Removal of Contact Lenses From Incapacitated Wearers
The American Optometric Association has some advice for fire fighters and other emergency workers who handle unconscious or otherwise incapacitated wearers of contact lenses. These lenses are not intended to be worn while sleeping, and “this restriction also applies to states of shock or semiconsciousness which may accompany emergency situations,” according to Dr. Henry W. Hofstetter, president of the American Optometric Association.
The AOA committee on contact lenses has prepared an instruction and information packet, “Contact Lens Emergency Care,” which is available for 25 cents from the American Optometric Association, Department of Public Affairs, 7000 Chippewa Street, St. Louis, Mo. 63119.
When professional help is not available, the AOA instruction sheet advises, determine whether the contact lens is the small corneal type, smaller than a dime, or the larger scleral type, about the size of a quarter, which covers all of the colored part of the eye and some of the white.
If the colored part of the eye is not visible when the eyelids are opened, emergency workers are advised to await the arrival of an optometrist or ophthalmologist.
The AOA instructions for removal of contact lens are as follows:
“It is acceptable to remove the lens with the patient in the prone position on his back. In all instances be gentle. Force can cause more harm than the effect from the lens on the eye. If any difficulty is encountered, obtain and await services of an optometrist or ophthalmologist.
“Corneal lens: With clean hands, lightly place thumbs from the side, close to the edge, and parallel with the upper and lower eyelids. Open the lids gently and observe if the lens can be seen. If it is not on the colored part of the eye, there is less concern; wait for an experienced practitioner. If the lens is visible, it should slide with the movement of the eyelids with thumbs still at the very edge of the eyelids. Gently position the eyelids slightly wider than the edge of the lens, maintaining this opening. Press gently straight upon the eye. This should cause the lens to tip up on one edge. Upon observing this, slide the eyelids and thumbs together; the lens should slide out between the lids where it can be taken off. Remember, all of this is done gently. Force should not and must not be used. If the lens is seen but cannot be removed, gently slide it to the white part of the eye where it can remain safely until experienced help is available.
“Scleral lens: With clean hands, place one finger parallel with and at the edge of the lower eyelid. Carefully press the lid back under the eye until the edge of the lens becomes visible. Maintaining the pressure, slide the finger toward the patient’s ear, pulling the eyelid taut. This should cause the lid to slide under the lens, lifting the edge so that it may be grasped for removal. This requires more pressure than for the smaller lenses, but avoid force.
“If the lenses are found or removed, place in a case or bottle and label (‘right’ and ‘left’, if known) with patient’s name.”