racing with contact lenses

[THE LONG RANGER]

Really interesting information in this thread. My thoughts:

* Baby Shampoo: The baby shampoo idea is a great one. I've had some pretty horrible eye infections, and have been told to wash my eyelids with baby shampoo daily if I start to see a flair up.

* Antibiotics. When I did the TD, I would also bring antibiotics for my eyes - never needed them, but if they got infected, it would completely shut me down. Good piece of mind, not too expensive, takes up 0 space in your pack. You can lose your eyesight from something as simple as washing your contacts in dirty water. Don't mess with this.

* Extra pairs - I brought multiple extra pairs of contacts with me on the TD. Different brands and types: monthlies, dailys, etc. You never know when you're going to have one pop out or tear one. Ask your ophthalmologist for samples. Glasses too - perhaps with shades to attach them with.

* Experiment with brands. Depending on your eyeball, one brand of contact may be more comfortable than another - especially when wearing them multiple days in a row. Start out with a completely new pair. I switched the brand I had been using for years, and am amazed at the difference in overnight comfort.

I think I'm in the, "don't touch your eyeballs, unless you can do so with the cleanest of hands" camp, and would rather keep contacts in longer than usual, if I can't handle them correctly. Good times to do this would be during a restaurant stop. Even if you don't take your contacts out at night, you can give your eyes a little break while eating lunch.

Unisol 4 has been discontinued, I'm reading?

[GrizzlyAdam]

I have keratoconus as well. Mostly in my right eye. I could never wear the contacts, my condition was too bad for even those. The cornea was so pointed that the contact would fall out of my eye. I just rode through it with one bad eye. Got used to it. But eventually the keratoconus got bad enough that I'd often rip my cornea after a night of sleep - my eye lid would stick to the cornea, and when I woke up it would tear. Hurt like a mutha! The doc gave me a couple options at that point - do nothing, or get a transplant.

About 4 years ago I had a cornea transplant in my right eye. Life improved greatly. I am still not a candidate for lasik, but I can wear glasses that correct my vision.

I was off the mountain bike for a couple of months afterward, but was back on the payment pretty quickly. I ride with prescription glasses these days. Being able to see the trail is pretty neat!

I know surgery is not viable for everyone, but it might be an option worth talking about with your eye doctor.

[FOG]

Adam,
It is great that you have had a successful transplant!  And that you can see with glasses is even better IMHO.
I have had both eyes transplanted and my corneas are steep enough that keeping hard GP contacts in a challenge.  I then was given the new Scearl lens and they stay in, they cannot blow out.  The comfort the scearl lens provide is unbelievable, dust and wind no longer bothers me!!!  .  Please keep this in mind if you have further problems with GP contacts.
Wayne

[Mini Bear]

It's been quite some time since I've had to use contacts (got lasik a few years back), but one potential way around the dirty hands and subsequent (possible) infection could maybe be bringing along some nitrile gloves to use specifically to deal with contacts. Doubles as first aid accouterments as well. Just a thought. 

[Flagster]

I wear "normal" contacts, and just take them out at night when I race (or bike pack, or backpack).   Dirty hands have never been an issue for me - so long as my hands are not covered in chain lube (or bear spray ) I take them out when I sleep without worrying too much, and put them back in when I get up.  Most of my multi day racing is in the winter (Iditarod Trail Invitational) and I do all of that inside my sleeping bag. I asked my eye doc about it, and he told me not to worry do much about it. Works for me.

For non-racing, like bikepacking, touring, or backpacking, I bring a small container of baby shampoo, and wash my hands before taking them out.  The baby shampoo gets your hands clean, but doesn't hurt to get in your eyes if you don't get your hands completely free of soap.  If I was doing the tour divide, I would go that route, just washing my hands before taking them out with whatever water I had.

Good luck! 

This is the technique I use...in and out inside my bag out of the wind...I carry a mini mirror to help...usually I just rinse my fingers with a wet nap and then saline...burns a bit more than when they are totally clean but seems to work. 

[FOG]

robotfury

I was having problems and went to my contact specialist, and she told me to NEVER sleep in Sceral lens , as this can damage the cornea.

