Tuesday, May 29, 2007
Heeding contact solution warnings
We covered a story this morning that provides an interesting look into the psychology of the average consumer. The story is about contact lens solution and the fact that a certain brand is linked to a devastating eye infection. The solution is called Complete MoisturePlus and is made by Advanced Medical Optics. The concern is that users of this solution have seven times the risk of getting the infection, caused by acanthamoeba, a parasite. Ick. This parasite is found in fresh water and salt water, and as it turns out, can even get into contact lens solution.

Admittedly, the numbers are very, very small. There were 39 cases of this infection (out of more than 30 million contact lens users in the United States) and 21 of those people used this solution. You literally have a 1 in a million chance of contracting the infection, which is slightly higher if you use this product. According to the CDC, improper storage, handling and disinfection of contact lenses, as well as swimming or showering while wearing contact lenses contribute to these kinds of infections.

If you do get the infection, you could go blind. In fact, nine of those 39 will require a corneal transplant with no guarantee of their vision returning.

So, what do you do? Obviously, the recommendation is to throw away the solution, the contact lenses and the carrying case. That costs money and aggravation. Do you think the average consumer goes through the steps to ensure that they aren't the one in a million or do they ignore the warnings - confident that it won't happen to them? What would you do?
I would throw out the lens solution and buy one of the other numerous brands available. I agree that its a waste, and I wish I didnt have to, but my eyes are worth much more.

There was a report like this for Bauch and Lomb, and I threw away my ReNu solution and used another brand. (http://www.fda.gov/bbs/topics/NEWS/2006/NEW01371.html).
My question would be, what makes these products bad, and how do I know that other brands dont have the same problem??
If you look at the bottle, you will see that this product is made in China, so what else is new!
Hi Dr. Gupta~
I wear contacts and I can assure you that if I used that brand of contact lens solution I would throw it away. Nothing is worth the risk of loosing your eye sight!
Speaking of eye infections, have you ever seen people rest their contacts on their tounge while taking them in or out of their eye? Isn't this a good way to get bacteria into your eye? It always grosses me out to see people do that.
Any comments?
I have 14yrs. son and he has contact lens for couple months ago.I read article about contact lens solution what should i do ? should he stop Renu solution ???please advise ASAP.

Thanks
Rajshree from nj usa
I thought it was B&L Renu that was contaminated last year???
Personally I hate sticking things in my eyeballs. I wore glasses for over 15 years before I finally forked over all that cash for WaveFront LASIK. Best money I ever spent.
I threw away my AMO solution. Is it OK to use B&L Renu now or do you recommend something else?
I would definitely throw it out.

I was using the Renu Multi-Plus last year and did get a pretty serious fungal infection in both eyes thought to be due to the solution (I had never had any eye infections prior to or since). The anti-biotic eye drops to "hopefully" get rid of the infection alone was over $70! I am just thankful that I had no long term vision loss, and it was very scary having temporary vision issues.

This new report just makes me afraid to use any brand!
I have to agree with the poster who pointed out the product was made in China. At the moment China does not have a good reputation for product integrity.

That said, no matter where the product was produced, I would still dispose of the contaminated product and buy a different one.

What really worries me is that we often have no way of telling who the manufacturer REALLY is; the recent pet food problems were mainly traced to one manufacturer who made all the brands recalled.

Sue
Stayton, Oregon
Personally, I use Focus Dailies. Daily contacts are the BEST contacts ever - wear them once and then throw them away. No worries about solutions or improper cleaning!
What is amazing that people don't realized that their non-compliance has more to do with these infections than the solutions! They don't change the lenses on the recommended schedule or swim in dirty lakes or ponds and don't change the lens sooner. Even a person that doesn't wear contacts can get Acanthamoeba by swimming in a lake or pond after rubbing their eyes. Be smart people! contacts are SAFE if you are smart about how you wear them. They are nice if your eyes change you change the prescription the next year. You can't go back and do LASIK after LASIK. When your 50 your still going to need a prescription when your 70 your going to have cataracts. Safer than some FAST FOOD LASIK Places!
I use MoisturePlus (as recently as this morning) and just saw the notice on CNN's website. I defintely will stop using MoisturePlus and use a different brand. The odds may be very low on contracting the infection, why risk it when the stakes are loss of eyesight? I'll err on the side of caution in this case...
I think the best thing to do would be to switch to daily/disposal contacs. No solutions are needed because you throw the lens out at the end of the day and start with a fresh pair the following day.
(I wear these now.)
Just toss out the solution. Same thing happened with the ReNu solution. Shouldn't we all abide by warnings and labels? If we did, then there wouldn't be any smokers, etc.
I just bought a bottle of this AMO Moisture Plus solution last week.

