Expert answers: Are contact lenses a safe option for over-60s?

Around half of the population is living with a vision problem so chances are you, or someone close to you, have had to make a decision about whether glasses or contact lenses are the best option to improve sight or correct eye problems. Designer brands and trendy frames have allowed glasses to become a significant part of a person’s identity and style, while technological and scientific developments mean even more people have the option to wear contact lenses if they choose to. But just how safe are contact lenses and are they something over-60s should consider?

Chandra Bala, clinical associate professor at Macquarie University and eye surgeon at personalEYES clinics, tells Starts at 60 that because contact lenses are placed directly on the eye, they tend to be less comfortable than glasses and can also increase the risk of infection. He explains: “The surface of the eye has protective barriers which, if you break down, can allow bacteria to get in.”

Contact lenses can damage these protective barriers which allows bugs, bacteria, viruses, fungi and even parasites to infect the eye and cause everything from pain, blurred vision and sensitivity to irritation and even blindness. To make matters worse, lenses that aren’t cleaned properly can become a hotspot for harmful bacteria which can lead to further problems.

Every year in Australia, 930,000 people are treated for bacterial keratitis, which is a painful infection of the eye’s cornea, while an additional 58,000 people are diagnosed with it in hospital emergency rooms. The rate of other bacterial infections varies between 1.2 per cent and 20 per cent – depending on the country, the type of contact lenses a person is wearing and how they’re cleaning them. Even in cases where bacterial infections are low, they’re a huge problem because they can cause scarring on the eye and can cause irreversible vision problems.

Wearing contact lenses for long periods of time can also desensitise the cornea and while contact lenses have drastically improved over the years, they still don’t allow as much oxygen into the eyes as glasses – which is vital for keeping the eyes healthy. When the eyes are less sensitive, they don’t water as much as they need to, which can result in dry eye and increase the risk of blurred vision and mucus production.

“What most contact lens wearers will find is that sometimes it’s hard to remove them as it gets more and more dry. It sticks more to the surface,” Bala says. “When you do actually remove it, you’re going to take off some of your top layer or cells. As it’s getting dry and it’s rubbing more, it increases your risk of infection.”

People who wear contact lenses can make changes to minimise the risk of infections, dry eye, discomfort, redness and itching, but the only way to completely prevent these issues is to stop wearing the lenses completely. If people still want to wear lenses, it’s important they visit their optometrist regularly to ensure the lenses don’t become too tight or too loose, as this can also cause problems.

Other issues arise when people simply don’t follow the instructions correctly or wear lenses in a way that can cause the eye harm. Bala explains: “Daily disposable ones are meant to be thrown out. Fortnightlies are meant to be thrown out.”

Similarly, professionals will never recommend people sleeping in their contact lenses as this can increase the risk of infection, reduce the oxygen in the eyes, cause damage and make it harder to remove them. And, while some people believe they don’t need to clean disposable lenses because they’re only going to get thrown out, cleaning them with a contact lens solution can actually increase comfort because you’re washing away protein the eyes have produced that could be sticking to the lens and impacting vision. No lens should ever be cleaned with standard tap water or chlorinated water and it’s always best to talk to an optometrist or eye doctor about which solution is best for you.

Some people also opt for contact lenses because they think they’re cheaper than glasses and easier to purchase, but it’s not necessarily true. Contact lenses can cost up to $1,500 each year – depending on the prescription and the type of lens – and this doesn’t factor in the cost for cleaning solutions, protective cases and other accessories that are needed to maintain lenses.

There can also be dangers to purchasing contact lenses online and items not sold from Australian stores may be dangerous and may not meet Australian safety standards. People are always advised to seek professional medical advice from the optometrist or eye doctor, have annual check-ups and always keep their contact lenses as clean as possible.

“They require more maintenance and they need to be reviewed regularly,” Bala says. “People need to change their contact lenses regularly and have follow-up care of a higher standard than the glasses.”