I am now thinking about carrying baby shampoo and extra water to wash my hands with and deal with putting them in and taking them out in a tent.  Plus cleaning them when I get a chance on the route.  At least dust will not be as big of a problem.  I always wear glasses when I ride.

I don't think one bottle of PuriLens Plus saline (a recommended replacement for Unsiol 4, which is no longer available) will do the whole tour, and I do not think it will be available on the route.  I was thinking of starting with 2 or 3 bottles, which I would also use for eye drops.  I am thinking about having a new water bottle for cleaning my hands only.  I could use my CamelBak since I only put water in it; but I am concerned with filtering water and getting any contamination in the bladder.

I have an appointment with my eye doc next month and I plan on asking him for thoughts/recommendations.

Wayne

[THE LONG RANGER]

Baby shampoo is a total must! Get a travel sized bottle, and you'll be good to go. Resup at any super market (Salida), or something like a Target (Silverthorne) or Walmart (Grants). It also works for a general cleaner, so it fits the, "multiple use" UL gear guidelines!  

No more tears!

[robotfury]

Wayne,

I am totally with you. I am pretty much going to follow the same system you outlined. I am taking a shelter purely to help with eye care. To get out of wind and rain. I wish I could just use a bivvy. The KC and Scleral lenses really add a weird dynamic to racing. I am going to use the baby shampoo and rinse the lenses at night and store them in a cleansing solution while I sleep. I am also planning to use wetting drops and blink and clean regularly. Any restaurant stop, i will clean the lenses with the RGP soap. As far as i am concerned, eye care is paramount. I will lose a day or two if I mess things up.  Also, sleep with the lenses and saline near your body heat. I don't know if you have ever put in the lenses with COLD solution, but it sucks. In addition to using a shelter, I am going to have to accept I may need to hit hotels/motels more than I would like. Just the way it is.

I have yet to figure out how much to bring - I was thinking one smaller bottle of saline (I don't have the PuriLens, I actually like the CVS stuff better), RGP soap, a solution, Blink and Clean drops AND some wetting drops for if my eyes dry out overnight. Even extra plungers. It is a little nuts how much we need to carry. I have been noting where CVS/Walgreens are along the route. Even Eye clinics. The list Lone Ranger provides is great.

I never sleep in Scleral lenses. I have to take them out for at least 5-6 hours. If I don't so this and I push it too much, I start down a slippery slope. I need to be on top of the eye care. The baby shampoo will be key. Lately I have been using Boston Simplus multi action solution to soak the lenses while I sleep. Then rinse with saline. This solution works really well for me.  Best yet. A bottle of saline, bottle of Simplus, Small bottle of baby soap, two kinds of drops. I will keep the drops in easy reach and the larger bottles in the frame bag. I too was thinking of a dedicated water source for the hands, but maybe saline will work?

The extra thing I might take and maybe this will help - my doctor gave me some antibiotics for my eyes when I had an ulceration. Also some steroid drops. They are tiny bottles. I figure, if I really irritate or mess things up, it would be better to have this stuff as a 911.

Best,

Michael

[robotfury]

I should add to everyone here, really helpful and oddly reassuring that there are others dealing with similar issues.

[FOG]

I second Robotfury comments above.
Thanks everyone,
Wayne

[Yagi]

I also appreciate the insight from everyone.  I go in tomorrow to begin fitment for scleral lenses for KC, and I'm a bit apprehensive.  Anything I should know, or questions I should be asking the specialist tomorrow?

I'm hoping it'll be much welcome relief after the crippling storm of pine tree pollen I rode through yesterday with my RGPs.  It's inexplicable if you haven't experienced it before, especially being allergic to the damn pollen. 

Thanks guys,

Steve

[FOG]

Steve
Welcome to the club.  Getting them in is my biggest problem.  But mine are the largest diameter available, likely yours will be smaller.  The other issue is getting a bubble under the lens,   the key is do not bump the lens when you put it in and to fill it with solution, the solution has to be basically chemical free.  They will recommend one that works.  When i get on the computer tonight I will post a couple links that provide a lot of good information on inserting solutions.
Wayne

You will enjoy the comfort.  Dust no longer bothers me, I have not beat exposed to lots of free pollen with them, but with GDP lens it was painful.