How dangerous is this product?

Can I return it to the store, even without a receipt, and exchange it for another brand?
I am glad to hear this...I am recovering from Acanthameoba (as of Fall 2006) and yes, I was using this solution. No, was no careless with precautions and still I ended up dealing w/ this for three months, culminating with going on short-term disability for all of December. The light sensitivity was excruciating and now, even though I am recovered 95%, I can never wear contacts again due to permanent corneal scarring. Fortunately, there is a research facility in St. Louis, where I received proper treatment. I am still trying to figure out who I need to talk to next (CDC, FDA, etc.).
Sure, It was annoying to toss out 1/2 a bottle of solution, the contacts that I changed (per my dr's recommendation) on 5/15/07 and the contact case - but you the cost and annoyance are nothing compared to my eyesight.
I am going to toss out my moisture plus. I hardly ever used it anyway. I have 30 day, 24 hour contact lenses, though I do take them out once a month and clean overnight with CIBA clean care. I'm not a germophobe and I don't get infections easily, but I have sensitive eyes and eye allergies so I can't tempt fate with a possible infection.
Dr. Gupta,
I have a a swollen eyelid for a week now, and have been using Moisture Plus. I've been on antibotics and the swelling has gone down. I've thrown out my old lenses and solution, but do I need to be worried about the infection?
More information would sure be helpful. I just began using this solution about two months ago with my new Acuvue Oasis lenses (2 week disposables). I haven't worn lenses in years due to dryness and discomfort. But this combination is so comfortable; I love it! Since I also have an immune deficiency, I would be grateful for more specific information.
I just started using the disposable contacs 3 weeks ago. The doctor gave me complete moisture. Bought another bottle Friday. Saturday began having irritation of left eye.Stopped useing contacs. Saw news this morning, and threw out lenses and soulution. Doctor says my eyes were probably dry because I play tennis.
Just throw them out.
Get a different brand of lense, and solution.
I buy the product last year and two month ago I have uveitis and My doctor said that was a bacteria. I used disposable contact lenses and clean it with the solution. What can i do cause I feel afected?
After seeing this recall story on CNN today,I called my eye doctor, who first gave me the AMO MoisturePlus saline, for a different product recommendation. They told me they are currently using Baush & Lomb ReNu MultiPlus in the doctor's office and that this product is not under recall. In addition to throwing away all the questionable saline, make sure to dispose of your cases.
I threw out my contacts, case and solution without a second thought. I found out about the recall on Saturday by accident on another news site. I looked on CNN and didn’t see it published here until today (and the dates seem to support that). From what I can tell this recall so far is easy to overlook. I find that concerning even if the infection is likely to result from improper contact lens usage.

Since the infection can be contracted by both people that wear contacts and those that do not, what is it about the solution that’s been found to increase the rate of infection? That didn’t seem to be clear from the information I’ve read.

