we see with bacteria and Acanthamoeba – and viruses are in that regard relatively less of a worry. Wish we could say the same about the Corona-virus and our general health.

Eef@online updates are available on Eef van der Worp’s LinkedIn profile. Connect with Eef on LinkedIn to receive updates.

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