Contact Lenses or LASIK: Making an Informed Decision for Your Eye Health in 2024
With the summer adventures in Colorado fast approaching, more people are leaning towards the convenience of not worrying about glasses. When you think of vision correction, the two main options that usually come to mind are contact lenses and LASIK Eye Surgery. Both options provide the freedom of clearer vision, but they also come with their considerations and risks. In this blog post, we will dive into the disadvantages of each option to help you make an informed decision about which path is the best for you.
Disadvantages of Contact Lenses
Contact lenses are a popular choice providing enhanced vision without considering surgery. However, along with anything, there are risks to think about.
Infection
Bacterial or fungal infections can occur when you are handling or cleaning your contact lenses improperly. According to the CDC, up to 1 in 500 contact lens users experience serious eye infections that could lead to blindness each year.
What causes infections from Contact Lenses?
There are several factors that can cause a contact lens-related eye infection. Some causes may include:
- Using extended-wear lenses
- Sleeping in your contacts
- Swimming with contacts
- Having microbes build up under the lens
- Herpes virus
- Bacteria, fungi, or parasites
- Not keeping lenses or cases clean, or reusing or topping off contact lens solution
These infections can cause redness, pain, and could result in vision loss if left untreated.
Most Common Eye Infections
Staph Marginal Keratitis
Staphylococcal marginal keratitis is an inflammatory condition affecting the cornea, typically caused by bacterial infection, specifically Staphylococcus aureus. It’s characterized by inflammation around the edge (margin) of the cornea. When it occurs in association with contact lens wear, it’s often referred to as contact lens-associated marginal keratitis (CLMK).
Typically, the skin harbors Staphylococcus aureus, which can transmit to contact lenses or eyes upon direct contact. Contact lenses can increase the risk of CLMK due to improper lens hygiene or bacterial contamination.
Pseudomonas
The leading cause of gram-negative bacterial keratitis, and one of the most common causes of bacterial keratitis overall. In one meta-analysis, prevalence of P. aeruginosa isolates in bacterial keratitis ranged from 6.8 to 55%[1] .
- It is widely known that pseudomonas keratitis is strongly associated with contact lens wear. In one study, incidence of pseudomonas keratitis was 2.76 cases per 10000 individuals per year, but rose to 13.04 cases per 10000 individuals when only considering contact lens wearers[2]. In the same study, 55% of cases of pseudomonas keratitis were associated with contact lens wear.
- Extended contact lens use allows adhesion of P. aeruginosa to contact lens surfaces and subsequently the cornea. P. aeruginosa possesses specific virulence factors, including pili, glycocalyx, and exotoxins, which allow adherence and invasion into the cornea[3].
- Pseudomonas keratitis in non-contact lens wearers tends to occur more commonly in the elderly and also causes significant morbidity. Non-contact lens wearers may experience worse outcomes due to factors such as worse initial visual acuity, older age, and the size and extent of stromal involvement.
Acanthamoeba
Acanthamoeba keratitis is a rare but serious infection of the eye that can result in permanent visual impairment or blindness. This infection is caused by a microscopic, free-living ameba (single-celled living organism) called Acanthamoeba. Acanthamoeba causes Acanthamoeba keratitis when it infects the transparent outer covering of the eye called the cornea. These amoebas are very common in nature and can be found in bodies of water (for example, lakes and oceans), soil, and air.
Acanthamoeba keratitis is most common in people who wear contact lenses, but anyone can develop the infection. For people who wear contact lenses, certain practices can increase the risk of getting Acanthamoeba keratitis:
- Storing and handling lenses improperly
- Disinfecting lenses improperly (such as using tap water or homemade solutions to clean the lenses)
- Swimming, using a hot tub, or showering while wearing lenses
- Coming into contact with contaminated water
- Having a history of trauma to the cornea
Dry Eyes
Dry Eye syndrome is where the eyes do not produce enough tears to keep the eye moisturized and is a leading cause of extended use of contact lenses.
Corneal Abrasions
Corneal abrasions occur from accidentally scratching the surface of the eye with a contact lens. These types of scratches can be painful and may increase the risk of infection.
Allergic Reactions
Some patients may experience an allergic reaction to the materials used in contacts. An allergic reaction can cause swelling, irritation, itching and redness.
Disadvantages of LASIK Eye Surgery
LASIK Eye Surgery gives patients freedom of contacts by providing them a more permanent solution by reshaping the cornea. Unlike the high infections rate of contacts, the percentage of infection with LASIK eye surgery is between 0.03% and 1.5%. Severe cases occur within 0.02% of patients.
While serious complications are rare, the most common risks with LASIK are:
Dry Eye Syndrome
Similar to contact lens wear, LASIK eye surgery can also promote Dry Eye Syndrome. This occurs during the procedure when the nerves administering tear production are disrupted. Dry Eye Syndrome can also occur more often in drier climates.
Under-correction and Overcorrection
In some cases, the desired level of vision correction may not be achievable to result in overcorrection or undercorrection. A secondary procedure (i.e. enhancement) may be necessary to fine tune the outcome.
Visual Disturbances
At night or in low-light conditions, some patients may experience glare, halos or potentially double vision. However, this may improve over time during the healing process, but can be cumbersome in the meantime.
Flap Complications
The LASIK eye surgery procedure consists of a thin flap created in the cornea. That flap is then lifted to reshape the underlying tissue. Complications with the flap are incredibly rare but can include dislocation or epithelial ingrowth.
Permanent Vision Changes
While permanent vision changes with LASIK are less than 1% and extremely uncommon, a patient may have a small risk of experiencing loss of contrast or visual acuity.
Conclusion
Whether you decide on contact lenses or the long-term effects of LASIK surgery, it is paramount to prioritize eye health and safety. When weighing your options between contact lenses and LASIK eye surgery, it is important to consult with an eye care professional to understand the risks and benefits.
Dr. Dishler is a trusted LASIK pioneer and has been in business for over 40 years! We pride ourselves on educating our patients to ensure their peace of mind when moving forward with LASIK surgery. Schedule your free consultation today!