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Product Spotlight: New Colored Contact Lenses at HEC

Honolulu Eye Clinic is so so excited to be one of the first clinics on the island to carry the new AirOptix Colors Contact lenses.

I’ll admit it – when I was young, there was nothing I wanted more than green eyes.  There was an auntie I used to babysit for down the street.  She was Indian with these gorgeous silver/green eyes and I used to tell my parents – “When I’m 18, I’m going to get colored contact lenses” . I wanted to look like the famous Indian actress (and former Miss Universe), Aishwarya Rai.  That’s her real eye color.

Fast forward to 2008 when we took over Honolulu Eye Clinic.  Finally, I thought, colored contact lenses.  The only option was the Fresh Look colors and alas, try as hard as I could, I could not get those contacts on to my eyes.  I thought it was just my inexperience wearing contact lenses, since I don’t wear glasses and have never needed contacts.  But, even when I had our stellar staff put them on for me, they were incredibly uncomfortable and moved all over the place on my eye.  On top of that, they blurred my vision.  I finally checked my corneal measurements and realized that my corneas were too flat for the standard size that the Fresh Look colors come in.  So, I resigned myself to having brown eyes (OK, I’m being a bit melodramatic).

But, just last month, Alcon introduced AirOptix Colors and it’s a contact lens I can actually wear!  The fit is comfortable – much less movement and drying than the previous iterations.  The Dk constant (which is just a measurement of how much oxygen the lens transmits) for the AirOptix is 6 times more than the Fresh Look Colors.

And, the colors are so much more natural.  My husband does not care for the fake, artificial colors of Fresh Look and these new AirOptix ones just make your eyes pop but in a subtle manner.  They have a 3 in 1 color technology, which enhances your natural eye color (instead of just covering it).  The outer ring defines and intensifes your eyes.  The primary color enhances your eye color and the inner ring adds depth and natural richness.  The colors are are on both surfaces of the contact lenses, which makes the color more life-like.

Here a pic of me wearing the green (subtle).

[caption id="attachment_1143" align="aligncenter" width="695" caption="Air Optix Colors in Green"][/caption]



[caption id="attachment_1139" align="aligncenter" width="259" caption="AirOptix in Gray"][/caption]


I hate taking selfies.

And, last one of me wearing just one green contact lens.

[caption id="attachment_1142" align="aligncenter" width="300" caption="Green contact in right eye and normal in left eye"][/caption]

Here’s some of my staff. Sam has beautiful blue eyes.  But, she likes to change it up,so she’s wearing a hazel contact lens in her right eye.


Sofie is wearing hazel on the left side.  Wouldn’t you just kill for those lashes?

And, last our optician, Becca who has beautiful brown eyes, but likes to play with the gray contact lenses.

The Air Optix website has a fun virtual studio, but nothing is as good as actually trying on the contacts on your eyes.  Please call us if you would like to try the new Air Optix colors.  They are monthly lenses and currently come in plano (no power in the lens) and minus powers (nearsighted).  The plus powers are supposed to come out by the end of the year, though they are not yet available.

Keep Your Eyes Healthy: Make-up Safety

We all do it – use make-up even when a nagging feeling tells you that you should probably toss it.  I know, it hurts to throw away your $30 tube of mascara, just because it’s been three months.  What’s the harm?  And, I’m pretty pake (that’s cheap for any readers who aren’t from Hawaii), so I think back in med school, I’d use the same mascara for a year.  But,now I know better.  Microbial organisms are present on your lashes and they can flourish in tubes and bottles when given the chance. Serious eye infections can occur, so I’m listing some guidelines to follow with eye make-up.

1. Toss your mascara every three months

You’ve probably read this in your beauty magazine or blog, but where did this magic 3 month number come from?  A study done almost 40 years ago in a very reputable ophthalmology journal showed that bacterial and fungal growth was found in 36% of mascara tubes after 3 months.  So, now ophthalmologists make the recommendation to discard your mascara after 3 months.

Like I said, I know this one is painful.  A little tube of Diorshow costs over $28 (I used to love this mascara) and I totally didn’t used to do what I knew in my heart was the right thing to do – throw it away after 3 months.  Think about it, you double dip your mascara wand and there are numerous normal bacteria on your lashes.  Once you apply your mascara, you’re putting that cespool of bacteria back into a liquid/gel bottle and sealing it tight.  That means staph and strep are growing and replicating inside your mascara tube.  Convinced now?  If not, here’s another great little fact – one study found that almost 80% of mascara samples contained Staph aureus and 13% contained Pseudomonas.  Pseudomonas is a terrible bacteria that is responsible for this below:

OK, so, I don’t think there’s ever been a reported case of Pseudomonas infection from mascara, however, that picture will probably convince you to dispose of your mascara in a timely fashion!

Once the mascara starts to smell funny, change in consistency and become clumpy or dry, then you know it’s time to dispose of it.  There are a lot of less expensive mascaras out there which work really well.  And, then you won’t feel so bad to throw it away.  Also, be conscious of the expiration date.  Before I wrote this blog post, I didn’t even realize mascaras had expiration dates – but here it is.  This is from the back of my Fiberwig mascara.

