Do you open your eyes in the ocean?

[seaangel]

From a contact wearing, nurse point of view: I do wear my contacts while diving, I have only lost one during one dive and that was in cold spring water. I have not lost any in the ocean and I do open my eyes when in the water without a mask. The only time I have had very strong stinging has been when water has leaked into my mask, causes more than likely were sunscreen, or the conditioner in my hair dripping down.

As for the bacteria and having to change or dispose of the contacts I have this bit of advice that we give to patients that have peritoneal catheters to perform dialysis. Often they ask about swimming with their catheter and possible infections. We teach them that they should not swim in lakes, rivers or ponds due to the risk of stagnet water. There is a higher level of bacterial, fungal and microbial count in that case. Ocean water is not contraindicated for them to swim in. Pools and spas are ok if they are only private use, not public, and are well chlorinated and cared for.

So my philosophy is ocean is ok, I don't throw them out after ocean dives. Lakes, rivers, springs I change them out after those dives. Pools well, during my training I did change them afterwards too.

You chose, you decide. It is your decision and your eye care. I also feel you should do what you are comfortable doing, if opening your eyes is a problem then don't, you will be causing yourself stress and we all know that is not a good thing to do while diving. Relax, and enjoy you diving, don't stress over it.

 

[Sea Biscuit]

The salinity of sea water does make it more similar to tears than lake water. I don't find that either sting particularly badly, but that's just me.

The bigger issues raised here are those releated to contact lenses:

1) Will they come out?

2) Will you get an infection?

1) Sure, they can wash out. Depends on your individual fit, how open your eyes are, and whether you get splashed at the surface with your mask off. Or if your mask floods or comes off under water while there are currents or your head is moving quickly. If you want to find out how secure your own lenses are in the water, try experimenting with it in the pool first, preferably with a disposable lens. That way you wont be up the creek on a dive trip, and it wont be much of a financial hit if you lose them. Of course, the fact that they don't come out in the pool is no guarantee that they wont come out on a dive trip, far away from any replacements. Therefore, if you choose to wear CLs on a dive trip, put an extra pair of disposables in your save-a-dive kit.

2) The risk of a corneal ulcer, an infection which can, in severe cases, cause permanent damage to the vision, is higher for contact lens wearers than non-contact lens wearers. Exposure to sea or fresh water increases the risk further because there are more bacteria in the water than you would come into contact with on land, in air. Soft contacts are like sponges, and bacteria can adhere to them. Particularly dirty contacts with protein deposits. The longer the contact is on your eye, holding bacteria up against your cornea, the greater the risk of an infection.

Another significant risk factor is the integrity of the outermost layer of the cornea, the epithelium. This layer serves as a barrier to penetrations of bacteria. Small breaks in the epithelium increase the risk of infection. Contact lens wear, especially overwear or a poor fit or dry eyes, can also cause the epithelial cells to break down. Traumatic insertion or removal of lenses can do the same.

My advice to my patients who wish to wear contact lenses in the water is this: The risk of an infection is increased. You can reduce that risk by doing the following:

1) Use clean, disposable lenses.
2) Make sure they fit well. If it's been a year or two since you had your ophthalmologist or optometrist evaluate your fit, make an appointment. (OK, this point may be self-serving, but it's still correct).
3) Don't overwear your lenses. Give your eyes at least a couple of hours of contact-free eyes-open awake time to allow the oxygen in the air to revitalize the epithelial cells.
4) If your eyes are dry, use lubricants while on land. This also keeps the epithelial cells from breaking down from lens tightening or chafing or decreased oxygen passage through the lens if it's too dry.
5) Take the lenses out atraumatically (the above post detailing instillation of lubricating drops immediately prior to removal offers good advice) as soon as possible after you get out of the water.
6) Throw lenses away after wearing them in the water, and use a fresh pair.

No one has exactly quantified how much more risk you're still taking compared to using a mask with a prescription instead of contact lenses, but it's probably pretty small. If you happen to be unlucky enough to get a corneal ulcer, you'll likely have a good deal of pain and poor vision for a week or two, and miss some work while you're preoccupied with taking eye drops and maybe pain killers. Depending on how severe the infection is and how soon you seek treatment, there is an extremely small risk that you could end up needing major eye surgery or with permanent loss of vision.

If you're comfortable with that, go ahead and use contacts in the water.


David Glasser, M.D.

None of the above is intended as medical advice for any specific individual, and no doctor-patient relationship is implied. This is offered only as general information. Each reader should check with his or her own physician for specific medical advice.

 

[g8trdiver]

I guess it depends from person to person- but I've found that salt water does sting initially, then feels fine. But after I get out of the water, they burn a little - it's more like they just feel 'hot'.

I recently had to replace my mask while descending in salt water, so I just kept my eyes opened, and followed my husband to the bottom. Once we got to the bottom, and I cleared my mask, it was fine - but once again, my eyes felt hot and teared a little, and my mask fogged frequently - which it usually doesn't do. I wondered if that was because my eyes were watering and causing condensation inside the mask....???

I USED to wear contacts diving, and I don't think I would have chosen to keep my eyes open and follow the group to the bottom with contacts on. In a word: Lasik!!

If you've never practiced mask replacement (with eyes open) in salt water, you should practice it at least once just to see how your eyes react. Having your mask flood or be kicked off can be annoying at best, but can also cause you to panic if you are anxious about the affects of salt water.

Oh - re likening ocean water to tears: When I first started diving, and wore contacts, I called my eye doctor to ask about wearing contacts. His response was "Well, the ocean is salt water, right? and the Saline solution you use is....? and tears are...? " That was the extent of his (rude) reply. I wish I had thought to ask him why there would be whale poop in my saline solution....

 

[Aquatic Eagle]

I recently had to replace my mask while descending in salt water, so I just kept my eyes opened, and followed my husband to the bottom. Once we got to the bottom, and I cleared my mask, it was fine - but once again, my eyes felt hot and teared a little, and my mask fogged frequently - which it usually doesn't do. I wondered if that was because my eyes were watering and causing condensation inside the mask....???

This is probably because when the mask was filled with water, it rinsed off whatever defog you had in it. You say that the mask was off of your face until you got to the bottom? If so, then the mask was exposed to the water for longer and it washed away the defog. That's my guess because it's happened to me before. It depends on how long it was exposed to the seawater.

 

[Sea Biscuit]

g8trdiver - sounds like you found a new eye doc - good move! While the salt in seawater makes it in some ways similar to tears, there is no comparison. Even the saline concentration is not the same - about 3-4 times higher in seawater than in tears, which is probably one reason it stings a little at first and feels uncomfortable afterwards. If the sea were no saltier than our bodily fluids, we'd be able to drink it. We've all seen enough shipwreck movies to know that isn't the case.

 

[jcorreia]

you'll get use to it

 

[ktarlecky]

i have always opened my eyes in the water. My brother keeps salt water aquariums and has done a lot of research into the subject. He always reminds me of the microscopic worms, bacteria, plankton etc. I guess...opening your mouth would be worse....right?

 

[zeN||]

Water in the face isn't too bad, swallowing sea water-now that's altogether different (gagg! spew! erp!) zeN

 

[Mr. Sunday]

There is no problem to open them underwater. Maybe sting a bit but that is about it.