Wayne

[robotfury]

The scleral lenses are magic. It is the insertion and removal that are the highest points of risk for me - when racing that is. In normal life, they just take a bit more care but they will change your life for the better. And dust isn't an issue.

[Yagi]

Thanks, guys!  Your support definitely helps.

[FOG]

Steve,

Here are some links for information on inserting solution for Scearl lens:

https://www.reddit.com/r/Keratoconus/comments/3tshch/unisol_4_is_being_discontinued_replacement/

https://keratoconusinfo.wordpress.com/scleral/

https://www.dryeyeshop.com/articles/lifeafterunisol4.htm?gclid=CjwKEAiA58a1BRDw6Jan_PLapw8SJABJz-ZWWw8lX1mTl0FoeJqtg3h6Jij46h8cstKvMVY5QUYknRoCbw3w_wcB

https://www.dryeyeshop.com/purilens-plus-saline-3pack-p706.aspx

Wayne

[Yagi]

Thanks, Wayne.  I appreciate the links.  Got fitted yesterday - comfort was pretty much amazing, even for trial lenses.  The added complexity of the new lenses will be worth it, I'm confident.

Steve

[robotfury]

Well folks, I am here to report that eye care/KC had a negative impact on my Tour Divide. I had to pull the plug in Silverthorne (I was NoBo).  For me, the contact lenses and the frequent need to remove, clean and insert became problematic. I had my system in place and my KC chemistry set (baby shampoo, multi action solution, cleanser, wetting drops, blink and clean drops and even a dry eye drops as well as bottles of saline, insertion and removal plunger). I can say absolutely that camping out was the most difficult for me. I tried my best to create a clean place to wash, store (while sleeping I put the contacts in a case with overnight solution) and insert the contacts in the morning. Once the contacts were in, no problem, but I have to take them out after 10-12 hours to hydrate the eyes. Problems mostly occurred when I had to take them out and put them in when outside, which is where you are 99% of the time. I also have to sleep with them removed. I had the most problems the morning after any bivvy.  No matter how hard I tried to keep things clean, the morning after sleeping out I always experienced difficulty. This difficulty was for some reason my eyes didn't readily accept the contacts. They wouldn't seat, if that makes sense. Eyes would get irritated/ I would need to take them out and clean them 2-3 times. It would take a while for my eyes to accept the contacts comfortably.  Once they did, though, i was good for the day. So, cleaning and eye care in the field was difficult and time consuming and greatly opened me up for problems. This was entirely different when i stayed in a hotel or a campsite with facilities like in Sargents. I never had a problem when i had a sink at hand. The result was I started aiming to stay at hotels/motels or campsites with facilities. This meant, I wasn't racing to my potential, but stopping where I thought I could best tend to my eyes. This got under my skin and it kept me, in my mind, from truly racing.  I could never capitalize on strong pushes.  I certainly didn't feel confident that I could just sleep anywhere. I did plan to make room in my race for eye recovery days. If things got bad, I would accept a day at a hotel for my eyes to recover. However, I had 2 major mechanicals during my race. The first required me to hitch from Canon Plaza to Santa Fe for a hub repair. I was able to do so, but lost a day and a half. This also happened in Salida. Another half day lost. I feel like a used my allotted recovery days on those mechanicals. I lost a lot of time. When I woke up in Silverthorne on that fateful morning, I couldn't wear my contacts. Even after a night in a hotel.  I just lay there in bed dressed to race waiting for my eyes to accept the lenses. I spent all morning washing them and trying, but I could not get my eyes to accept  the contacts. I was looking at another day or more stuck in a hotel. I just sat there with blurry vision. I called the race later that morning.  I suppose in my next iteration, I will organize my strategy entirely around towns/motels/campsites with facilities and Montana Motels.  I am not going to let this deter me from another attempt or keep me from racing. Not yet at least.  Nevertheless, for the TD, it was a factor that I could not overcome.  Not this time.