If you look closely, it actually states 6 months, but don’t do it – stick to the 3 month guideline to be safe.


2.  Don’t share mascara or eyeliner

Anything that it’s in gel/liquid form can harbor bacteria more than powder form.  Therefore, don’t share!  If I get my make-up done by a make-up artist, I always bring my own gel liner and mascara.  Perhaps that’s being too careful, but I have no idea how long that tube has been open, even if they use a clean, disposable applicator each time.   Honestly, probably the best thing to do is to avoid the samples at make-up counters all together.

3.  Dispose of eye make-up after an eye infection

If you get conjunctivitis (pink eye), even if it resolves with antibiotic drops, you must throw away your eye make-up, at the very least your mascara.  Adenovirus particles can live on the surfaces of inanimate objects for upwards of one month .  And, you likely had the infection even before you started manifesting symptoms.  So it’s not good enough to just stop using the products when you have the conjunctivitis and the resume use once the pink eye improves.

One question I get asked often is if a patient can wear make-up if they have blepharitis.  Blepharitis is not an eye infection.  It’s inflammation of the eyelids, so technically, you can continue using your make-up with blepharitis.  However, there are certain types of make-up which are non-clogging and may be better tolerated by people with blepharitis.   Cosmetics may say “non-comedogenic” but that doesn’t necessarily mean they are oil-free.   AND, blepharitis can be caused by staph – remember, there’s a lot of staph just hanging out on your skin and lashes.   So, if you have the severe form of blepharitis – staph marginal disease – then check with your ophthalmologist regarding make-up use.

4.  Eye shadows (powder form) are good for 1-2 years, but don’t forget to clean your brushes

I have a bit of an eyeshadow addiction.  It started when I moved here to Hawaii.  I would get my make-up done at the MAC counter before our photos for our Honolulu magazine ad and have to buy $50 worth of makeup.  There’s just something so pretty about all the colors.  Anyway, here is the embarassing picture of the contents of my make-up drawer.  I own one eyeliner, one blush and a million pots of shadow.

Thankfully, since most eye shadows are powders, they carry much less risk of bacterial infection.  So, I’m safe to indulge my eye shadow addiction.  Though, now that I pulled out all my eye shadows, I see some in this pile from my days in NYC, which was 8 years ago!  Guess those are going in the trash now.  Another thing is even if eye shadow is safe for 2 years,  people often neglect to clean their make-up brushes and these can harbor bacteria.  I clean my brushes with MAC cleaner.  I’ll also use baby shampoo for a real deep clean as well.

5.  Remove make-up before sleeping (even if you have lash extensions).

This is a great time to review some standard eyelid cleaning techniques.  I see a lot of blepharitis in my adult patients, especially in women who wear lash extensions.  They have the extensions and then wear make-up, but they are so worried about losing their precious extensions, that they don’t clean their eyelids properly.  This almost always results in blepharitis.  Washing your eyebrows and eyelids with antibacterial shampoo (Johnson & Johnson’s baby shampoo is what I prefer) can help control blepharitis.  Put a small bit of dilute baby shampoo on your ring finger and suds right on to the lid margin for 30 seconds on each eye.


Lash Extensions – the long and short of it

Many of you remember when I wanted to take “The Latisse Challenge” last year.  I was planning on using Latisse and taking weekly photographs of my lash growth.  But, since I was breast feeding my second son, I decided against doing it (Latisse is not FDA approved in pregnant or nursing moms).  And, since I got very quickly pregnant with Arya after ceasing nursing Taj, I really have never had the chance to try Latisse.  I have been jealously checking out  all of the people around me with their gorgeous eyelashes.  Even both my boys have lashes that Kim Kardashian would covet.


[caption id="attachment_958" align="aligncenter" width="695" caption="My Boys"][/caption]

To top it off, I have suffered from madarosis with pregnancy.  Madarosis is the medical term for loss of eyelashes and eyebrows.

There can be many different reasons for it – inflammation such as caused by infections, blepharitis, or even allergy.  Or it can be a sign of a systemic disease or condition, toxicity from medications, nutritional disorders, autoimmune disorder (lupus), tumors, hyperthyroidism or hypothyroidism, or traction (did you know that a lash curler can cause lash loss??).  For me, I think it’s been a combination of hormones and my lash curler.  The skimpier my lashes got, the more I tried to make every lash count – so I started curling them which really made things worse.  Oh, and I’m a notorious eye rubber.  I get bad allergies and I never remember to take my Pataday drops and just end up pulling and stretching my eyelid skin, which is never a good thing.

