Correspondence| Volume 43, ISSUE 3, P214-215, June 2020

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The importance of credible information about contact lens wear during pandemic

Published:April 27, 2020DOI:https://doi.org/10.1016/j.clae.2020.04.008
      Dear Editor-in-Chief,
      During these times when the world is occupied with the peril of the COVID-19 pandemic, and while society is endeavoring to stop the spread of coronavirus disease, contact lens patients are seeking wearing guidance from eye care professionals. Hundreds of millions of people around the world use contact lenses each day and, in many cases, these prescribed medical devices are essential for their jobs. This includes frontline healthcare professionals and emergency responders who are working day and night fighting the outbreak.
      In recent days and weeks, there have been considerable media reports speculating that contact lens wear is unsafe, that wearers of contact lenses are more at risk of contracting COVID-19, and therefore contact lens wearers should stop wearing lenses and revert to spectacle wear to protect themselves. An egregious example has been guidance issued and actively promoted by the American Academy of Ophthalmology [], which was carried by leading news outlets [] that led to at least almost 600 stories in the past month [
      • Meltwater Global Media Database Search
      McDougall Communications.
      ]. A social media video in Italy conveyed that contact lenses are not safe to wear and that certain contact lens materials are “riskier” than others. The guidance to stop contact lens wear has even extended into an article on Do-It-Yourself (DIY) injuries during the coronavirus lockdown [
      • British Broadcasting Corporation
      Coronavirus: Eye Injuries Increase ‘Due to More DIY’.
      ].
      The dissemination of this speculation has been particularly unfortunate in that almost none seem to be evidence-based. An evidence-based approach in healthcare is essential in providing the best outcomes, and it can be dangerous to not rely on or even consider what research shows in the management of patients [
      • Lewis SJ, Orland BI
      The importance and impact of evidence-based medicine.
      ,]. Even when confronted with updated guidance on contact lens wear and care from the U.S. Centers for Disease Control and Prevention (CDC) [

      Centers for Disease Control and Prevention: Healthy Contact Lens Wear and Care. Protect Your Eyes. https://www.cdc.gov/contactlenses/protect-your-eyes.html.

      ], i.e., there is no evidence to suggest contact lens wearers are more at risk for acquiring COVID-19 than eyeglass wearers, and that contact lens wearers should continue to practice safe lens wear and care hygiene habits, imperious guidance to stop contact lens wear has continued. A clinical spokesperson for the American Academy of Ophthalmology was quoted in an interview [
      • NBC News Today.com
      Should You Stop Wearing Contact Lenses to Prevent Coronavirus?.
      ] as saying, “The CDC is staffed by epidemiologists. They are looking at published data; what is known about this new virus.” But the fact is, there’s not a lot known about COVID-19 and its behavior in the eye." The spokesperson—who is a practicing ophthalmologist—then went on to say, "Ophthalmologists are physicians, we look at it a little differently. We look at what is known about other viruses and how they can be transmitted through tears asymptomatically. We also know that most patients don’t follow proper contact lens hygiene. Add that together with a dose of common sense (emphasis added), and we err on the side of caution, and suggest patients consider taking a break from contact lenses for a while.”
      The purpose of sharing this is not meant to criticize the spokesperson’s sincerity, but to highlight that regardless of how well-meaning he is in expressing his opinion, he has admitted that the direction to stop wearing contact lenses and wear eyeglasses instead is not based on any evidence. It is understandable that not all healthcare providers have access to the latest research and information. When this is the case, they may decide to fall back on their experiences using their own judgement along with what they think is a “dose of common sense.” However, what healthcare providers believe what may be best for a patient is not always aligned with the most up-to-date advances in knowledge and technology.
      There is another factor undoubtedly in play with some news organizations distributing misinformation about contact lens wear, and this is based in the common saying “bad news sells.” In other words, it is often believed that news media focus on negative events and stories to increase their audience [
      • Buhl F.
      • Günther E.
      • Quandt T.
      Bad news travels fastest: a computational approach to predictors of immediacy in digital journalism ecosystems.
      ]. There appears to be a trend during the COVID-19 pandemic that has been described as an “insatiable appetite” for more coronavirus-related news [], in which consumers may be drawn into rumors and misleading information that has direct application to their wellbeing and lifestyles [
      • British Broadcasting Corporation
      Psychology: Why Bad News Dominates the Headlines.
      ], and this very well may be leading to the cascading of misinformation about wearing contact lenses. It is certainly delivering bad news—an attention-grabbing shock—when someone hears or reads that they can no longer wear contact lenses, especially if they rely on their lenses for clear vision and enjoy the freedom and convenience of wearing lenses. The worry of not wearing contact lenses also carries over to parents whose children are in myopia management treatment plans with contact lenses designed to slow down the progression of myopia.
      While it is not unusual for one news service to publish a story about something bad and then have other media move quickly to match it, there may be interest amongst some to seek good news that will lead to positive impact on their quality of life []. Consumers are interested hearing from their eye care professionals and will welcome the good news and reassurance about wearing contact lenses. During these periods of lockdowns in countries and localities around the world where many eye care professionals are not able to be in their practices to personally care for their patients, having resources to stay informed on latest developments about safe contact lens wear is critically important.
      We are fortunate that there is credible guidance and related resources available from many eye health and contact lens organizations. Practitioners can utilize these to assure their patients that they can keep wearing their contact lenses, and that there is no scientific evidence to suggest contact lens wearers have an increased risk of contracting COVID-19 compared with spectacle wearers. These resources can also be used to reinforce the importance of good hand washing and drying habits along with good contact lens case hygiene if patients are wearing reusable lenses. Recent expedited, peer review publications [
      • Zeri F.
      • Naroo S.
      Contact lens practice in the time of COVID-19.
      ,
      • Jones L.
      • Walsh K.
      • Willcox M.
      • Morgan P.
      • Nichols J.
      The COVID-19 pandemic: Important considerations for contact lens practitioners.
      ], that have been thoroughly researched and referenced, have provided the foundation for much of the guidance on safe contact lens wear and care. Although these resources are too numerous to list all of them, amongst the more notable to provide statements, information and links to additional resources have been the British Contact Lens Association [], the American Academy of Optometry [

