Any advice about glasses and NHS staff masks?

[SmallFacedMaskedPeople]

I am posting about a situation with my DD and grateful for any advice! (Apologies as it's in AIBU for traffic!)

She is a first year student nurse due to start placement in January and recently went for her FFP3 mask fitting. She has inherited from me an extremely small face and very short sighted eyes with astigmatism. (She also wears hearing aids but they aren’t the issue here). The mask fitter advised her glasses won’t fit with the mask and she needs contact lenses. (The mask fits but then when she puts her glasses, they cause gaps in her mask and the air leaves)

She had her lens appointment today but the lenses are difficult for her to wear. Surely there must be some small faced HCPs out there who have the same problem? I would think a pair of smaller glasses would solve it but due to thickness of lenses we both usually need big plastic frames!

She is going to go to a different optician and try lenses again and also ask how thin they can make the lenses so she can try different frames.

Does anyone have any experience or advice re this? She is really stressed about it as the mask fitter has said she won’t be able to start her placement (4th Jan) if she can’t wear a mask!

She has done so well to get this far especially with the challenges of being deaf and studying and face masks in general! She has worked so hard and I’m so proud of her. I’m just off to pick her up so will be back this afternoon - I have told her MN is the font of all knowledge and I’m sure she will get useful advice

What's her prescription? I'm also v v short sighted with astigmatism (-8.5 in one eye and -10 in the other) and Asda include thinning of lenses based on how high your prescription is, which means I get the thinnest with no extra charge. Which is a massive saving on the other opticians I've tried.

Not sure specifically about the mask but hoping maybe a pair of glasses that is smaller/thinner/lighter could help?

Contacts wise, the only ones I've got on with over the years are the Johnson&Johnson toric dailies - everything else that works for my prescription, my eyes do not love. They are soft enough that I can wear them even a couple of times a year and cope, whereas the others I found I needed to wear much more regularly for my eyes to stay used to them and not water madly for ages. Definitely get her to ask if there are any difference makes she can try because that makes a massive difference, as does dailies over monthlies and the cleaning faff.

Wish her luck from me - it's an extra hassle but I hope she can find a solution that works for her!

Has she tried daily disposables? I have dry eyes so pay bit more for high water content and found them much more comfortable.

Surely you just put your glasses on over the top of the fitted mask? They cannot insist she wears contact lenses and I would be making it clear she cannot wear them. They are not suitable for everyone. They can't discriminate her for this?

Was she actually prescribed toric lenses for her astigmatism? I once had an optician who didn’t and it put me off lenses for years…torics were a revelation!

A mask not fitting generally means she'll need a hood for Aerosol generating procedures, it's only problematic because they're hard to come by and not generally kept on ward level.

She'll also have to wear goggles on placement and can testify myself that they are so much easier with contacts than with glasses due to steaming up and glare, mine make me feel seasick.

In our trust she would be asked to trial and alternative mask. Has she asked if there are any others. I have a small face and can only wear one style of.ours.

I have Acuvue Moist toric daily contact lenses and find them very comfortable. They are the thinnest profile you can get, I think, worth trying other kinds 'til she finds something that works. (My worst eye is -8.0 plus another -1.75 for the astigmatism)

I wear gas permeable lenses for short sightedness (-12 and -15) and astigmatism. I was told this was the only option for my prescription. They took a long time to get used to (wearing for short periods of time each day) but I couldn't see them being ready to wear all day in January.

That sounds really good re Asda hilariousname here. It sounds just what I need instead of being forced to pay hundreds of pounds for glasses, supposedly the thinnest lenses which still make me look like I'm wearing milk bottle. Pity my nearest Asda is 55 miles away

As above. She should be able to try a different mask or a hood. Also depending where her placement is she may not need to wear a FFP3 all the time. I would advise her speaking to the placement team and student support within the hospital she’s going to who should be able to help.

Contact lenses can be strange at first but once you get used to them they are so much better than glasses. Well in my experience anyway!
As someone else suggested, does she have a Toric lens in the eye with the astigmatism? That makes a real difference for me.
I also have daily moist lenses for work and I find they are more moist.

What is her prescription?

I wouldn’t usually say that high minus prescriptions need big plastic frames - you’re usually better off with a smaller frame as the smaller the diameter of the lens, the thinner it will be.

I would also have thought that they should try a number of different masks for her. Saying she should get contact lenses is just ridiculous. I’d be surprised if there’s not a suitable mask.

Also came here to say toric lenses, they’ll have to find her an alternative placement where they just wear the normal surgical masks if she can’t wear the ffp3

I really do not think that if you don’t currently wear contact lenses you should be expected to suddenly get them and wear them all day working long days like that. So many healthcare workers wear glasses and I’m sure they’re not all just told to get contact lenses. I would imagine it’s one person who can’t get the mask to fit and has said it instead of putting in the effort to find one that does.

