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contact lens DOs and DON'Ts

Cutest contact lens case in history? Obviously.

While many people wear contact lenses without ever having any issues or complications, thousands of Americans are affected annually by contact lens-related eye infections.  In my own experience treating such cases, many, if not all, are due to poor contact lens hygiene and/or contact lens abuse.  A recent American Eye-Q® survey (1) found that, among contact lens wearers:

• 57% admitted they wore disposable contacts longer than directed
• 54% reported they waited 4 to 6 months or longer to change contact lens case
• 39% stated they did not clean lenses with a multipurpose solution daily
• 35% said they did not wash their hands prior to handling lenses
• 26% stated they wore lenses while swimming
• 21% reported they slept in contacts

Those are dangerously high percentages! So this blog post is my attempt to help spread the word on contact lens hygiene.  Here are my "DOs and DON'Ts" of contact lens wear.   

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DOs

1. DO wash and dry your hands thoroughly before touching your contact lenses.  Your fingers have a ton of germs on them, and your contacts can act as a vector, transmitting bacteria to your eye (2).

2. DO remember to care for your case.  Rub and rinse your contact lens case with contact lens solution (not water), and store it upside down on a clean tissue.  Change your case AT LEAST every 3 months- I would recommend monthly.  A study done in 2010 showed that, on average, well over half (as many as 81%) of the contact lens cases tested were contaminated (3).  

3. DO clean your contact lenses regularly.  When removing your contact lenses, place the lens in the palm of your hand and pour multi-purpose solution onto the lens.  Gently rub the lens with your finger and rinse the lens with solution.  THEN you can put the lens in a clean case, fill with fresh solution, and store.  Researchers have demonstrated that the most effective cleaning regimen involves rubbing AND rinsing contact lenses before storage (4).

4. DO remove lenses and see your optometrist immediately if you experience eye redness, pain, discharge, sensitivity to light, or blurred vision.  These are often symptoms of an eye infection, and should be addressed quickly to avoid further complications.  

5. DO have a back-up pair of glasses. In the event that you lose a contact or have to be out of your contacts due to an infection, having a pair of glasses is a must.

6. DO see your eye doctor every year.  Even though you may feel your prescription hasn't changed (and it may not have), a yearly exam and contact lens evaluation allows your eye doctor to check the health of your eyes as well as your vision.

DON'Ts

1. DON'T swim or shower or go in a hot tub with contact lenses in. The goal is to keep water away from your contact lenses, because water contains all sorts of nasty microbes. When those microbes come in contact with your lenses, they can adhere to them and infect your cornea (the clear part of the front of the eye). A certain parasite found in water and soil called Acanthamoeba can cause a rare but very serious infection that is difficult to treat (Google "Acanthamoeba keratitis"- the images will scare you straight).  Some studies have concluded that one-third of Acanthamoeba keratitis cases are associated with swimming, and the risk of infection with this parasite is six times greater when swimming in contact lenses (5). For safe swimming and water sports, consider talking with your eye doctor about the option of prescription goggles. If contact lenses must be worn, reduce your risk of complications by wearing daily disposable contact lenses with air-tight goggles, trashing the contacts once you're out of the water. 

2. DON'T wear your lenses for longer than your eye doctor recommends.  I come across many patients that do this in order to save money.  I can pinch a penny with the best of them, so I can certainly understand the motivation behind this.  But trust me when I tell you that the cost of treating an eye infection (multiple office visits, prescription eye drops, etc) could cost you far more than what you could save by stretching out your lenses.  Not to mention the fact that you only get one pair of eyes, so the risk really isn't worth it.

3. DON'T "top off" the existing solution that remains in the case.  The used solution has been exposed to microbes from your contact lenses and from the case. Dump out all of the old solution in the case, clean the case, and use fresh multi-purpose solution every time you store your lenses.

4. DON'T sleep in your contact lenses.  Some contact lenses are FDA approved for extended wear, but I personally do not recommend sleeping in any soft lenses.  Sleeping in contact lenses increases your risk of infection- studies show anywhere from a four to ten times greater risk (6,7).  If you are using extended wear contact lenses, make sure you take them out at least once a week to clean and disinfect them overnight.  If you are considering extended wear contact lenses, I encourage you to talk to your optometrist and discuss the risks/benefits. 

5. DON'T wear any type of contact lens- even cosmetic or costume lenses that don't provide visual correction- without a prescription.  Contact lenses are FDA classified as medical devices, and require a valid prescription from an eye care professional.

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After reading this list, it's probably not hard to see why I'm a big fan of daily disposable contact lenses.  You eliminate most of these areas of risk- no case, no solution, no cleaning regimen.  Convenient and safe.  We'll talk in more detail about daily disposable lenses in a future post.  

CliffsNotes- DO: wash your hands, rub and rinse CLs, rub and rinse case, take CLs out and see optometrist if experiencing problems, have a pair of back-up glasses.  DON'T: let water come in contact with CLs, stretch the life of CLs, re-use existing solution, sleep in CLs, buy/wear CLs without a valid Rx.  

Additional recommended resources:

• Contact Lens Safety
• CDC: Contact Lenses
• AOA: Contact Lenses
• All About Vision: Contacts