My 87-year-old grandmother isn’t doing too well lately, and I’m guessing will not be with us much longer. She’s lucid and as active as she can be, given her health problems. She broke her hip about 8 weeks ago; it’s healing as well as can be expected. Recently she’s had a bad bout of arthritis in her right shoulder, and it’s severely restricted what she can do with her right hand.
One thing that’s been affected is her ability to put her contacts in. Yes, she wears contacts. Twenty or thirty years ago she had cataract surgery, and they removed the cataracts and her lenses along with them. She’s done fine with contacts ever since.
Now, though, she’s having a hard time with them. A few months ago her eye doctor suggested only taking them out once a week, so that she wouldn’t have to fiddle with them every day. She’s been doing that, but even that’s hard. With the arthritis, it’s even harder.
My mother called me last night, and told me that I’m the only one in the family who wears contacts, and if it gets bad, it may be up to me to go visit my Grandmother every Friday and help her get her contacts in. :eek:
OK, I’m hip to helping my Gram, and I’ll do it if I have to. But I have to 'fess up and say that the whole idea gives me the heebie-jeebies. I’m no eye care professional, and though I can deal with my own contacts just fine, the idea of sticking my fingers in someone else’s eyes scares the hell out of me.
My first thought was to go to the eye doctor and see if there’s some non-contact solution to this. Can’t she just wear glasses? I asked my mother this, and she said they’ve asked the doctor and it’s not a possibility. Problem is, this is third-hand information from a source I don’t trust. I don’t think I can just call the doctor myself because of privacy laws (right?). So I give it to the teeming millions: Does this sound correct? Is she stuck with contacts forever? If that’s true, anyone got any good ideas for how to get contacts into a weak old woman’s eyes?
Does she have special lenses (like for astigmatism?) If not, she could try 30-day lenses that at least would minimize how many times she had to mess with them.
I’ve called doctors about my grandfather and they seemed more than eager to discuss his medical care with me on my declaration that I was a relative. The worst that could happen when you call is they tell you they can’t tell you anything.
As far as actually changing someone else’s contacts, you might do better to hire a health-care professional for that. Either get a visiting nurse-type or do what gigi suggested and get 30-day contacts and take her to the eye doctor once a month for the changing. You touch your own eyes all the time, but you never touch your grandmother’s eyes so there is a really good chance that you could give her an infection from bacteria that your body is immune to, but hers isn’t. Or you could give yourself something from her unless you practice clinical level hygiene by wearing gloves and sanitizing your hands and all that stuff. From a practical point of view, what happens if one comes out, or if she gets an infection and needs to take one out and you aren’t available to help her because you are out of town, or sick, or have a vanload of carpool kids, or are giving the most important presentation of your life? She needs a professional health care provider to be able to call, they have back-ups for when they are not available.
I’ve done this for my Mom on occasion and, although it’s kinda freaky, it’s really not that bad after the first time or two.
Do call and talk to her doctor; explain that you’re a relative and what’s been asked of you. If they still won’t talk to you, call with your Mom (or whoever holds medical power of atty) available to tell them it’s OK.
Even if it’s true that she can’t wear glasses (they actually removed her lenses in the cataract surgery? If so, it could be true that glasses wouldn’t do anything), the doctor or her contact lens specialist can help you learn how to do this. They also should have some nifty little soft rubber tools that you can use instead of your fingers, if you prefer.
I’d be willing to bet that she is wearing a Rigid Gas Permeable lens, not soft lenses (so, therefore, no 30 day lenses). These are very common for aphakia (no natural lens inside the eye). Years ago, before the advent of the intraocular lens implant, this was how people were able to see post cataract surgery. I have a handful of patients over 90 years old wearing these. I’ve not seen a pair of aphakic eyeglasses in over 12 years. I’m not even sure which labs make them anymore. I’ve never sold a pair, in 18 years in the business.
If indeed you will be taking care of this for her, I certainly hope that her eye doctor would have someone teach you. I wouldn’t just teach someone who came in and asked me, but in our office, I’d imagine one of the doctors would tell a tech “have WishIhadACoolName teach Mrs. Whatsername’s granddaughter how to insert and remove her RGPs”. At which point, I certainly would do so.
RGPs can be tricky, and if that’s what she’s wearing, ask for a removal tool. We use the Royal Remover. It’s a rubbery little stick with a teensy suction cup on the end. Apply the cup to the contact lens and out it will come! The opposite end of the Royal Remover has a cup that is not suction-y and can be used for insertion. When I have to insert a patient’s lens, I use my fingers, but I use a Remover for removal. HOWEVER when removing a len, be sure that the Royal Remover ONLY touches the contact lens!!! This is extremely important, as you do not want to injure the cornea or sclera. Fortunately, it’s pretty easy to see an RGP in someone else’s eye if you are the one removing it. When inserting it, wet your fingertip with the contact lens conditioning solution, just a touch, so the lens will stick to your finger until it pops onto her cornea. Also, if you drop a lens on the floor, turn off all the lights and use a flashlight to find it. I’ve heard that works like a charm.
As far as privacy laws go, Grandma can simply add you to her HIPAA list.
I did go ahead and call the doctor, and they had no problems talking to me (so much for HIPAA).
According to them, she does have glasses and they should work. They are very thick, though, and I’m pretty sure she doesn’t like them. They said they couldn’t get her any lightweight glasses.
The good news is her contacts are soft lenses, and they can be worn for 30 days. I think that will take care of our problem!
That’s actually what cataract surgery is - removal of the lens. A cataract is cloudiness of the lens or (less often) the membrane that encapsulates the lens. Removal of a cataract is removal of the lens.
These days they insert an artificial lens when they remove the natural lens. I know surgery is probably the last thing she needs, but could she get intraocular lenses implanted?
I’m not sure how cataract surgery used to work, but if they removed the entire lens and its capsule they can’t put in an intraocular lens. The lens capulse and a little bit of the lens material around the periphery of the capsule need to be present to anchor the implant in place.
The implant used looks like this; the clear part in the middle is the lens, and the little filaments get hooked into the bit of lens left to anchor it in place.
Yellow glasses might be worth looking into: my aging mom has had trombosis in one eye and she says her yellow glasses have improved her eyesight and made seeing a lot more comfortable. As you grandma weasr contacts, she could add yellow glasses.
Thanks for the suggestion. That’s a pretty cool link!
I don’t think my Gram needs any vision correction - she sees well, if she has her contacts in, and they’re comfortable. It’s just getting them in that’s the hassle.
The eye doctor mentioned lens replacement surgery. But the last thing she needs right now is surgery; she’s getting pretty frail. I’m honestly not sure how long she’ll be with us.
