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.

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.

1) CORNEAL NEOVASCULARIZATION

     Neovascularization means the growth of new blood vessels, which in itself doesn't sound so bad, right?  Well in the case of your cornea, it can have potentially devastating results.  The cornea is the clear dome of tissue where your contact lens sits, and the clarity is essential to your clear vision.  As a clear tissue, the cornea must receive the majority of its oxygen from the atmosphere.  When a contact lens sits on top of the cornea, this atmospheric oxygen must travel through the contact lens to supply the corneal tissue.  As a contact lens ages, the amount of oxygen to the eye gradually decreases until it reaches an unsafe level (which coincides with the FDA required disposal time, be that monthly or bi-weekly, or daily).  What happens if you continue to wear the lens past the time that it is supplying adequate oxygen?  Well the cornea has to get oxygen somehow, so it grows it's own blood vessels.  With time and repeated insult, your cornea could end up looking like this: 

GPC: a nasty allergic response to your contact lenses

Treatment = No contact lens wear for 1-2 weeks, prescribed eye drops (typically a steroid if advanced or antihistamine drops if mild)

3) CONTACT LENS ACUTE RED EYE

    Commonly abbreviated as CLARE, this acute onset red eye is also a side effect of poor oxygen levels to the cornea.  Remember that the cornea receives most of its oxygen from the atmosphere, so when you sleep and your eyelids close, you are depriving your cornea of oxygen to some degree.  Now put a contact lens on the cornea, and those levels go dramatically down.  This is why most doctors NEVER recommend sleeping in lenses as the ideal form of contact lens wear, and when you do sleep in your contact lenses you need to be prescribed a special contact lens made for extra oxygen delivery. If you have CLARE, you will wake up with red, irritated, watery eyes.  Best thing to do is take those contact lenses out and throw them away!

Treatment = No contact lens wear for around 1 week.  Drops prescribed as needed

4) BACTERIAL ULCER

 If the picture isn't enough to sway you, let me just emphasize the fact that you do NOT want a corneal ulcer. They are painful.  They are really nasty looking.  They cause permanent scarring.  They can take a very long time to heal up.  Did I mention they are VERY painful?  Corneal ulcers come in all shapes and sizes, and most are smaller and located more towards the periphery.  When I do see a large central ulcer, that means immediate referral to a corneal specialist.  If your ulcer is anywhere near your pupil (where light passes through to allow you to see), then you are going to have a permanent scar obstructing your line of sight!  Where do these ulcers come from?  Like most of the problems we've discussed, a lack of oxygen is a trigger.  When the cornea is deprived of oxygen the integrity of the tissue is weakened.  Bacteria on your contact lenses can then penetrate the cornea and result in the ulcer.  

Treatment = No contact lens wear for several weeks (or indefinitely depending on the severity).  Frequent antibiotic use (typically every hour round the clock in severe cases).  

5) YOU ONLY GET ONE CORNEA PER EYE.  FOREVER.

I frequently tell my patients who are overwearing contact lenses that their cornea has to last them to age 100.  You don't want to be depriving it of oxygen in your teens or twenties! Here's another question that I have heard doctors pose: "would you sleep in the same pair of undewear for months at a time without washing it?"  Your contact lenses are very prone to accumulating bacteria, so it is very important to properly clean them and throw them away at the end of their lifespan to ensure you aren't depriving your eye of the oxygen it needs.  

Take home points:

• If you have a red eye, remove your contact lenses and see your doctor.  Most of these conditions require a high powered microscope to properly diagnose.
• How much money are you really saving by overwearing contact lenses when you take into account that if you get a contact lens complication, the office visits and cost of medicated eye drops is very high?  Not to mention the fact that you will be causing permanent damage to the health of your eyes.
• If you wear contact lenses, you need a pair of glasses.  No exceptions.  If you can't see to drive legally without contact lenses, you MUST have back-up glasses.  I don't care how old they are.  They just need to be good enough for you to use in case you have a complication where you have to be out of contact lenses.