Unusual Situation - Client With Dermatiological Issues Involving Acetate Frames

[Lelarep]

Client has had an unusual reaction to an acetate frame. They said they have a history of dermatological issues, especially with items that touch/press against their skin. Client has always had metal frames, until this one, with no issues. Now, with the acetate frame, they have developed a focal bacterial infection behind the ear and on the bridge of the nose right where the frame sits. I have to believe that this is in response to the frame, since it started only a few days after the new frame, and its obviously two spots where the frame would be touching the skin. They really want to keep the frame. I'm pretty good with material science, but not with acetate specifically.

What can I recommend they use to wipe the frame down with to keep bacteria/oil from building up on it that won't damage the frame over time? They said when they've had this issue with other items they just have to clean the item and the area where it makes contact just before use, and that usually resolves the issue. I didn't want to recommend anything before I was sure it wouldn't end up causing acute or chronic damage to the frame over time.

[Chris Ryser]

When I learned the profession Europe we also had to get to know all the used frame materials.

There was a rule to store acetate plates up to a year or even more before cutting them and produce optical frames. They had to age properly so they would not leach any chemicals that might create some skin allergies on some people.

These day it could well be that due to competition some manufacturers are not following these old rules and are bringing out newer looking materials too fast.

We used to make a coating material for just such cases but discontinued it as it never sold and there was very little demand for anything along these lines.

[SharonB]

Are you SURE the frame is actually cellulose acetate? I have seen this problem with "plastic"or "zyl" frames that are actually injection molded propionate. The plasticizers or surface dyes used were blamed as the culprit. Chris is also correct about the aging process with true acetate. The slight oxidation tightens up the surface, and eliminates any chemical leaching.

As far as a solution goes - in the past I have used RGP cleaning solution on the affected parts of the frame, or (on the temples) those silicone sleeve temple protectors. If trying the silicone, make sure the patient doesn't have problems with silicone nose pads or latex gloves. Why the latex allergy correlates to this I don't know (they are barely related chemically).

If the frame is truly acetate, don't use anything with a high concentration of alcohol. It will speed up the dehydration of the frame material.

Could it be the patient's body chemistry??

[mervinek]

I just had this happen with a client the other day! Her old frame is a Coach frame (according to Lux is an acetate). This year she purchased computer glasses, which is a Saks fifth frame (Safilo has it listed as acetate) and a pair of progressives, which is a Kate Spade frame ( Safilo has it listed as acetate). Pt had SEVERE allergy with the Kate Spade frame. No problems with the other frames. Her reaction was the worst I've ever seen in over 20 years. Super swollen and red. Actually looked painful. She had to get medication for it. I couldn't figure out why she would have this kind of reaction to just the one frame. Perhaps that is the case, that the acetate in the Kate frame wasn't aged properly? She will be coming in next week to restyle and quite frankly, I am a little nervous for her to select a new frame. The only thing she told me she knew she was allergic to was the powder in latex gloves. Any recommendations would be welcome!

[rbaker]

An issue best resolved by a consultation with a dermatologist. Of course this will not provide much of a solution to either the customer or the frame salesperson but it may postpone any resolution to the distant future.

[drk]

Yeah, I'd be thinking contact dermatitis and not bacterial soft tissue infection, too.

[Robert Martellaro]

An issue best resolved by a consultation with a dermatologist.

I saw two clients with squamous cell carcinomas on the nose in the last year. The latest was an outside client (her daughter and son-in-law are both geriatricians). I recommended that a dermatologist get involved.

Consider a temporary library temple fit (straight-back) until the irritation is resolved.

[Lelarep]

Frame is listed as "Acetate" on the Ray Ban site, and they are authentic, so, I assume its correct. It was indeed focal bacterial infections, according to the derm, as the client brought a letter. The cleaning of the skin and the frame before wear came on his recommendation, that's why I was looking for ways to clean the frame. The derm. didn't specify what to clean the frame with, which I believe he was leaving up to us to recommend to the client. Client has no history of reactivity to the plastic tips used on the stems of metal frames, nor silicone nose pads. I think that is why we haven't seen the issue before with this client, the problem seems to be specific to the acetate frame.

[Chris Ryser]

Chris is also correct about the aging process with true acetate. The slight oxidation tightens up the surface, and eliminates any chemical leaching.

Fresh acetate of less than 12 month old, when worked on will leach chemicals, and can be totally and safe medically sealed on the finished frame with a Polysiloxane coating and will prevent all unwanted body reactions.

It is being done on bone implants for many years.

[JERRY HUANG]

I had seen a few cases that end users using alcohol content facial cleaner to remove make ups at night with glasses on the face! "The facial cleaner" Somewhat eats the acetate frame material and gum up make ups can be seen on both sides of temples & nose pads in contact of skin especially from the white color frames!