By the way, in the Press Release on the AMO site (http://www.amo-inc.com/site/) there is a phone number you can call for a product return/refund kit. I have one unopened bottle that I haven’t thrown out yet and will hold on to until I receive more information from the company.
HI I want to know what the symptoms are?
How do I know if I have the infection?
i use alcon opti free
is it safe to use?
thanks
keni patel
If you read the press release, this is not a manufacturing problem, so why are people blaming China? Also, not all solutions are manufactured there. All of my bottles say Spain, not China. I have used this product for nealy 3 years now and when the voluntary recall is over, I will continue to use the product.
wow, i have been dealing with a mysterious infection in my eye, which either the emergency room appointed eye docter or the cornea specialist could really get a handle on. I lost most of my cornea in the area around my pupil. Now that I am "recoving" well enoungh realise whats going on in the world, I see the contact solution I've been using faithfully for a long time has some kind of nasty parasite in it. Thought I was safer than that. . . .
I am throwing away my Complete Moisture Plus although I really like it. I am a healthcare provider and just cannot risk the risks!
I am a college student and have only had contacts for a couple months. Just last month I got a severe eye infection (conjunctivitis with a bacterial infection on top of that). Even that was enough to freak me out. I am VERY paranoid about keeping my contacts clean now. The thought of a parasite in my eye is enough to make me not want contacts at all. Thank you SO much for this warning! I will be sure to stay away from that contact solution!
I can't believe it! I just started using AMO Complete when the B & L scare surfaced and now I have to throw all those bottles away! What's left? Are the two problems related? Didn't AMO learn from the B & L fiasco? What gives?
I use this solution too. A lot of people do, but the article isn't very clear on this. If 75% of the contact wearers uses AMO products and 75% of those infected are users of AMO products, then I don't think the product is to blame.
I would definitely throw it out. I'm close enough to blind as it is without having to worry about getting there completely. When it deals with my health, my family's health, or my pets' health, I don't intend to play around with it.

I'm curious though, have they found yet whether the solution somehow raises the chances, or do they suspect that the solution is infected? If it's the latter, there's an easy way to test for that, one would think.
I have three various sized bottles of the AMO Complete solution here at the moment, all in current date code. Of the three bottles, one is marked "Made in China" and the other two are marked "Made in Spain". I seem to recall that the B&L Renu solution with the same reported problem was made in Spain as well, so I don't think made in China has anything to do with the problem.

Since the problem seems to be an increase in suceptability to the infection, and *not* contaminated product it makes me wonder whether over time it will be determined that the same insreased risk applies to any brand of solution with the ones not yet implicated simply not being detected yet due to lower sales volume.

Possibly when the dust settles it will be found that the increased risk is due entirely to contact use and has nothing to do with the particular solution used.

I've called the AMO number and left my info with their VRU. I'm supposed to receive a product return kit in the mail in a few days. For those that still have AMO solution, do not just throw it out, call the AMO number (1-888-899-9183) and see if you can get a refund since solution isn't that cheap.

Since I SCUBA dive and swim it seems I'm already in the high risk category. I'm starting to seriously investigate Lasik options even though I have a general aversion to surgery of any kind. It would seem to be a matter of trading a continuing risk (Contacts) for a one time risk (Lasik).

Pete
I had two small bottles of this, great for travelling, that came from my optometrist. As soon as this was announced, I got up, went to the medicine cabinet and threw out both bottles. I threw away the case I use when I travel since that had been exposed. My eyes are too important for me to gamble on this. Yes, it cost money, yes it is annoying, but not nearly as costly or annoying as losing my sight or needing a transplant.
Although the risk is exceedingly small, I would recommend to all contact lens wearers using the Complete MoisturePlus to discard his or her current contact lenses, cases and solution. As far as what to use next, contact your optometrist or eye care practitioner! Your doctor knows your eye history and will be able to make a recommendation.
Several years ago, I did get that infection, but it wasn't even related to the eye solution I was using. It was general poor contact hygiene. All the while, I was sure I was doing everything the eye Dr. instructed me to do. I decided my eyes are worth more than the risk and was assessed for lasik surgery. I was a candidate and received my surgery over three years ago, with absolutely no complaints. I find the up front cost of the surgery out weighs the risk of losing my sight. RENEE
As an eyecare professional, I can tell you that there are very few patients who actually follow the care instructions related to contact lenses. I even have patients who will openly disobey instructions in front of our staff in our office. Patients will come in with cases that are green with mold and black with dirt. Patients overwear their lenses, don't clean, don't replace on schedule and still would like to place blame with someone else.
This is absolutely ridiculous - the company is blaming the people with infections! I read the CDC press release on Saturday ... my husband happened to come across it and recognized it as the brand I've been using. I had to go back out and buy another brand (no, not ReNu, I wouldn't trust them after they did not report the problems right away). Oddly enough, all the AMO is still on the shelves. They claim they are contacting retails and consumers but who has heard about it so far? All I have seen is what CNN has picked up. And the CDC and AMO's info did NOT say I had to throw away my contact and contact lens case. At first I was just worried and a little irritated, but after reading comments from AMO's "higher ups" I am REALLY angry. I have already called their return line and requested the information to return the bottles I have, but now I'll throw the case and contacts in too and ask when I get reimbursed for my contacts. This is crazy, $8 a bottle and it can't even prevent such a severe infection? I used basic store brands for years until I developed chronic dry eye. At least none of them ever blinded me. They've lost a customer!
Well, isn't that interesting. I stopped using Bausch & Lomb during the last recall affecting that brand. I switched to AMO Complete. Sometimes I think somebody's trying to sabotage the competition, and they just keep going back and forth in an effort to steal each others' lunch. Maybe I'll just get Lasik and ditch the contact lenses altogether. It's becoming too much trouble.
I've been wearing contact lenses for over 15 years and never have had any eye infection problems related to my contacts (kids giving me pink eye is another issue). I had been using a rigorous daily cleaning regimen for most of those years (alcohol cleaner, peroxide, weekly enzyme treatment) which worked well but was getting tedious. I switched to monthly disposables and the AMO solution and it worked great, though I make a point to boil-sterilize the case and change the lenses monthly.

