Cosmetics and the Contact Lens Wearer - What and Why By Diane F. Drake, LDO, ABOM, FCLSA

Mission Statement

Better Quality of Life Through Better Vision

Course Description

This presentation discusses cosmetics offered for the male and female contact lens wearers. Obvious and not so obvious cosmetics such as hairsprays, aftershaves, colognes, and soaps will be discussed. Proper handling and hygiene of contact lenses and the various structures of the tear layer and ocular structure will be included. Discover how improper cosmetic use can affect tear layers and the success or lack of success of the contact lens wearer.

Introduction ν Tear layers ν Cosmetic usage ν Importance of tear film ν Patient instructions ν Types of cosmetics ν Conclusion - Communication

ν Prefit examination

Anatomy of the Eye

Cornea Eyelids ν Five distinct layers ν Important in health of eye

– Epithelium – Help to keep eye moist – Bowman’s layer – Help to distribute tears, oxygen and – Stroma nutrients – Descemets membrane – Protects the eye from light and injury – Endothelium – Lids are elastic ν Lose elasticity with age

Tissues of Eyelids Conjunctiva ν Conjunctiva ν Thin mucous membrane, running ν Termed palpebral aperture continuous from lid to corneal limbus – While opened – Not always same size – Palpebral - lids – Bulbar - Globe of eye ν Contain Meibomian glands ν Contain Sebaceous glands ν Muscles of eyelid – Levator Muscle ν Pumps tears away

– Orbicularis Oculi Muscle

Contact lenses cannot get lost behind the eye Lacrimal Apparatus - Tear Production ν The conjunctival membrane runs continuous ν Lacrimal glands from the edge of the iris around the eye to – Provides reflex tear secretion the back and connects to the eyelid along ν Irritation the eyelid margin ν Coughing ν Contains goblet cells ν Sneezing – Produce mucins ν Taste or smell

ν Glands of Krause – Newborns have minimal output of reflex ν Glands of Wolfring tears

ν Inflammation – Conjunctivitis – Caused by bacteria or virus – Symptoms ν Pain ν Photophobia ν Impaired vision ν Discharge ν Blood Supply – Becomes injected when conjunctiva is inflamed ν Innervation – Very sensitive

Accessory Glands Kinetics of Tears ν Accessory glands ν Tears move upward and downward with – Provides basic tear secretion each blink ν Steady state – Spreads tears over entire eye and – Wolfring conjunctiva

– Krause – Moves from temporal to nasal

ν Normal tears contain various antibacterial ν Tear Film and immune substances to clean and protect eyes – Three Layers – Lysozymes – Immunoglobulin ν Lipid – Depressed in patients with tear ν Aqueous deficiency ν Mucin ν Patients frequently suffer from blepharitis Lipid Layer is produced by glands in the eyelids ν Innervation ν Outer Layer - Oily – Sympathetic ν Help to regulate blood supply – Lipid

ν Produced by meibomian glands ν Parasympathetic ν Prevents evaporation – Comes from superior salivary nucleus

ν Middle Layer - Aqueous ν Tear drainage – Volume

ν Provides oxygen – Through lacrimal punctua ν Provides nutrients – Into canaliculi

ν Tear canals – Produced by lacrimal glands – Into nose via lacrimal duct – Contains proteins and lysozymes which contain bactericidal property ν Kinetics of the tears – Forms thin film over both cornea and ν Inner Layer - Mucous conjunctiva – Creates tear meniscus – Produced by goblet cells ν Prism ν Lake – Attaches tears to cornea

– Decreases surface tension

Tear Layer Causes of Dry Eyes Mucin Layer Produced by Goblet Cells in ν Systemic Conjunctiva ν Conjunctiva lines globe and lids ν Chemically induced - Medicines Importance of Tear Layer to Corneal Health ν Interruption of three layers could result in ν Environmental dry eye

ν Exposure to cosmetics and other chemicals ν Could make difficult or impossible to wear contact lenses

ν Could affect corneal health – Both contact lens wearers and non- contact lens wearers

Prefit Cosmetics ν Patient evaluation ν Both cosmetics and contact lenses are emotional choices – Lids – Orbit ν No need to sacrifice either – Lashes – Others ν Educate yourself first – Tear BUT

ν Educate your patient next ν Note any abnormalities

ν Observe cosmetic use

ν Discuss cosmetic application now

Types of Cosmetics What are Cosmetics ν Proper types of cosmetics ν Obvious ν Application of cosmetics ν Colored cosmetics ν Removal of cosmetics ν Facial cosmetics ν Improper cosmetics ν Not obvious ν Frosts ν Perfumes, colognes, aftershaves ν Glitter ν Lotions, creams ν Hairspray ν Liners ν Deodorant ν Shadows ν Soaps ν Facial tissues containing lotions ν Others

Meibomian Gland Function ν Improper types or use of cosmetics can clog openings

ν Can get directly in the eye

ν Can coat contact lenses Goblet Cell Function ν Cosmetics may coat conjunctiva

ν Causes goblet cell dysfunction

ν Will not allow tears to adhere to cornea

ν Causes dry spots on cornea

Insertion Removal ν Wash hands, eyes and face ν Wash hands

ν Use oil free, deodorant free, fragrance free ν Remove lenses soap ν Remove cosmetics ν Rinse thoroughly

ν Use oil free remover ν Dry with clean, lint free towel Contact lens Case

ν Wash case with hot tap water and allow to ν Insert lenses air dry

– Rinse with disinfecting solution ν Teach the patient proper insertion techniques ν Replace case regularly - every three months or more ν Apply cosmetics ν Replace case if contaminated ν Discuss proper application of cosmetics

Conclusion ν Proper use and removal of cosmetics necessary

ν Brands should be appropriate

ν Proper hygiene necessary

ν Never share cosmetics

ν Discuss aerosols and fumes

ν Replace cosmetics regularly

ν Visual health

ν Eye health Thank You