Contact Lenses: The Risks You Need to Know

The View From the FDA

Lauri R. Graham; Bernard P. Lepri, OD, MS, MEd

Disclosures

October 24, 2012

Editorial Collaboration

Medscape &

In This Article

Caring for Contact Lenses

Medscape: There are various contact lens solutions and products available. What problems can occur if they are used improperly? How should these products be used in the care of contact lenses?

Dr. Lepri: Incorrect care of contact lenses and solutions can increase the risk for eye infections and corneal ulcers. These conditions can develop very quickly and can be very serious, and in rare cases, they can result in blindness. In terms of how to handle the lenses, the solutions and products page of our contact lens Website provides specific step-by-step directions and cautions, which I'll summarize here.

The first and most important step is to properly clean and disinfect the lenses, following all labeling instructions provided with the lens care products. Only use the contact lens products and solutions recommended by the eye care provider. The eye care provider knows what care products are best suited to the specific type of contact lenses, the patient's eyes, and the wearing pattern. A big mistake that is often made is the assumption that all contact lens care products are the same; they're not. We have had people use them improperly and develop severe irritations to their eyes. So it's important to read every label and to follow the instructions carefully.

The next most important thing is to rub and rinse the contact lenses. Rubbing reduces a significant number of microorganisms and helps reduce the potential for infection. If you rub off the debris (essentially microorganismic dirt) before putting the lenses in the disinfecting case, the effectiveness of the disinfecting solution is enhanced because there are fewer microorganisms to kill.

Do not top off solutions in the case. We often hear about individuals who take out their lenses in the morning and there is still solution in the case; instead of discarding that solution, cleaning and drying the case, and then using a fresh solution at night, they just add a little more solution. This is using a volume of solution that is not at its full capacity for effectiveness. So it is important to not top off the solutions in the case. Always discard all of the leftover contact lens solution after each use. Never reuse any contact lens solutions.

Do not expose contact lenses to any water -- tap, bottled, distilled, lake, or ocean water. Never use nonsterile water, such as distilled water, tap water, or any homemade saline solution. Exposure of contact lenses to water has been associated with Acanthamoeba keratitis, which is a corneal infection that is resistant to treatment and cure.

Do not use contact lens solutions that have gone beyond the expiration or discard date. Typically, people feel guilty about throwing away a bottle of contact lens solution if it's half full or almost full, even if it's past the expiration date. Using your multipurpose solution beyond the discard date could result in contamination of the solution and can lead to severe infection, vision loss, or blindness. If you find a full bottle and it has an expiration date on it and it has passed, do not use it.

Use sterile saline solutions only for rinsing. People mistakenly think that a saline solution is the same as a cleaning and disinfecting solution. It is not the same. Sterile saline solutions are only for rinsing off a lens. You should never put your lenses in your mouth to wet them. Saliva is not a sterile solution.

Finally, clean, rinse, and air dry the lens case each time the lenses are removed. We recommend that people rinse out the lens case with a fresh disinfecting solution. Flip over the case, shake out all the excess fluid, and let it air dry. If the solution stays in there and the case is open, then microorganisms from the environment can get in and start to breed there. The contact lens case is a major source of bacterial growth. We typically recommend the case be exchanged every 3 months or every time you start a new bottle of disinfecting or multipurpose solution.

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