      American Academy of Optometry. COVID-19 Hub. https://www.aaopt.org/my-covid-hub.

      ], the American Optometric Association [

      American Optometric Association. Contact lens wear during COVID-19. https://www.aoa.org/contact-lens-wear-during-covid-19.

      ], the U.S. Centers for Disease Control and Prevention [

      Centers for Disease Control and Prevention: Healthy Contact Lens Wear and Care. Protect Your Eyes. https://www.cdc.gov/contactlenses/protect-your-eyes.html.

      ], and the Centre for Ocular Research & Education [

      Centre for Ocular Research & Education. https://core.uwaterloo.ca/COVID-19/.

      ].
      Public health authorities, ophthalmic and contact lens educators, clinical research scientists, practitioners, professional association leaders, and contact lens industry representatives from all over the world are disseminating important eye health information about the safe wearing of contact lenses. During these times, I am tremendously proud to join so many in our contact lens-related professions to share credible, evidence-based data about the safe wearing of contact lenses in order to be able to help millions of contact lens wearers enjoy the gift of clear, corrected vision with contact lenses each day.

      References

        • American Academy of Ophthalmology
        Coronavirus Eye Safety.
        2020 (10 March)
      1. CNN. https://www.cnn.com/2020/03/27/health/contact-lens-glasses-coronavirus-wellness/index.html 27 March 2020.

        • Meltwater Global Media Database Search
        McDougall Communications.
        (15 March–14 April)2020
        • British Broadcasting Corporation
        Coronavirus: Eye Injuries Increase ‘Due to More DIY’.
        2020 (12 April)
        • Lewis SJ, Orland BI
        The importance and impact of evidence-based medicine.
        J. Manage. Care Pharm. 2004; 10: S3-S5
      2. The BMJ Why Do We Need Evidence-based Medicine? https://bestpractice.bmj.com/info/us/toolkit/practise-ebm/why-do-we-need-ebm/.

      3. Centers for Disease Control and Prevention: Healthy Contact Lens Wear and Care. Protect Your Eyes. https://www.cdc.gov/contactlenses/protect-your-eyes.html.

        • NBC News Today.com
        Should You Stop Wearing Contact Lenses to Prevent Coronavirus?.
        2020 (April)
        • Buhl F.
        • Günther E.
        • Quandt T.
        Bad news travels fastest: a computational approach to predictors of immediacy in digital journalism ecosystems.
        Journalism. 2019; 7 (2019): 910-931https://doi.org/10.1080/21670811.2019.1631706
        • Foreign Policy
        The World is Addicted to Pandemic Porn.
        2020 (7 April)
        • British Broadcasting Corporation
        Psychology: Why Bad News Dominates the Headlines.
        2014 (28 July)
        • Jazeera Al
        Hunger for ‘Good News’ Grows Amid Coronavirus Crisis.
        2020 (14 April)
        • Zeri F.
        • Naroo S.
        Contact lens practice in the time of COVID-19.
        Cont Lens Anterior Eye. 2020; https://doi.org/10.1016/j.clae.2020.03.007
        • Jones L.
        • Walsh K.
        • Willcox M.
        • Morgan P.
        • Nichols J.
        The COVID-19 pandemic: Important considerations for contact lens practitioners.
        Cont Lens Anterior Eye. 2020; https://doi.org/10.1016/j.clae.2020.03.012
      4. BCLA Guidance: Contact Lens Wear and Coronavirus (COVID-19). https://bcla.org.uk/Public/Consumer/COVID-19--Coronavirus--Contact-Lens-Care-Guidance/Public/Consumer/Contact-Lens-Wear-and-Coronavirus-guidance.aspx.

      5. American Academy of Optometry. COVID-19 Hub. https://www.aaopt.org/my-covid-hub.

      6. American Optometric Association. Contact lens wear during COVID-19. https://www.aoa.org/contact-lens-wear-during-covid-19.

      7. Centre for Ocular Research & Education. https://core.uwaterloo.ca/COVID-19/.