How A Simple Contact Lens Mishap Can Destroy Your Eyeball
Once upon a time, contact lenses were giant discs made of stiff impermeable glass, and sticking them in your eye was roughly as comfortable as adding four robot tentacles to your spine. As the years went by, contacts got smaller and more practical, and that's great. But that kind of ease can make people complacent, which is not so great, because contacts come with risks. And by "risks," we mean "getting so infected that they have to cut a cornea out of a corpse and graft it into your goddamned eyeball." Just ask Heather Topf.
Warning: Heather's account includes graphic descriptions of gross eye stuff.
There's A Risk Of Huge Damage From Leaving Your Contacts In
Nearly a million people go to the hospital in the U.S. every year with a kind of eye infection that's most often caused by contact lenses. At its mildest, this can be fixed with drops, or it may need some more serious antifungal medication. At its most severe, it's a fucking nightmare.
A lot of the time, it starts with people not washing their hands before handling their contacts, or letting their lenses touch water (water, unless specifically sterilized, is always swarming with bacteria). But there is a special risk when those contacts happen to be continuous-wear lenses -- those designed to be left in for a month or more. But customers love them, because they're so convenient that it's like you don't have contacts at all. ("Waking up being able to see each morning, bloody great!" says Heather, foreshadowing the horror that is to come.)
She did get some warnings from her eye doctor -- maybe she should take them out overnight every week or so. Get more frequent checkups, like every six months instead of yearly. She didn't.
In fact, the CDC says there's a pretty wide tendency for contact lens wearers to ignore warnings, and as proof, they offer a bunch of cases of people who ended up suddenly popping their eyes or needing transplants. They also offer the example of a Scottish woman who accidentally lost a contact lens under her eyelid for 28 years, and while that's not typical and actually not especially relevant, they couldn't help sharing it, and we can't blame them.
It Started Small -- Just A Watery Eye
In June 2017, Heather was working and attending the Glastonbury Festival, the largest music festival in the world (with 150,000 people attending, it's over twice the size of Burning Man). She was manning one of the crew bars, a little sanctuary away from the crowds and madness, and spending nights in a tent with her sister and a bunch of friends. The week went by with many late nights in dusty fields, so she didn't think it all that strange when she felt some irritation in her eyes. Note: If you ever feel irritation while wearing lenses, the FDA insists that you rip those things out immediately and make a beeline to an eye care professional.
Instead of doing that, Heather spent the night getting drunk on cider, staying up to see the sunrise, then reading her Kindle while alternating between sleeping in the tent and out of it -- polyester prisons can be sweltering and leave you claustrophobic, a condition that festival goers call "tent death." She then realized tears were streaming out of one eye. "Not watering," she says, "proper pouring down my face and really quite sore." She passed out, and when she woke up it was worse. "I looked like I'd been punched in the face, my eye was literally swollen shut."
Those are symptoms pretty similar to those of this other British woman, who got an infection from her contacts and ended up losing sight in her eye. Or this woman, or this one, who ended up suing the maker of her contact lens solution. There have actually been a couple lawsuits over eye-gobbling germs popping up in lens solutions.
Heather's friends got her to put some ice on the eye and visit the festival hospital, which wasn't equipped to diagnose something like this. So she headed for the nearest emergency room, where a nurse poured in some dye and then spotted a cut right under where the contact lens sits.
No worries, he said. He went on to explain that the body is very clever and had produced a swelling response to protect the eye. He gave her some antibiotic ointment just in case, said to apply it every few hours, and to keep the lenses out for a week. No harm done.
Whatever relief Heather felt upon hearing this would be short-lived.
Then Came Total Blindness
Heather went home and ordered a pizza, then went to bed without eating it and without showering. This was just as well; showering with your contacts in is actually one way of contracting blinding infections (it counts as "bad hygiene," or "infection via irony"). Heather's eye still hurt, and she hoped sleep would make it better. Spoiler: It did not.
The next morning was the first time she'd peeked at a mirror in ten hours. Her right eye now looked entirely white. Then Heather realized she was staring at her reflection through her left eye, because the right one couldn't see at all. Also, it hurt, a lot. Despite normally being a devout never-nude, she tore into her roommates' room without getting dressed to point out the growing evidence that she was turning into a wight. "Poor lad takes one look at me," she says, "stumbles out of bed, and says, 'Hospital, now.'"
