THE RELATIONSHIP BETWEEN THE LEVEL OF KNOWLEDGE’S

CONTACT LENSE USER WITH EYES IRITATION IN FACULTY OF

MEDICINE STUDENTS 2016-2018
NORTH SUMATERA UNIVERSITY

Nurul Atiqah binti Ramlan1, Masitha Dewi Sari1,2*

1
USU Faculty of Medicine Students, class of 2016
2*
USU Faculty of Medicine Faculty of Eye Health Teaching Staff

ABSTRACT:

Background: Contact lenses are an alternative visual aid besides glasses to treat eyes
refractive disorders such as myopia, hypermitrophia and astigmatism. However, over the times
and technology, contact lenses that initially functioned as glasses for people with eye disorders
have now turned into fashion and style attributes. Lack of knowledge of contact lens wearers
can be fatal for the wearer ie eye irritation occurs. Eye irritation is superficial discomfort and
usually occurs due to eye surface abnormalities.
Research Objectives: The purpose of this study is to determine the relationship of the
level of contact lens wearer's knowledge with the incidence of eye irritation in 2016-2018 of
Faculty of Medicine students at the University of North Sumatra.
Research Methods: This type of research used in this study is an analytic study with a
cross sectional design which makes observations and short-term measurements of 2016-2018
Faculty of Medicine students at the University of North Sumatra. The samples in this study
were 229 students of the 2016 Medical Faculty class and 259 students of the Medical Faculty
class of 2017 and students of the 2018 class were 258 students. The number of research samples
that met the inclusion and exclusion criteria was 86 students. The sampling technique is to use
consecutive sampling and data analysis used is the Chi-Square test.
Results: The number of respondents in the study were 90 students who wear contact
lenses. The results of the univariate analysis showed that the level of good and medium
knowledge of contact lens wearers was 82 people (91.1%) and 8 people (8.9%). Hence, the
incidence of eye irritation shows 48 people (53.3%) experienced eye irritation and 42 people
(46.7%) did not experience eye irritation. Bivariate analysis results from the Chi-square test
showed the p-value was 0.042.
Conclusion: There is a significant relationship between the level of contact lens
wearer's knowledge with the incidence of eye irritation of the 2016-2018 Faculty of Medicine
students of the University of North Sumatra with a p-value of 0.042 <0.05.

Keywords: contact lenses, eye irritation, Chi-square test

Introduction
Contact lenses is a type of thin and curved plastic that is designed to be used on the
surface of the cornea. Contact lenses are an effective and safe way to correct refractive
disorders other than glasses when used in the right way and with neat supervision. In addition
to correcting refractive abnormalities, accommodation abnormalities, contact lenses are also
used as therapy and cosmetics1. Contact lenses are a result of technological developments in
the field of ophthalmology which are used as an alternative to glasses to treat eye refractive
disorders such as myopia, hypermitrophic and astigmatism2.
Eye irritation is superficial discomfort usually due to abnormalities on the surface of
the eye. Itching as a primary symptom, is often a sign of an allergy. Dry, sore, gritty and mild
foreign body sensations can cause dry eyes or other types of corneal irritation. Sudden eye
water reflex is generally caused by irritation on the surface of the eye. Dry eye secretions are
not specific. Eye irritation is a condition of redness, pain, swelling, itching and watering in the
eyes and blurred vision which may lead to more serious eye problems such as infection3.
The occurrence of eye irritation is one of the complications that is often found in contact
lens wearers. The results of research conducted in the United States show that one-third of
contact lens wearers in America visit health facilities with complaints of red or itchy eyes when
wearing contact lenses. This relates to the level of knowledge of contact lens wearers,
evidenced by 99% of contact lens wearers reporting at least one behavior as a risk factor for
the incidence of eye irritation3.
Knowledge is the result of human sensing or the result of knowing someone about
objects through their senses (eyes, nose, ears and so on). By itself at the time of sensing to
produce knowledge is strongly influenced by the intensity of attention and perception of
objects4. Knowledge that is included in the cognitive domain has six levels. Namely; know,
understand, application, analysis, synthesis and evaluation.

Method
This type of research is analytic research using cross sectional design that aims to
determine the relationship between the level of contact lens wearers' knowledge with the
incidence of eye irritation of 2016-2018 Faculty of Medicine students of the University of
North Sumatra. The samples in this study were all students of the medical faculty of the
University of North Sumatra who used contact lenses and met the inclusion and exclusion
criteria. This research was conducted from July 2019 to September 2019. The sampling
technique in this study was to use a non-probability sampling technique with consecutive
sampling type. The size of the study sample was 90 students. Data analysis uses chi-square
test.

