lessons learned

Under the Eyelid and Into the Brain

In the “olden” days, fitting contact lenses was a tearful proposition.

Jack Runninger, O.D.

I suppose I could wear contact lenses,” humorist Dave Barry wrote in one of his columns many years ago, discussing his high myopia. “But people who wear them are always weeping and blinking, and their eyes turn red, as though their mothers had just died. You want to go up to them on the street and say, ‘There, there,’ and maybe give them money.

“Also, you never hear of anybody who wears them successfully for more than maybe three weeks. People are always saying, ‘I really liked them, but my hair started to fall out,’ or, ‘I had this girlfriend, Denise, and one of her contacts slid up under her eyelid and went into her bloodstream and got stuck in her brain, and now she never finishes her sentences.’”

Rough in “them days”

Barry's remarks were written during the early days of contact lenses, prior to the availability of soft lenses and oxygen permeable materials. I'll tell ya', fitting contact lenses was rough back in them days! Oxygen deprivation to the cornea made it difficult for patients to wear them comfortably.

“I tried contacts,” said humorist Bill Geist. “They were kind of experimental technology back in those days, fashioned from thick shards of jagged glass—or so it seemed.

“Pushing 50, my wife also got contacts, so she'd look younger,” he continued. “She looked like a younger woman all right, albeit one that had just been maced. Her red eyes watered, and she blinked 220 times per minute, more than Clinton lying on TV.”

Practitioners tried all sorts of things to help deliver tear fluid and oxygen to the cornea. One system was to fenestrate the lens with small apertures for the tears to theoretically get through the lenses to the cornea. My dear friend, the late Neal Bailey, O.D., Ph.D., who taught contact lenses at Ohio State University and was editor of Contact Lens Spectrum, once described the way to make fenestration work best:

“If you've fitted a patient with a 8.8 lens, use a 9.0 fenestration,” he once said in a lecture.

Great answer

“I recall the Q and A session following one of Neal Bailey's lectures,” Dr. Mel Wolfberg told me. “A member of the audience presented a complicated case study. After a long period of description, he asked, ‘What might the problem be, based on these symptoms?’

“‘Perhaps the patient is trying to tell you his damn contact lenses hurt,’ was the response from the one and only Neal Bailey.”

I was fortunate to have this wit and wisdom of Dr. Bailey's mentoring. We were fellow members of a round robin tape group. Also in the group were two other outstanding contact lens pioneer practitioners, Drs. Bob Koetting and Paul Farkas. (Other members were Drs. Irv Bennett, Richard Hubler, Sol Tabak, and Murray Klaff.) Even with such expert mentoring, I still had multitudinous headaches in fitting the oxygen depriving little critters.

Different doctor

“Runninger, I can't wear these contact lenses when we play golf,” a patient and golfing buddy told me. “My eyes tear up so bad that I can't even see the ball.”

“Nonsense,” I said. “Gil Morgan is a champion golfer on the PGA tour and he wears contacts.”

“Yeah, but you didn't fit his,” was his wiseass reply. OM