There's got to be a way to make it work, I am not allowed contact lenses, no optician will prescribe them because I'm classed as severely visually impaired in my right eye so the risk of an infection impairing my vision in the left eye is too big for any optician to accept as it would leave me blind.

I do find with glasses I have to pinch the nose wire to make a firm seal then put the bridge of the glasses over the top of the mask. When I first started wearing masks I found it difficult to get the seal so used a small strip of micropore tape to seal the top of the mask over my nose. That stopped my glasses fogging. I also needed to tighten the arms of the glasses and reshape the ear bend by warming the arms of the glasses with a hairdryer and gently bending them. That stopped my glasses slipping down constantly.

@angerelle

I have Acuvue Moist toric daily contact lenses and find them very comfortable. They are the thinnest profile you can get, I think, worth trying other kinds 'til she finds something that works. (My worst eye is -8.0 plus another -1.75 for the astigmatism)

I think the Acuvue Oasys may be a slightly thinner. I use the two-weekly versions of these which you can (though I don't) wear for long periods continuously including sleeping.

Obviously all extended use of contacts lens should be discussed with your optician.

She needs to go to occupation health and they need to find another option. It may mean sourcing something non standard. If they can’t then they need to find an alternative placement.

Hello.
I’m an ffp mask fitter for the NHS and I also wear glasses. I have never advised anyone with glasses to change to contact lenses.

I’ve been wearing these masks and my specs for over a year without issue in the clinical area.
You just put on the mask, tighten it up and position you glasses accordingly .
They certainly do not need to go under any part of the seal of the mask.
It’s a bit of a none issue really!

My glasses don't sit quite right with my fpp3, I just use an elasticy headband that attaches to my glasses arms so they don't fall off. Has she tried a stealth mask, they are generally good for smaller faces and only about £30, a hood will likely need occupational heath approval as they're £400+, theyre also quite noisy inside which won't be helpful to her. I think she needs to see a different fit tester for a start as this should be solvable.

Could she could try medical tape over the top edges of the mask?

Thank you all so much! And thanks too on behalf of SmallFacedMaskedPeople Jr 

Very interesting especially about different types of contact lenses and hoods. A hood would be amazing as it would also stop tangles in her hearing aids with masks (she's just used to this aspect and gets on with it) but she has also had to ask people to wear visors instead of masks if she can't understand them (strong accents or quiet voices are really hard when you can't lip read them).

We are really grateful - she is going to back to the optician (and see if she can get in at Asda!) and then have a another mask fitting next week (hopefully with someone else, imagine if it was you @Diditopknot!)

@Steelesauce

Surely you just put your glasses on over the top of the fitted mask? They cannot insist she wears contact lenses and I would be making it clear she cannot wear them. They are not suitable for everyone. They can't discriminate her for this?

OP has said that when she puts the glasses on top of the fitted mask, the mask leaks. So the mask isn't properly fitted when the glasses are on. No they can't force her to wear contact lenses, but if she can't pass a face fit test and there's no workround, they can decline to employ her. The alternative is a positive pressure respirator (air hood) but these are very expensive.

Visors for staff instead of masks is an absolute no no. No one would agree to this in the clinical area.

Hoods and belt type air filters are extremely hard to come by due to price. Very heavy and noisy, impossible to hear anything and difficult to do any moving & handling in.

There are alternative masks but not every clinical area will stock them so she will need to make sure her placements have them, it’s such a palava ordering them in.

The rubbish thing about the ffp masks is that they are one size fits all, not sized so lots of folk fail the fit testing.
The only disappointing thing is redeployment or change of placement to less patients faceing areas.
I feel for your girl op, really really tough times are coming again.

@Diditopknot

Hello. I’m an ffp mask fitter for the NHS and I also wear glasses. I have never advised anyone with glasses to change to contact lenses.

I’ve been wearing these masks and my specs for over a year without issue in the clinical area.
You just put on the mask, tighten it up and position you glasses accordingly .
They certainly do not need to go under any part of the seal of the mask.
It’s a bit of a none issue really!

This doesn't work if you wear varifocal glasses though as you are constantly looking through the wrong part of your lenses.

I have this problem and I was giving an over the head mask - similar to this - www.sprayplant.co.uk/products/airvisor-2-mv-breathing-air-kit-wilson-sperian-honeywell?gclid=EAIaIQobChMI7rTM3Ljt9AIVxO3tCh0xpw_BEAQYAyABEgLcVfD_BwE
But I am not sure if the cost would be justifiable for a student who is only on a temp placement - but you could use it forever so it may well be worth the cost

I have verifocals …I’ve not had any problems, steaming up at first but then ok. I can see out of them ok, see drug labels etc which are of course teeny tiny.

I have a -9 prescription in both eyes and astigmatism and find the only lenses I get on with are Specsavers daily torics. I struggle to wear glasses with my strong prescription without getting a headache. I work for the NHS so used to wearing a mask all day but I'd really struggle to wear it with my glasses. I hope she finds a solution and enjoys her placement.