Results
Location Description
This research was conducted at the Faculty of Medicine, University of North Sumatra
(USU). The university which is located at Jalan Dr. T. Mansyur No. 9, Medan is one of the
best universities on the island of Sumatra. The university was inaugurated on November 20,
1957 by Dr. Ir. Soekarno as the seventh state university of Indonesia and is the first university
on the island of Sumatra that has a Faculty of Medicine.
Description of Respondent Characteristics

Table 1. Year of Respondent

Year Frequency Percentage (%)

2016 34 37.8
2017 32 35.6
2018 24 26.7
Total 90 100
Based on Table 1, it shown that based on the year of class, it is known that 2016
students who wear contact lenses are 34 people (37.8%), followed by students in 2017, 32
people (35.6%), while there are only 24 people (26.7 %) 2018 students who wear contact
lenses.

Table 2. Gender of Respondents

Gender Frequency Percentage (%)

Boys 13 14.4
Girls 77 85.6
Total 90 100
Table 2 shows that the majority of students who wear contact lenses are 77 women
(85.6%). While the number of male respondents was 13 people (14.4%).

Table 3. Types of Contact Lenses Used

Types of Contact Lenses Frequency Percentage (%)

Softlens 90 100
Hardlens Nil Nil
Rigid Gas Permeable Nil Nil
Total 90 100
In Table 3 it was shown that all students who used contact lenses were 90 people
(100%) used contact lenses of soft lenses.

Table 4. How Often Respondents Wear Contact Lenses

How Often Respondents Frequency Percentage (%)

Wear Contact Lenses
Daily wear 23 25.6
Extended wear 10 11.1
Users are rare 57 63.3
Total 90 100
Table 4 shows that the majority of students are uncommon users who use contact
lenses, 57 people (63.3%), followed by daily wear users, 23 people (25.6%) and extended
wear users, 10 people (11.1%).
Table 5. Age of Respondents

Age Frequency Percentage (%)

18 years 4 4.4
19 years 23 25.6
20 years 32 35.6
21 years 21 23.3
22 years 7 7.8
23 years 2 2.2
24 years 1 1.1
Total 90 100
From Table 5 shows that the majority of USU Faculty of Medicine students who used
contact lenses were 20 years old as many as 32 people (35.6%).

Univariate Analysis Results

Univariate analysis was performed on each study variable. This analysis will produce a
frequency distribution and percentage of each variable studied.

Table 6. Level of Knowledge of Contact Lens Wearers

Level of Knowledge Frequency Percentage (%)

Good 82 91.1
Average 8 8.9
Poor Nil Nil
Total 90 100
Based on table 6 above it can be seen that respondents who have good knowledge
numbered 82 people (91.1%). Respondents who have moderate knowledge are 8 people
(8.9%).

Table 7. Eyes Irritation

Eyes Irritation Frequency Percentage (%)

Irritated 48 53.3
Not irritated 42 46.7
Total 90 100
Based on table 7 it can be seen that respondents who had or have experienced eye
irritation wearing contact lenses are 48 people (53.3%) and respondents who did not or had
never experienced eye irritation are 42 people (46.7%).
Bivariate Analysis Results
Based on research data, the relationship between contact lens wearer's knowledge and the
incidence of eye irritation can be seen in Table 8:

Table 8. Distribution of Respondents According to Knowledge of Contact Lens Wearers

with Eyes Irritation

Eyes Irritation p-value

Irritated Not
Irritated
Knowledge Good Frequency (n) 41 41 82
Percentage (%) 45.6 45.6 91.1
Average Frequency (n) 7 1 8 0.042
Percentage (%) 7.8 1.1 8.9
Total Frequency (n) 48 42 90
Percentage (%) 53.3 46.7 100
Based on the table above it is known that from 90 respondents with good knowledge,
the occurrence of eye irritation are 41 people (45.6%) when the eye irritation did not occur are
41 people (45.6%). Whereas the respondents with knowledge of the occurrence of eye irritation
are 7 people (7.8%) and there is no eye irritation only 1 person (1.1%).
From the results of the analysis of the relationship of the level of knowledge of contact
lens users with the occurrence of eye irritation in USU FK students in 2016, 2017 and 2018,
the value of p = 0.042 (p <0.05) means that there is a significant relationship between the level
of contact lens user’s knowledge with the incidence of eye irritation.