The gang borrowed a van from the pothead next door and headed for help. "By now I'm in real pain," she says. "Clinging-onto-my-eyeball, sobbing, no-idea-what's-going-on pain." She walked into the hospital rain-soaked, wearing Birkenstocks and sweatpants borrowed from her much taller ex. This first hospital turned her away, because she needed a dedicated eye hospital. The second one saw her and acted fast.
According to contact lens companies, the risk of getting infected from lenses and losing vision is "only" 4 in 10,000 per year. They seem to be referring to this data, which says those chances go up to 20 in 10,000 when it's extended-wear lenses. For comparison, your chance of being hospitalized for the flu is 300 per 10,000. So we're not saying this is ever going to happen to you, but the probability isn't exactly zero either.
Cocaine Offered Some Relief
"The lady on the desk took one look at me," says Heather, "and all of a sudden I was being given cocaine in the eyeball." Yeah, turns out cocaine is a legit anesthetic applied directly to the eye for quick results. "Instant relief!" she says. "They touch this stuff to your eye and it's numb in seconds. It doesn't last very long -- 15 minutes maybe -- but it was the only thing that they gave me that really worked for the pain."
Note: We're thinking you should only do the above under the supervision of a doctor.
Then came corneal scrapings, then an IV drip and a series of painkillers that were unfortunately not nearly as effective as cocaine. The immediate diagnosis was of some serious but unknown infection, so until they could figure out which it was, they'd treat all possible culprits. Every hour, on the hour, came a series of antibiotics, steroids, and atropine. This was continual, with no breaks for a night's sleep. Adding to the discomfort, Heather was forbidden from bathing, despite now stewing in a week's worth of festival stink.
This was a teaching hospital, so when she was next examined, after a fresh round of eye cocaine and dye that made her snot glow, a line of bright-eyed university students looked at her and went, "Ewww." She was diagnosed with a bacteria called Pseudomonas aeruginosa, which her lens had trapped against her cornea. The infection had birthed an ulcerated abscess right in her eyeball. Feel free to go google photos of that on your own time.
This type of bacteria is particularly common on non-prescription lenses -- novelty ones, like you might get at a tattoo parlor or for Halloween -- which are fun little accouterments you should never ever wear if you give even the tiniest of fucks about your eye health (and also, they're illegal). Other kinds of germs on more conventional lenses have caused a sudden spike in cases of blinding infections this past fall, enough to send alarm bells ringing worldwide.
Heather's eye drop regimen continued, the nurse each time having to pry her lids open with Q-tips because gook kept sealing them shut. After several days of this routine, the doctor visited with no students, and Heather asked point blank if she was ever getting her vision back. "It's a very serious infection you have here, Miss Topf," she replied. "You're very likely going to need a cornea transplant." And how is such a transplant done, exactly? "Well," said the doctor, "once a person dies, they harvest the corn-"
And on hearing that, no joke, Heather lost consciousness.
Yes, They Transplant Eye Parts From Corpses
So here's the upside of needing a cornea transplant:
Corneas are unique organs in that they receive no blood flow (instead they're fueled by tears and the eye's other fluids). That means there's no real need to match up donors to recipients. There's some risk of rejection, but not like how it is with every other kind of transplant. There's also no shortage of corneas because so many deceased individuals donate them, and so many of them turn out to be usable.
The donor they'd use for Heather actually died in between scheduling the procedure and having it done, in a car accident. Which, Heather points out, means they had scheduled a transplant from a person who had no idea they were destined to be the donor. "They were still fannying around out there," says Heather, "doing their thing, with no idea their world was going to end, that their family's lives were going to change forever." It was creepy to think about, as was the very real fear that the transplanted eye would let her see ghosts.
It took two surgeons four and a half hours to complete the surgery. "They inflated an air bubble into the layer of my eye under the scar," she says, "which peeled the damaged part off, then they scraped down to the Descemet's membrane, before prepping the donor tissue to the right shape, size, and thickness. They then sewed it in place with 16 tiny sutures, which is so delicate they did one each and then had a rest. It's proper micro surgery."
Hopefully, this means Heather's out of the woods. It wasn't the case for that other British woman we mentioned earlier. That patient got a corneal transplant too ... and then the infection carried over to it, and a second transplant failed to fix the problem, so that eye went blind permanently.
So yeah, be really careful with your eyeballs, kids. Shit can go south in a hurry.
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