ANDREW GASSON CONTACT LENSES

A LONDON SPECIALIST CONTACT LENS PRACTICE SINCE 1972

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BLINKING*

(These notes are taken from exercises originally developed by Donald Korb of Boston)

 

Blinking is generally regarded as an involuntary action although its type and frequency varies considerably from one person to another.  Poor habits are often acquired, particularly among contact lens wearers.  Investigation has revealed that large numbers of people, even with no visual problems, develop an incorrect blink, whereas almost all infants are naturally excellent blinkers.  If poor habits do exist, it is possible to retrain them by means of special exercises.  Correct blinking is essential for all contact lens wearers as it frequently makes the difference between success and failure.

Modern contact lens designs and materials encourage normal, correct blinking but the best results are achieved with a little effort and practice.

 

Why blinking is important.

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.

 

Blinking Exercises

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.

                                           

The Ideal Blink

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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