My understanding is that the solution itself is not contaminated, but when not used according to directions (which includes using the solution for more than 30 days and not washing your hands) stands a 1:1000000 chance being able to grow ameoba IF an ameoba got into your solution/onto your lens (what are the odds on that?).

I suspect that these eye infections we keep hearing about (first B&L and now AMO) are due to better reporting by the doctors and media and not an increased prevalance of the problem or decline in manufacturing. Its only a matter of time before all the other manufacturers and their generic counterparts are linked to some problem or another.

I just started on a new pair of lenses the day before the recall. I suppose I'm in the minority, but I'm comfortable with the odds and I'm going to keep wearing my current lenses and finish the bottle I have. I've got an unopened bottle that doesn't expire for another year kicking around. I'm not sure if I will ask for a refund for or just use it up. Its going to come down to whatever is easiest.
A small percentage of Complete is manufactured in China, most of it is made in Spain. Do people even listen to anything? Did you notice that the cases have been since Jan 2005, almost 2.5 years!!! Complete has been on the market with this same formulation for 4 years now and never had a problem. It is the most comfortable solution on the market and as soon as it gets cleared, I'm going to use it again! Until then I'm using AMO's Ultra Care system (Peroxide). It's no doubt that this is all caused by non-compliance. By the way, they say that out of the 39 contact lens patients, 21 used Complete. What solutions were being used for those 18 other cases, huh!?
This isn't a case of the manufacturer blaming the consumer, this is a case of consumers not taking responsibility for their eye care. Look at the numbers. There's very little reason to say that AMO solution is to blame for the infections and there is nothing that implies that the solution itself is contaminated with the parasite. All the data show is that a certain number of people who had the parasite used AMO solution. That's like saying that if a certain number of people who have cancer drive a Ford, that driving a Ford is linked to cancer. This is a ridiculous knee-jerk reaction to a very rare disease. I'd like to hear more facts about this situation before I freak out and throw away my lens solution and cases.
I threw out my lens, cases and solution. It was the most comfortable solution I could find as other solutions irritated my eyes and generally led to bumps developing under my eyelid within three days of use.
I continue my search for a solution that will work with my sensitive and dry eyes. I use disposables, but dailies are not comfortable, while Acuvue 2 are so I need a solution to care for the lens.
What if I am using Complete solution that was bought in the UK? Does it all come from the same factory, or are there different sources? We live in a fast-moving global world so the press could help with this information. Please don't assume that we all live our lives solely in the US.
I have about 5-6 bottles of the AMO solution, only one of which is open. Are you saying that I need to pitch all the bottles, even the ones not opened? How do you know if you have this infection or not? What are the symptoms? Does it look like pink eye, but without the goop?
FYI, no multi purpose solution on the market can kill the parasite Acanthamoeba. And there are 5 different types of the parasite. So even if one solution could kill one of the types, the other 4 could still infect the eye.
I got acanthamoeba a year ago and let me tell you it is a very serious infection. I am one of those 21 people they surveyed who used Complete solutions. Im scheduled for a cornea transplant in July. I would do anything to have my eye sight back.
"You can't go back and do LASIK after LASIK."