[smallworld]

Is there a weight difference from the metal frames they usually wear to the new zyl frames? From your history it states the patient has dermatological issues from anything that presses or rests on the skin. One of my children had a rare condition in childhood that would cause him to get hives if anything touched his skin. The seat belt in the car literally left a welt across his chest. I was told that his skin basically was so sensitive that being touched caused a histamine release. I would compare weight and pressure from old to new.

As for cleaning the frame, I would think the dermatologist would be the one to say what solutions are safe. Alcohol usually is really bad for sensitive skin. My thought would be Johnson and Johnson shampoo.

[Lelarep]

Is there a weight difference from the metal frames they usually wear to the new zyl frames? From your history it states the patient has dermatological issues from anything that presses or rests on the skin. One of my children had a rare condition in childhood that would cause him to get hives if anything touched his skin. The seat belt in the car literally left a welt across his chest. I was told that his skin basically was so sensitive that being touched caused a histamine release. I would compare weight and pressure from old to new. As for cleaning the frame, I would think the dermatologist would be the one to say what solutions are safe. Alcohol usually is really bad for sensitive skin. My thought would be Johnson and Johnson shampoo.

Weight is less than a previous frame that has no issues.

The condition you're mentioning is known as pressure or delayed pressure urticaria, a mechanical urticaria that is caused by compromised mast cell stability to mechanical stress. It is indeed very rare.

I like the idea of shampoo, but I would imagine the patient will want something easy, quick wipe-on and wipe-off. So far RGP solution seems to be the only easy fix mentioned, thus far. Any anyone else? The client is due back on Monday.

[Robert Martellaro]

Treat the infection, clean the eyeglasses once or twice daily with dish detergent. Dry thoroughly with a clean, non-treated thin cotton towel or microfiber cloth.

[Lelarep]

Gave the client the wisdom here, but it turned out to be a no go, they developed another focal infection behind their ear where the acetate frame touched. I guess they just can't wear acetate. Good learning experience, but I feel bad for the client.

[Chris Ryser]

Frame Materials and Allergies

It is uncommon to have an allergic reaction to eyeglasses, and when it happens it can be difficult to find help and support from your eye doctor. However, if you know you have allergies to specific types of materials, then you should find out what your glasses are made out of before you order them. This can be difficult because many manufacturers do not list all of the materials in the glasses.

If you think you are having an allergic reaction to your glasses, you need to track your symptoms and isolate it to your glasses. One of the major signs is that the skin is irritated only where your eyeglasses are, or where they touch your skin. You may develop a masklike rash around your eyes, or you may just have spots where your glasses actually touch the skin. The symptoms are different for everyone.

Some people have an allergic reaction to the eyeglass frames. One common allergy is a nickel allergy. This causes a rash in the area that comes in contact with the glasses. If you have an allergy to nickel you should try to purchase plastic frames or frames made of titanium. Titanium glasses are the best choice for people with allergies, but if it does not work for you then try the plastic glasses. Stainless steel glasses also work for people with a nickel allergy. Some people do have a difficult time with plastic glasses as well. The cheap eyeglasses are often made from nickel, especially the ones that you purchase at a drugstore. You may consider going in for allergy testing if you are having a difficult time finding a frame that works for you.



see all of it: =============>
http://glassescrafter.com/informatio...Allergies.html

[mervinek]

I ended up re-styling my patient into a silhouette frame. Felt that was the best option.

[smallworld]

Weight is less than a previous frame that has no issues.

The condition you're mentioning is known as pressure or delayed pressure urticaria, a mechanical urticaria that is caused by compromised mast cell stability to mechanical stress. It is indeed very rare.

I like the idea of shampoo, but I would imagine the patient will want something easy, quick wipe-on and wipe-off. So far RGP solution seems to be the only easy fix mentioned, thus far. Any anyone else? The client is due back on Monday.

I'm surprised you've heard of it. I had fun explaining to people my child was allergic to being touched. It made allergy testing quite challenging too. I never knew how serious allergies could be until his most of his skin peeled off from a massive reaction we have no idea what triggered. Spent a lot of time in emergency rooms.

[Lelarep]

I'm surprised you've heard of it. I had fun explaining to people my child was allergic to being touched. It made allergy testing quite challenging too. I never knew how serious allergies could be until his most of his skin peeled off from a massive reaction we have no idea what triggered. Spent a lot of time in emergency rooms.

My education and training is as a biologist, and my master's was focused on immunology, so I tend to know some of the rarer disorders of various elements of the immune system.

[Chris Ryser]

When the frame material has not been stored for a minimum time before cutting it into frames, it will leach those chemicals through its surface.

You can treat the skin with the best intentions, but not cure the problem until you seal the frames leaching surfaces.

[Lelarep]

Client switched to a Propionate frame, so far, so good. But, I don't consider this case close until a least a month has passed. I'm hoping to get there.