So you started wearing contact lenses! Congratulations! Now What? Now you have to clean them and disinfect them and wear them according to your doctor’s recomended wear schedule or else you run the risk of getting an eye infection. Compliance with wear and care of contact lenses remains one of the most challenging aspects of caring for our patients who wear contact lenses particularly with lens disinfecting regimens.
So what are we to do? Daily disposables are probably the best mode of contact lens wear from a health perspective. With this mode, not only does the contact lens solution become a non-issue, there is also no contact lens case that needs to be cleaned or that can become contaminated. If we are not using daily disposable contact lenses, then multipurpose disinfecting solutions are used to clean, rinse and disinfect contact lenses.
Are we actually rubbing and cleaning and rinsing our lenses before we store them in the disinfecting solution? Are our lens cases clean? How often are we replacing our lens cases? Are we using the right contact lens solution that is compatible with the type of contact lenses that we have been prescribed? Are we using fresh and new disinfecting solution every night? Are we disposing our lenses at the recommended interval? Are we washing our hands with soap and water before handling our contact lenses? These are the type of compliance issues both doctors and patients have to deal with.
Research has shown that adding a rub step removes 90% of the debris thereby reducing or eliminating deposit buildup on lenses. What is more crucial is that the rubbing step removes lots of bacteria from the contact lenses. This reduced bacterial load makes it easier for the disinfecting solution to take care of the rest. Yet, some lens wearers have reported never rubbing and rinsing their lenses after removal before storing their lenses in the disinfecting solution. What about the disinfection soak time? Some solutions require that the lenses be soaked a minimum of 4 to 6 hours for complete disinfection. Yet some lens wearers have not been soaking their lenses for the minimum indicated disinfection time.
Bacterial and microbial contamination of lens cases have been found to be as high as 40%. Of all the contact lens care proceedures, compliance with the care of the lens case has been reported to be the poorest. It is recommended that the case be mechanically scrubbed both the inside and outside with contact lens disinfecting solution, avoiding the use of tap water to wash or store lens cases, and to air dry the lens case when not in use. It is highly recommended that patients replace their lens cases every one to three months.
Most contact lens eye infections is caused by patients either sleeping with their lenses or overwearing them past the recommended disposable interval. For 2-week disposable lenses, a helpful reminder is to replace them on the first or fifteenth of the month. If you get paid every two weeks, use that as a reminder. For lenses replaced every month, replace them on the first of the month or link it with a monthly activity such as paying your mortgage.
There has been a higher rate of lens complications in patients who use private label or generic contact lens solutions. Generic brands are often older formulations of the name brands and they can change in composition every quarter. In fact, many of the generic lens care solutions predate the new silicone hydrogel contact lens materials that are widely used today. More importantly, few of the current generic lens care products contain formulations indicated by the FDA for use with silicone hydrogel contact lenses. I can’t stress enough how many contact lens patients with red, irritable eyes I have solved simply by switching contact lens solutions. If the hypersensitivity to the solution is a delayed type response, it can take months of exposure to the solution before the patient starts to show symptoms. Therefore, only use the contact lens solutions that have been prescribed by your eye doctor and follow-up with your eye doctor if your eyes start to get red or irritated or if you find you can no longer wear your lenses comfortably all day like you used to be able to do.
Discard all used contact lens solutions and always use fresh solutions every day. Contact lens wearers should not swim, shower or use a hot tub while wearing contact lenses. Always remove your lenses and report to your doctor immediately if you experience symptoms of redness, pain, tearing, increased light sensitivity, blurry vision, discharge or swelling.
So now that you have started wearing contact lenses, you can clearly see that all these issues concerning the proper care of your lenses will contribute to your successful lens wear. Hygienic practices and proper compliance with prescribed wearing regimens is crucial, as is the use of appropriate lens care solutions.
Meyer Izaac, O.D.
Optometrist in Encino, Ca.