This is true, but a good eye doctor will refuse to discuss LASIK with you until your eyes are stable. I am in my early 20s, right about the age my eyes should be settling for a while. Once they have stopped changing for long enough, I will broach the subject with my doctor again. I can see 4 inches in front of my face without lenses right now, so to me it would be more economical to get LASIK (high-index lenses are expensive, and rarely covered as well as the other types by insurance). Will my eyes change again when I'm 50? Sure, but I've got a ways to go before that. And hey, even if they do change, my new glasses will be at a lower prescription - MUCH lower - and thus far cheaper than what I'm paying yearly now. It may not be sensible for somebody whose vision is just a tiny bit blurry, but when you take off your lenses and the whole world becomes a giant colorful blob, it's well worth it.
I tossed the AMO solution, case, and disposable contacts. Replacing the solution and case cost me about $10 - not a huge price compared to an infection or worse. Two recalls in twelve months has me considering Lasik, though.
MINE WAS MADE IN SPAIN! I CANT BELIEVE THIS! WHAT IS IN THIS SOLUTION?
The makers of contact solutions keep trying to push users into multi-purpose solutions. I tried one and started to develop symptoms similar to conjunctivitis. I immediately went back to the old separate-solution regime and the symptoms disappeared. Now, every time a practitioner - or a lens-solution maker - tries to convince me to use a multi-purpose solution, I say, "I can't use those. Don't try to take away my separate-solutions option."
I've been using "Clear Conscience" Multi-purpose solution for years. It's a cruelty-free solution made in England, and it's fantastic! They also sell great contact lens cases. You're supposed to change those every few months anyway. Solution is sold online and in all Whole Foods.
It doesn't matter where the solution was made, Spain or China!! Nothing is in the solution, HELLO!!! They are just looking to see if you can catch the parasite easier using Complete compaired to other solutions. Your chance of catching this is one in a million.
The main problem with these contact lens solutions is not the solution. It is the fact that people do not wash their hands before handling their lens. They do not clean the lens container. We went through this same situation a few years ago. The moisture plus solution is a great growth medium for germs that are left in the lens storage container and when lens are not cleaned appropriately.
I just recently began wearing contacts again.Before I used the hard contacts and never had an infection for the 6 years that I wore them.

Within the last month, I have two infections. One was minor and was gone within a day or so. But just last week I had bloodshot eyes that were very dry. I even had "mucus" coming from the corners. I stopped using my contacts over the holiday weekend and couldnt get into see my doctor because he was on vacation.

Tuesday morning, I hear on CNN that a contact solution is causing infections and sure enough it is the brand that my doctor suggested. I went into the doctor that morning and was told to buy a $20 bottle of drops that contains steroids to kill the infection. Now my eyes are much better, new contacts are on there way, and three appointments later I hope my eyes will be like before.

I never had this problem with my old contacts and being the germ freak that I am, I believe that the solution is containated. Thanks so much complete moisture for ruining my week!
I read an article in the wall street journal that stated that no soultion kills the acanthameoba keratitis. So I would have to say you should not be thanking complete for your week but maybe thank yourself.. Consult your dr and see what he has to say about about a steroid killing your infection. To my understanding there is no antibiotic or steroid that can kill this keratitis. So I bet you are dealing with a different infection. Good Luck on your germ free life
My son had AK, and I just learned about the AMO recall. At its onset, AK is often misdiagnosed as a herpetic infection or bacterial infection, and is most often treated with antibiotics and/or steroids. Such treatments actually help foster the infection and help the parasite to grow and multiply.

I would recommend that you stop using AMO, but DO NOT throw it away. If you develop AK, you may need the bottle to prove where you got the parasite.
Although it may not be a manufacturing problem with China, before the recall AMO blamed their plant in China because their water facility in China did get contamined so they closed their facility for a while. So it may have to do with a Chinese manufacturing problem, which scares me because I just recieved a free bottle of a different version of complete but that says made in china, but the amo company says it is not contaminated. Since they dont know the real reason why complete moistureplus causes AK 7x more likely i dont know if its safe to use the other ones...
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