Discussion
From the results of the study found that the knowledge of respondents in the good
category are 82 people (91.1%). While the average level of knowledge are 8 people (8.9%) and
there is no respondents with poor knowledge. This is in line with the research conducted by
Kiat2 that the research on 44 students of the Faculty of Medicine at USU in 2012, the number
of respondents who had a good level of knowledge are 25 people (56.8%) and the level of
knowledge was 19 people (43.2%) and none for bad knowledge students. The results of the
research are in line with the theory put forward by Notoadmojo that knowledge is the result of
one's knowledge and experience in sensing a particular stimulus. Knowledge or cognitive is
dominant which is very important in shaping one's actions (overt behavior)6. In this study, the
distribution of questionnaires that have been validated to measure respondents' knowledge at
the level of knowledge known has been carried out. Meanwhile, according to Nazhriyah7
contact lenses that are directly related to the eye, especially the cornea, need to be considered
how to use them appropriately. Improper care and negative effects that might occur on the use
of contact lenses. Therefore, knowledge is an important indicator for contact lens wearers so
that negative impacts and possible side effects can be avoided.
From the results of the study found the number of respondents who experienced eye
irritation are 48 people (53.3%) while those who did not experience eye irritation are 42 people
(46.7%). This is in line with research conducted by Puspitasari8 in which a study of Soetomo
Nursing Study Program students in Surabaya showed that most (57%) of respondents
experienced eye irritations. Eye irritation can occur due to the use of contact lenses that are too
long, contact lenses that have passed the expiration limit, lack of contact lens care, how to use
the wrong way, intolerance to cleaning fluids or secondary infections due to contact lens wear3.
In addition, the bad habits of the users themselves is of the one factor in the occurrence of eye
irritation for example still using contact lenses during sleep.
Based on the calculation of the p-value obtained is 0.042 (p <0.05), it can be aggreed
that there is a significant relationship between the level of contact lens wearer's knowledge and
the incidence of eye irritation in USU Faculty of Medicine students of 2016, 2017 and 2018.
The results of this study are in line with research conducted by Yunita10 obtained p-
value = 0.007 which shows that there is indeed a significant relationship between contact lens
user knowledge with the incidence of eye irritation. The results and finding of the statistical
tests from Ringgo Alfarisi3 research showed that the p-value obtained was p = 0.035 which
also showed that there was a significant relationship between contact lens wearers' knowledge
and the incidence of eye irritation. The results of this study are also in line with research
conducted by Desyana (2015) which shows that there is a relationship between the level of
knowledge about contact lenses and the negative impact of their use (p = 0,000) as the shown
by the research conducted by Sari in Surabaya which shows that there is a relationship between
level of knowledge with a history of eye irritation (p = 0.009).
The results of this study are in line with the theory put forward by Notoadmojo that
knowledge is the result of knowing and this happens after people have sensed a certain object.
Cognitive knowledge is a very important domain in shaping one's actions4. Students who know
the importance of knowledge of wearing contact lenses will tend to be careful when wearing
contact lenses so that they can reduce the risk of eye irritation or health problems that originate
from hygiene and accuracy in wearing contact lenses10. According to Notoadmojo, knowledge
is the result of a person's sensing of an object. This knowledge has six levels, namely know
(know), understand (comprehension), application (application), analysis (analysis), synthesis
(synthesis) and evaluation (evaluation)5. Students' knowledge about contact lens wear was
obtained from several sources including their own experience in contact lens wear, electronic
media such as internet and printed media such as newspapers, bulletin or doctors.
For contact lens users, an infection in the eye can cause eyes to become red, itchy, runny
to more severe conditions. Bacteria found in eyes that use contact lenses are three times more
than in eyes that do not use contact lenses11. The best way to avoid red eye due to infection or
something more severe is to limit the use of contact lenses. In addition, microorganisms found
in the eye appear to originate from the skin so that the cleanliness of the eyelids and hands must
be a concern3.
Knowledge of the choice of contact lens types is also very important11. Some things to
consider include, for users who use contact lenses for appearance, you should use disposable
contact lenses to avoid infection. For nearsighted patients it is advisable to use contact lenses
that are clear colours while if the normal eye a variety of colour choices can be adjusted to
taste. Pay attention to the water content and thickness of the lens, comfortable contact lenses
are thin and contain lots of fluids. Adjust the black part of the eye that is iris to the diameter of
the lens to be comfortable during use. Especially for nearsighted patients, it is advisable to
choose contact lenses that match the minus on the eye. Minus discrepancy can cause
discomfort, including the sensation of confusion if the size is too high. Be sure to wear contact
lenses that have not yet expired. Use after the expiration date is possible that the lens material
has been damaged and can cause severe irritation12.
Knowledge about personal hygiene and healthy living is also needed by individuals in
maintaining life habits that are in accordance with health and will create optimal well-being
and health. Practices that are based on knowledge will be more lasting than practices that are
not based on knowledge. The attitude expected by students not only knows how to treat contact
lenses effectively and efficiently but the growth of the attitude itself to behave7.
Conclusion
Based on the results of the research and discussion that has been presented in the
previous chapter, the conclusions that can be drawn from this study are that the level of
knowledge of USU Faculty of Medicine students about the use of contact lenses shows that the
respondent's knowledge is in the good category of 82 people (91.1%). Furthermore, there were
48 students who experienced eye irritation while using contact lenses (53.3%). Frequency
distribution of the year of year shows that the respondents who used the most contact lenses
were the 2016 generation of 34 people (37.8%). Most contact lens users are female with 77
people (85.6%). All contact lens wearers use 90 contact lenses (100%). Most of the students
are rarely contact lens users, as many as 57 people (63.3%). While, the majority of students of
the Faculty of Medicine who use contact lenses are 20 years old as many as 32 people (35.6%).
This is so, regarding the relationship of the level of knowledge of contact lens wearers with the
occurrence of eye irritation in USU Faculty of Medicine students in 2016, 2017 and 2018
concluded that there is a relationship between the level of contact lens wearers knowledge with
the incidence of eye irritation where p value 0.042 <0.05.

