Mary, ideally, your friend should have been told that histo can reactivate years later and cause problems. However, in some areas of the country, histo is endemic, and doctors may get weary of going through the whole explanation for all patients with retinal signs of histo when only a small percentage of them will go on to have visually threatening complications. From an outcome standpoint, it is probably useful for histo patients to know about it, since treatment with laser at the earliest point in the progression of the disease will likely result in the least loss of vision. I have a patient who, when he first consulted me, was completely unaware that the vision in one of his eyes was markedly reduced from an active histo lesion. With both eyes open, he couldn't tell!

Fibula, in the context of your question, I'm not sure what is meant by someone saying that there "shouldn't" be problems with continuous, or extended wear of contacts. The fact of the matter is that problems do develop sometimes, occasionally severe. Whether or not they "should" is a philosophical question. The risk of severe corneal complications (infection and scarring) is about 15 times greater when one sleeps overnight in contacts compared to when one removes them at night to give the eyes a rest. I tell all my patients that a nap during the day with contacts on is OK, but no overnight wear. Mark's advice is right on.

One more thing contact lens wearers should know is to try to avoid swimming with contacts on, especially in places like public swimming pools, hot tubs, and water parks. There is a nasty bug called acanthamoeba that can get in your cornea and cause a painful infection and scar. It is an uncommon infection, but much more likely to occur while wearing contact lenses. I have a patient who got this bug and required treatment for almost a year before the infection was cured. A permanent scar remains.

Al