[Yagi]

Sorry to hear the contacts were such a factor.  I was wondering how you'd fare, and it's a bummer you had to drop out.  I've been wearing my sclerals for about 20 days now, and despite the unbelievable comfort, I can totally understand what you mean in your description above.  Just this last weekend, we camped near Blue Mesa Reservoir/Gunnison, Colorado, and it was a total PIA to attend to my contacts without a bathroom.  I mean, it was really tough compared to my old RGPs.  I've had a few instances where it seemed like the contact(s) never wanted to settle down on my eye(s).  Never any pain, but it's sure frustrating.  I plan on bikepacking in the near future, and I'll try and report back here, too.

I'm glad you reported back, but I'm sorry about the race. 

Steve

[FOG]

Michael,
I am sorry to hear about your having issues with your sceral lens during the TD.  I think I figured out who you are and was following you on track leaders, and noticed a couple of down days, and was hoping they were not sceral lens issues.  Mechanicals suck under the best of conditions but on the TD they really have to suck.  Glad you got them solves though and could continue.

I must be lucky in that I can and do wear my lens 16-18+ hours a day without any issues, and my eye doc says if I do not have issues no problem.

I am not sure what you are referring to with problems with getting the lens to seat on your eye ball.  I occasionally get a bubble under my lens when I am inserting it, and the only solution is to remove it and re-insert it.  My lens are 22 or 23 mm in diameter, the largest available I think, and my eyes are narrow, so getting the lens in without hitting an eye lid is challenging.

Did you rinse the baby shampoo off your hands before using fingers to handle the lens or clean out your eyes?  Getting anything with any preservatives or chemicals under the lens is not a good thing and I have been told to be careful here.  I was thinking on having a bottle/bladder (new and clean) for clean water to wash my hands with before touching my eyes or lens.  I understand this is added weight but if I can keep going I think it would be worth it.  I have always used Unisol 4 (yes I got lucky and still have some) in my lens before inserting it.  I also use it for cleaning out my eyes and for lubrication when I need it, or think I need it.  I plan on going to Pura Lens Plus when my Unsiol 4 is gone.  They are the same solution, just different names.  My eye doc says they have clients using it with no issues.  I use Boston Advanced cleaner and store my lens with Boston Simplex and totally rise it off with water before I insert the lens.  This is what my eye doc taught me to do when I got my Scearl lens.  My objective is to help us figure out how do deal with our Scearl lens on bikepacking trips and the TD.  It sounds like you were having enough issues to be detrimental to the health of your corneas, especially since KC is a deterioration and thinning of the cornea.  I was also scolded, by my eye doc, for sleeping with my lens in too.

I started to look at going from motel to motel and looking at distance and time based on staying in a room so i could better care for my lens.  This will take time; but we may not need to plan for off days.  If I remove my lens, I am totally blind and cannot see anything, so spending a day not seeing would not be fun.  It is no fun when I get my enes dilated and cannot wear my lens for several hours!

Yagi,
I am glad that you are enjoying your scearl lens.  they are really a great tool to us in seeing and comfortably wearing our contact lens.

Pleas keep us posted on what you find on your back packing trips.  Right now I am not able to do any overnight trips, and I am slowly building up riding time and distances; but my hopefully goal is to try the TD in 2018, when I will be 70 years old.  i ho;e it is not a pipe dream.  By the way I live in Lakewood, CO.

Wayne

[robotfury]

Thanks for following me. The mechanicals were set backs for sure. I did get to spend a day in Santa Fe though and half a day in Salida eating burgers and drinking MUCH MISSED coffee at the place adjacent to Absolute Bikes.  I got to hang out with Chris Plesko a bit too while waiting for our bikes.  Not the worst ways to spend the day. They added up. The time lost was a huge bummer, but I was pleased with getting back to the course. It added to the adventure. The debacle in Silverthorne haunts me. Physically, I was fine. I could overcome the mechanicals too and feel like I could have made up time and distance if only I was able to push it past city limits.

