Should you wear contact lenses with Type 1?
It’s a little scary to think about the surface of the eye, right? While eyes, the phenomena of vision, and the science behind how what we look at becomes what we see, fascinates some, and makes others equally squeamish. There’s a reason the old Halloween parlor trick of a bowl filled with fake eyeballs is so discomforting. But those with Type 1 diabetes should be paying careful attention to the surface of their eyes.
For years the popular rhetoric around diabetes and contact lenses has been pretty limiting. In a nutshell: nope, don’t, can’t do it. But what’s the truth here? Can you safely wear contacts? What are the real risks? And if you can (hint: you can) which ones are best?
Most doctors say there is little to no reason that T1D patients can’t wear contacts. And those with T1D report wearing contact lenses for years without issue. But there are concerns, and contact lenses can increase the risk of eye complications for T1Ds versus non-T1Ds.
Talk to your doctor
Your first step should be a conversation with your optometrist about contact lenses. Be up front and frank about your T1D diagnosis — this would seem to be a no-brainer, but people forget to divulge underlying medical issues to their eye doctors all the time.
Most of us know that diabetes can have serious ocular side effects, mainly diabetic retinopathy. Over time tiny leaks form in blood vessels in the retina, the light-sensitive lining at the back of the eye. Those leaks cause retinal tissue to swell, resulting in cloudy vision and, if left untreated, blindness in the worst cases.
Ocular complications, however, extend beyond the inside of the eyes. The cornea — the transparent lining that forms the front of our eyes, covers the pupil and iris, and controls our ability to focus by refracting light — faces increased risks in people with Type 1 and Type 2 diabetes as well.
Dry eye syndrome
Diabetes patients often have a harder time producing tears and eye lubrication, leading to dry eye syndrome. You know, the awful itchy, burning sensation that leaves you swearing your eyes are filled with sand. Higher HBA1C (your average blood sugar level over 8-12 weeks) levels generally equal drier eyes. In fact, studies have shown that people who have both Type 1 and Type 2 diabetes have a 50% chance of suffering from dry eye syndrome.
Other then general discomfort, what’s the risk of a little eye dryness? Well, a fair amount, actually. Dry eye syndrome can lead to eye tissue damage and impaired vision from repeated corneal abrasions. If you have Type 1 diabetes, it typically takes longer for your body to heal, and that includes the eyes. So those small scratches can become a big deal. Contact lenses dry the eyes out quicker. They also increase the risk of corneal ulcers (open sores on the cornea) and infections. All of these conditions are harder for those with T1D to recover from.
Are contacts for you?
Not every person with Type 1 diabetes is a good candidate for contact lenses. Doctors like to see clear and healthy ocular surfaces and HBA1C levels within a certain range. A value within the 7-8% range warrants caution. Patients with levels over 10% are generally not considered good candidates for contacts. Optometrists report prescribing higher BGL patients disposable, daily lenses and monitoring their eyes closely. Any abrasion is cause for concern and possible contact use reassessment.
How to proceed
Your goal here is to do everything you can to minimize the risk to your eyes as a contact wearer with T1D. First, make sure to let your eye care provider know about your diabetes as it may inform the contact lenses and contact lens solutions he or she recommends.
Following appropriate contact care instructions is crucial.
- Clean your lenses daily with the correct solution.
- Do not wear your lenses overnight.
- Wear glasses if and when you can to give your eyes a break.
- If prescribed multi-use contacts, replace them when instructed.
- If given disposable contacts, do not wear them for more than a day, and do not re-use them.
If you’re a T1D patient and a contact wearer there are certain things you can monitor yourself.
- Pay close attention to your HBA1C fluctuations. If you start trending higher be aware that your eyes could be at a greater risk while wearing contacts.
- Watch out for dry eye. Symptoms include eye dryness, burning, itching, grittiness, and the feeling of having a foreign body (like a piece of sand) constantly stuck in your eyes.
- Note vision disturbances. Blurriness, floaters, and dimness are all warning signs.
- If you notice increased scratches or abrasions, or any odd sores or spots on your corneas, talk to your eye doctor right away.
Managing Dry Eyes
If you ditch the contacts, and the dry eyes continue, there are medications that directly combat dry eye syndrome.
Furthermore here are some preventative self-care tactics what may help relieve your eyes and stimulate increased tear production.
- Massage your eyelids
- Apply warm compresses to each eye periodically throughout the day
- Blink regularly when at the computer and when reading
- Wear sunglasses while outdoors
- Use a humidifier at home and at work to increase the humidity in the air around you
- Keep your blood sugars in your target range