How to Decrease the Risk of Contact Lens Complications

For millions of contact lens wearers, it is easy to forget the little piece of hydrogel you pop into your eyes every morning is really a technologically sophisticated medical device that puts you at risk for bacterial and other pathogenic infections every single day.  Contact lens technology has improved leaps and bounds since they first became main stream in the 1970s, but there are still a large number of complications from contact lens wear that arise every year.  The newest soft contact lenses on the market are made from a highly oxygen permeable material called silicone hydrogel.  When these lenses were first introduced, doctors had hoped that the higher oxygen levels would greatly reduce the rate of infections.  While there has been improvement, complications like corneal ulcers and infiltrates continue to exist.   Here's a look at what we can do to reduce the risks of contact lens wear.

Corneal Ulcer via review of ophthalmology

WEARING TIME

Please, please, please.  Follow the wearing time that your doctor prescribes for your contact lenses.  Your doctor is not just making up a number; the number of days to wear your lenses is an exact medical prescription, not just a loose recommendation. Contact lenses go through rigorous studies by the FDA, and based on their performance they get approved for a certain length of wearing time.  Your doctor will tell you whether your lens is approved for daily, 2 week, or monthly wear.  There is NO soft contact lens currently on the market that is approved for longer than 1 month of wear (unless you are in a few special order exceptions).  There is only 1 contact lens approved by the FDA for 30 days of extended wear (sleeping in the lens): Air Optix Night and Day.  If you are sleeping in your lenses every single night, you are putting yourself at great risk for a vision threatening complication.  There is no doctor who is ever going to tell you to "wear this lens until it hurts or your eye gets red."  I hear a lot of patients say that is when they dispose of their lenses; but lets be honest, there is no way anyone can possibly think that wearing a lens until your eye hurts is a good idea!    Your eye hurts and turns red if the corneal nerves are damaged or the health of the eye is compromised by oxygen deprivation or bacterial invasion.  If you are waiting until there is actual discomfort, your eye has already suffered significant damage.

Large Corneal Scar following an ulcer.  Vision will never
return to normal with a large scar like this.
Photo from andrewgasson.co/uk

PROPER CLEANING

There are a ton of multipurpose solutions on the market, and they all do a great job of killing bacteria. (For more information on solutions, click here) It is best to rub your lenses gently for a more thorough clean after removing them for the night.  Never reuse solution for multiple nights; the used solution is full of bacteria and other contaminants cleaned from your lenses!  Throw your contact lens case away every 3 months to keep the microbial levels of the case low.  NEVER clean your lenses with tap water, saliva, or any other liquid not designed for contact lens use.  Do not try to make your own solution unless you are a trained chemist who makes contact lens solution for a living.  It is not just water and salt to taste.  Just, no.  Don't do it.

I always put it to my patients this way: How much money are you really going to save if you have to be treated for an infection?  Any corneal ulcer or infectious event is going to require several follow-up treatment visits, so believe me, unless you have a really great insurance plan, getting treated for an infection is VERY expensive.  Not to mention that your eye may never fully recover.

FOR THE OD READERS:

A lot of discussion has been made over the findings from research like staingrid.com.  We still don't have a full understanding of what contact lens solutions provide the best health benefits for what contact lens materials.  If you have a patient with an infiltrative event, you can participate in an online study at http://www.thecontactlenssolution.com/.  Log on to this website to report the name of the contact lens and the solution your patient was using.  With time, researchers with the site hope to collect enough data to find correlations between particular lens materials and solution interactions.  We can only learn more if ODs report their findings!

Still wanting more?   Click here for 5 REASONS TO NEVER OVERWEAR YOUR LENSES.  More horrifying pictures will ensue.