References
1. Narainasamy, D. (2013). Tingkat Pengetahuan Mahasiswa Fakultas Kedokteran yang
Menggunakan Lensa Kontak . Tingkat Pengetahuan Mahasiswa Fakultas Kedokteran yang
Menggunakan Lensa Kontak , 1.
2. Kiat, L. M. (11 April, 2014). Tingkat Pengetahuan Tentang Lensa Kontak Pada Mahasiswa
Stambuk 2012 Fakultas Kedokteran Universitas Sumatera Utara, 1.
3. Ringgo Alfarisi, Reno . (2 April, 2018). Hubungan Tingkat Pengetahuan Pemakai Lensa
Kontak dengan Kejadian Iritasi Mata Pada Mahaiswa Fakultas Kedokteran
4. Intansari, R. (2017). Konsep Pengetahuan. 9.
5. Siswanto, S. (Juni, 2015). Tingkat Pengetahuan Siswa SMP Negeri 1 Sayung Terhadap
Musik Keroncong. Tingkat Pengetahuan Siswa SMP Negeri 1 Sayung Terhadap Musik
Keroncong, 9.
6. Wawan dan Dewi. (2010). Teori dan Pengukuran Pengetahuan, Sikap dan Perilaku
Manusia. Yogyakarta: Nuha Medika.
7. Nazhriyah, R. (7 Januari, 2015). Gambaran Tingkat Pengetahuan Pelajar Putri Tentang
Penggunaan Lensa Kontak di SMK Nusantara 1 Ciputat Kota Tengerang Selatan, 18-21
8. Puspitasari, R. (2015). Hubungan Pengetahuan Tentang Perawatan Lensa Kontak dengan
Kejadian Iritasi Mata. 8(2).
9. Idayati, R. (Desember, 2016). Gambaran Penggunaan Lensa Kontak (Softlens) Pada
Mahasiswa Universitas Syiah Kuala Ditinjau Dari Jenis Lensa, Pola Pemakaian, Jangka
Waktu Dan Iritasi Yang Ditimbulkan, 16(3), 133-134.
10. Yunita, S. (2015). hubungan tingkat pengetahuan pemakai lensa kontak dengan kejadian
iritasi mata pada mahasiswa pendidikan dokter universitas syiah. aceh: universitas syiah
kuala banda aceh.
11. Amra, A. A. (2007). Lensa Kontak. 6-7.
12. Astri Agustina, Merdeka.com. Bahaya Pakai Softlens Bisa Buta.,2015 [Online]. Available
at: https://www.merdeka.com/gaya/bahaya-pakai-softlens-bisa-buta.html