Problems getting them in: Sometimes when my eyes are fatigued or "tender" the contacts suddenly feel like they weren't made for my eyes. They feel like they don't fit. They don't suction to the eye, dry out quickly and cloud when they are in. I had quite a bit of clouding. No bubbles. This happened after a night out in the field. The best way I can describe it is that they simply feel like I am putting the wrong set of contacts in.  Usually I clean them with the cleanser, rinse with water and add the saline and all good. BTW - I am the one person who prefers the cheap CVS saline to the Unisol 4. One thing that I did this time that was new to me and worked great was when I did remove the contacts, I would use a straight up Visine dry eye on the eye before reinserting the contacts. This worked so well.  I had some redness at one point and this trick completely eliminated the redness. I would remove the contact for washing and add the visine and this made a huge difference. The baby shampoo was also great.  Anyway, that day in Silverthorne and a few before that, the contacts just felt like they were meant for another person's eyes.  I have ulcerated my cornea in the past due to contacts and now I am SUPER careful and worried about it. As soon as the contacts were problematic, I just stopped and considered my options. I have already scared the cornea enough. This is not something one can muscle through. Something my friends and fellow racers do not understand. 

I can keep my contacts in for long durations, but I notice that the longer I leave them in, the more likely my eyes are irritated when I take them out. It is weird. I did this for the Dixie 200. I wore them the entire time and constantly used drops. It was fine, but when I finally took them out to clean them, man I couldn't get my eyes to accept my contacts. My eyes dry out under the lens and they had been dry for so long. Fortunately my friend drove us back to LA, but the entire time all the way from Utah I could not use my contacts. I could not see and tears never stopped dripping from my eyes.

DEFINITELY a dedicated water source JUST FOR EYES that is filtered and as clean as possible is something I will consider for future races. I used water from my bladder.  I will add that I was surprised how much water I actually used for the cleaning process.  At least a cup and it needs to flow. I would also bring an eye washing cup and maybe even eye wash solution.  I already had quite a kit, but it is worthwhile weight.  I tucked frequently used eye drops in my top tube food bag; the majority of my eye stuff - plungers, drops, small saline bottle, cleanser - I stored in my Revelate JerryCan. I put my extra bottle of saline in my Bedrock Bags Tap Eats to Go Stem bag. 

Eyes. This is just going to be a puzzle. The distance and nature of event is also a factor. I feel that, for example, the Trans Am maybe be less of an issue. Frequent services and paved roads.  TD or Trans Am, I am going to have to consider hotel to hotel or to campsite with a few nights sleeping rough. A fully enclosed shelter.  Dedicated water source for eyes. Eye wash cup and solution. I did notice that my I could better care for my lens as long as I had an enclosed shelter, so the campsite bathrooms are a great last resource.  So, yeah, next TD will focus on town to town, motel to motel or campsites. There are some really nice campsites or RV parks that will suffice when motels aren't available.  The RV park between Horca and Platoro was one. I didn't realize until the next day it was there. I camped just next to Horca. I had SO MANY ISSUES riding that dusty road to Platoro. OMG. I stopped so many times to add drops to the eyes and then I saw the RV park and it has a bathroom and made all the difference. Until then, the dust from each passing car was awful.

At this point, I am going to start looking at some of the treatments. I know I can never fix this, but MAYBE I can get to a point where I can also wear eye glasses. This would make a huge difference. I am too young (43) for cornea transplants, but maybe intacs... i don't know. I have been told that if I can't wear glasses now I won't be able to with treatment.

The odd thing is, I truly feel lucky that science has me seeing. 100 years ago I would be completely useless.  Because of the scleral lens, I can see and see quite well. They are better than my old RGPs which hurt like hell when I got a gust of wind under my Oakleys.  I raced the inaugural TNCA and did it with ONE contact after my right one broke.  This is with old RGPS. I could never do that now with the scleral lenses.  The scleral lenses are way more high maintenance.

I am happy to have this forum to bitch, whine and try to find solutions. There aren't really any KCers who mess around with ultra endurance sports.  I am glad to have this resource with you guys.