All of this lead me to try lash extensions.  Several of my friends have them and they are super popular here in Hawaii.  Many of my patients ask me about them and I wanted to try it out.  The licensing for lash extensions varies state to state.  In Hawaii, an aesthetician or cosmetologist can be licensed to apply lash extensions, even currently no classes or lectures are taught about lashes in these two fields.  Therefore, anyone can do lashes and you should make sure that the person you choose for your lash extensions does not skimp on the type glue, types of lashes and is diligent with their application.  After all, this is a non-surgeon using crazy glue and sharp instruments approximately 1 mm from your eye!  The American Academy of Ophthalmology cautions about the dangers of lash extensions.  They warn about:

  • Infection of the cornea
  • Infection or swelling of the eyelid
  • Permanent or temporary loss of lashes

I went to a lady who was highly recommended.  The process of lash extensions involves gluing, with cyanoacrylate glue (Dermabond – the same type of skin glue doctors sometimes use instead of stitches), lashes on to the base of your natural lashes.  I have since learned that there are a few different types of lashes – synthetic, silk and mink.  For mink lashes, think the Kardashians or Beyonce.

The adhesive should not be adherent to your eyelid skin.  The first time I had the lashes done, I liked their look and did not have difficulty with them.

The typical lash cycle consists of 4 different phases, and most women have between 100-200 upper lashes on each eye.


Therefore, even though it takes a full 3 months to cycle through your lashes, most women will want to get their lash extensions filled in every 3-4 weeks.  I went back for my fill=in and asked for more noticeable lashes.  One thing to note is that I had my baby 3 months ago.  This is important because, as many of you mamas out there know, like clockwork, right around the 3-4 month mark, all that luscious hair on your head that the baby hormones were promoting starts to fall out.  Same is true for your lashes.  Unfortunately, the lash lady saw that I had baby fine lashes, since I was shedding a lot of lashes due to the hormones, and applied extra glue to make the lashes stick better.  The fumes from the glue caused my eyes to tear throughout the entire process. The end result was that the lashes were too heavy and caused most of my real lashes to fall out.  Even though I’m an ophthalmologist, it didn’t occur to me to check the ingredients of the glue used.


[caption id="attachment_950" align="aligncenter" width="417" caption="Lash extensions glued to multiple of my lashes with excess glue at base"][/caption]

I looked online for studies regarding lash growth and lash extensions.  You might be scared yourself to try lash extensions because you’ve heard “it causes your lashes to fall out”.  In reality, no study has actually been performed to support or deny this assertion.  But, there are risks associated with lash extensions – irritation, inflammation, infection, allergic reaction and even madarosis.  Some of you may remember Kristin Chenowith showing up on David Leterman wearing huge sunglasses because of an allergic reaction from her lash extensions.


Long and short of it, I started developing irritation and redness of my upper eyelid skin from the lash extensions – I wanted them off.  I almost attempted to pull them off myself, but I knew that would result in more missing lashes.

So, I tried another lash stylist (is that what they are called?) who had been highly recommended by another friend.  Kristin Wood of the Kristin Wood salon.  She spent an hour and a half carefully removing all of the excess glue at the base of my lashes and the few errant lashes remaining.  At the conclusion, my upper lids were swollen and red and she advised me to wait  to get new lash extensions until my eyelids had healed.

[caption id="attachment_952" align="aligncenter" width="417" caption="Redness and swelling at base of lashes after lash removal"][/caption]

I knew that was the right call, so I came back in two weeks and she worked her magic.

[caption id="attachment_954" align="aligncenter" width="417" caption="New lashes!"][/caption]


One week later, only two of my lashes have fallen out.  The lashes are longer and feel much lighter than my previous ones.  When I touch them, they don’t feel stiff, but soft like my own lashes.  However, most people in the lash industry will admit that lash extensions do cause your natural lashes to fall out more quickly.  So, what should you do to avoid complications from lash extensions?  The FDA and American Academy of Ophthalmology offers the following advice:

  • Check the ingredients of the glue to make sure you are not allergic to it
  • If you have an eye infection or the skin around the eyes is inflamed, avoid lash extensions (as I did initially)
  • Make sure that the technician applying your lashes wears gloves and practices proper hygiene
  • Ensure that the aesthetician is properly certified and working at a reputable place.

If you develop an infection from the lash extensions, resist the urge to pull them out yourself.  Go to an ophthalmologist for treatment. An ophthalmologist can prescribe an antibiotic or antiobiotic/steroid ointment.  The lashes will fall out over the period of about six weeks and with it, the glue should also fall out in that time.

Also, beware of a lash stylist who tells you not to get your lashes wet at all.  Usually, you shouldn’t get them wet the first 24 hours, but after this, you should clean your lashes and remove make-up with an oil-free make-up remover.  Kristin advised to perform the same baby shampoo lid scrubs that I recommend to my patients with blepharitis to prevent build-up of protein and oil (and this was before she knew I was an ophthalmologist!)

So, what do I think of lash extensions?  I had one experience which seems to echo everything that the Academy of Ophthalmology warns about – glue on the base of the eyelid skin, allergic reaction and lashes that were too heavy for my natural lash to sustain, thus causing traction madarosis.  And, I had a great experience with another lash stylish with no complications.  So, the choice is yours – lashes, Latisse, good old fashioned mascara, whatever you choose, be safe and make your eye health your top priority, don’t just look for a good deal.