A SPECIALIST CONTACT LENS PRACTICE SINCE 1972
[ Andrew Gasson ] [ Front Page ] [ Contact lens information ]
(These notes are taken from exercises originally developed by Donald Korb of Boston)
Modern
contact lens designs and materials encourage normal, correct blinking but the
best results are achieved with a little effort and practice.
The most important function of blinking is to spread the tear film evenly across the front surface of the eye (the cornea) and to maintain its naturally moist state. This protects the eye from the irritating effects of dryness. During a blink the upper lid moves downwards to make contact with the lower lid whilst the lower lid hardly moves at all. If the upper lid does not close completely, an area of the cornea will remain exposed and will not be lubricated by the tears. As a result of this partial blinking, the exposed area of the cornea will become dry and feel itchy, scratchy or burning; there may also be a tired or heavy feeling. The eye's response to dryness is usually to become red in the affected area so that apart from any discomfort the cosmetic appearance may well be unacceptable. Dry and red eyes can often become a severe problem for contact lens wearers. They mainly occur with hard gas-permeable lenses but can also be a problem with soft. Most modern hard lenses tend to position themselves in a high-riding position on the eye. That portion of the cornea covered by the contact lens is obviously protected but the area surrounding the lens tends to dry very quickly, especially if blinking is inadequate. Although drying may sometimes make contact lenses difficult to wear from the beginning, the irritation may well occur after several months or even years of successful wear. If the discomfort becomes severe, it may be necessary to refit with a different type of contact lens or even discontinue wearing altogether.
The
following exercises are designed to eliminate faulty blinking by substituting a
fully relaxed and normal blink. They
have been developed over a number of years and have proved successful with large
numbers of patients.
There
are two sets of muscles in the eyelids, which we can call heavy and
light. The purpose of the
heavy muscles is to close the eyelids quickly in the event of an emergency and
they force the lids together with a vigorous action.
They are not intended for normal blinking.
If the heavy muscles are utilised for 'squinting' or partial blinking
because of faulty habits, they will need retraining for contact lenses to be
worn with optimum success. The force
created by the heavy muscles can be felt simply by placing your two index
fingers at the extreme outer corners of your eyes at the angle of the lids.
Gently move your fingers so that they rest on the heavy muscles and feel
the excessive tension created when a forced blink is made.
Most people, in fact, do not have ideal blinking habits for contact lens
wear but with a little effort and practice you should be able to eliminate the
forced blink by relaxation of the heavy muscles while learning to use the light
muscles correctly. This usually
requires a two to eight week period of consistent and regular application.
After this time a reduced maintenance programme can be followed.
Steps
for correct blinking exercises
1.
RELAX. In order to relax the eye
muscles you must yourself be totally relaxed and at ease. Throughout the
exercise it is very important not to force any eye movements.
A forced movement causes muscle tension, which can be sensed by the
fingertips. Instead, the eyes should
close and open naturally with a smooth fluid motion.
The correct posture for the exercise is simple.
The head should be held upright and erect with the eyes directed straight
ahead. But do not concentrate on
looking ahead when the eyes are closed, as this tends to force unnatural eye
movement.
2.
CLOSE. The eyes should be closed
slowly and gently, in a fluid motion, as if you were closing them to fall sleep.
If you are relaxed as in step one, this should not be a difficult task to
perform. The fingertips will detect
any deviation from the correct closing procedure as unwanted muscle tension.
If tension is sensed, concentrate on closing 'in slow motion' as if
slowly falling asleep.
3.
PAUSE.
At the completion of the closure, pause for approximately a count of
three. This will allow the upper lid
to complete full closure. In this
way, you will begin to learn the feeling of complete lid closure.
A 'hidden movement' of the eyes during the pause will also be sensed
if the exercise is performed properly.
4.
OPEN.
Open just slightly wider than normal but this movement should not be
accentuated to the point of a wrinkled brow.
5.
PAUSE. In the wide open
position pause for a moment.
Quickly
reviewing: head straight, look straight, fingertips at the corner of the lids,
relax, close slowly, pause, open wide, pause.
The timing of the complete exercise should be as follows:
Blink.....
pause,
pause, pause..... open..... blink..... pause, pause,
pause..... open..... etc.....
This
exercise, should be performed regularly 15 times a day, or as otherwise
prescribed, with each practice period consisting of 10 correct blinks.
This will require just a few minutes of your time per day.
Within three to six weeks your blinking habits should improve greatly and
you should then progress to a maintenance programme of about five practice
periods per day. You should make an
effort to incorporate these exercise periods into your daily schedule, much the
same as brushing your teeth. The
exercises can be performed with and without contact lenses, but not while
engaged in situations requiring concentrated attention such as reading or
driving.
If
this programme is followed carefully, within a few weeks the partial, squinting
blink will become a full, fluid, natural blink.
This is the goal of your efforts. For
assistance, watch other people blink: it is particularly valuable to observe
actors in films or on television. Notice
how they blink and when they blink. In
order to look attractive we do not normally blink while looking directly at or
conversing with someone else. Instead,
blinking is performed while looking from side to side or from one object to
another. Practice concentrating on
blinking while changing direction of gaze. Learn
to look straight at people without blinking.
Learning to blink when changing direction of gaze will help in the
development of a natural-appearing and beneficial blink.
Blink
frequency varies from one person to another.
However, for most people about every five seconds is normal and you
should learn to blink at approximately this interval.
Each blink will automatically become complete and smooth as a result of
the training exercises.
There
is one caution for the new wearer, particularly with hard gas-permeable lenses.
During the first four weeks of lens wear, vision may blur temporarily as
a full, correct blink moves excess tears over the contact lens.
There may be a temptation to inhibit blinking or to blink only partially
in order to prevent this temporary blurring of vision.
If this occurs, it is essential to continue working for an ideal blink to
prevent symptoms of dry eyes developing. Within
four weeks your vision should become clear and constant.
The
rewards gained through correct blinking are sharp vision, improved ocular
health, reduced redness and maximum contact lens comfort.
Remember, when a 'forced' blink is made it will be felt.
By monitoring your blinking in this manner, you will at first probably
feel the muscle tension or pulling during blinking.
In summary, most people do not actually have ideal blinking habits for contact lens wear. However, a strong personal effort to improve blinking by practice exercises can eliminate tension through relaxation of the 'heavy' lid muscles, while learning to use the 'light' muscles correctly. This usually requires a two to six week period of regular practice followed by a reduced maintenance programme.
*These notes are taken from exercises originally developed by Donald Korb of Boston
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