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Eye Problems - Lenses

Dr Jules Eden, dive medicine specialist and founder of e-med, answers divers' questions - as published in Sport Diver magazine:
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Q - Diving is one of my major passions in life, the other being rifle shooting. In competition I am finding it more and more difficult to focus on faraway targets, and my optician has advised me that I need a prescription to correct my distance vision. The options appear to be glasses, contact lenses or laser surgery. I'm most keen on the third option as the thought of never having to wear milk bottles or fiddle about with bits of plastic and solutions really appeals. What I would like to know is, which is the best option from a diving point of view? I suspect there are pros and cons to each, so bearing in mind my shooting hobby, what would you go for?

A - An age old query this, but still relevant with all the newer approaches to refractive surgery these days. No easy answer either, Iím afraid. The least risky option is a prescription mask, as clearly this doesnít involve any direct interference with the eyeball itself. Problem is, itís more of a hassle kitting up. Contact lenses are generally very safe, but due to their close adherence to the cornea can cause abrasions and scratches. These then present an easy portal of entry for marine nasties if the eye is exposed to contaminated water. Most authorities advise using soft disposables rather than hard lenses, and they generally donít wash out even if you do lose your mask underwater. Any signs of soreness or redness after diving should make you run for the nearest optometrist and antibiotic eyedrops though. Finally, the surgery options are many and varied, and the burgeoning amount of data gleaned in the last decade suggests itís a safe long-term option for the vast majority of people. LASIK, the commonest procedure used nowadays, has not been linked with diving-related complications, but you need to wait a good month or more to allow any bubbles around the incision site to dissipate and the flap to heal. If it was me, Iíd probably go for surgery, but itís all down to individual decision-making in the end. Good luck.

Q - I have been interested in scuba diving for some time now and have taken part in a couple of try-dives with my local diving center (SeaScape Scuba) in Ashford, Kent. I really enjoy diving and wish to attempt the PADI training later on in my life. However, I am short sighted and have asked around for information considering this problem. The main answer has been that I could get a prescription mask but I have also wondered whether wearing contact lenses would be alright. My mother mentioned something about wearing contacts and there being suction in the mask, I personally can't see there being any suction in a mask but I am however wondering about this! Can you give me any information considering this or even tell me if I can scuba dive when I am short sighted.

A - You should have absolutely no problem.

Obviously don't dive without any kind of visual help underwater.

Your buddy and the fish will not thank you for crashing into the reef, even if you have seen the boat to get on in the first place.

Getting a prescription lens for a mask is easy to do nowadays and this issue should carry a couple of ads in the back for manufacturers of these masks. They can be pricey and if you got 2 it would be really good. There's no accounting for who will drop a tank on your kit on the first day of a liveaboard.

Many divers do dive wearing contact lenses and have absolutely no difficulty. There is no issue with the mask pulling them off your eyes as you descend as you should be taught how to correct a mask squeeze, by blowing a bit of air into it with your nose, as you get deeper.

The only thing to watch out for with contacts is that they can leave micro grazes on your eyes. This has been linked to an infection by a bug called acanthamoeba. This little nasty can make your eye flare up red, and even lead to blindness if left untreated.

So get a prescription mask, and if you ever do dive with contacts, see an eye doc if you get any redness within 2 or 3 days of a dive.

Q - I am currently a Divemaster trainee, who wears contact lenses. I went for a contact lens check up recently and was "told off" for wearing my contacts whilst both swimming and diving due to the high levels of bacteria and particularly "flesh eating protozoa". I was warned that if a protozoa such as this got into contact with my contacts that I could lose my sight overnight. I was so stunned at the time that I didn't think to ask any further questions.

My concerns fall into two categories:

1. This is not a well advertised fact, and I have noticed when helping with student divers that many of them also wear contacts. Should I warn them not to?

2. Is the bacteria/protozoa problem also valid in the sea? Or is it confined to swimming pools.

I am quite prepared to get a prescription mask if necessary, I just find that whilst kitting up etc. it is far easier to have contacts in. I have never had a problem before.

I would really appreciate your feedback on this issue, as it seems to affect a large proportion of divers.

A - I have spoken to a selection of optometrists and ophthalmic surgeons and the good news is that it should be fine to dive in contacts.

Sure there are situations in swimming pools where there are bacteria that could infect your eyes but this is not as common as you think.

What they suggest is that you use softer lenses and after diving in the pool wash them thoroughly before replacing them. If you develop any redness in your eyes afterwards then go and see your doctor to rule out any conjunctivitis. Don't worry about flesh eating bacteria, that is alarmist nonsense. The Ebola virus is the flesh eater you are worried about, and at the moment the only way you will get that is to eat some bushmeat in the rainforest of Central Africa, and not by doing a try dive in your local baths.

As for diving in the sea, I don't think you should worry either with the lenses, again stick to soft and if you get any reaction because of the salt water then perhaps its time to try a prescription lens mask.

You do raise a good point though that if your sight is particularly bad, then kitting up without your lenses can be difficult and that is where mistakes could happen. So in all I suggest you go with contacts in the sea and the pool and if any problems occur they can be easily treated with antibiotics, and then you can think about the mask after that.

(other dive medical questions)



   


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