Contact lenses are a great alternative to glasses for many reasons. They don’t fog while cooking, don’t get covered in raindrops in wet weather, don’t fall off your face during aerial yoga, and don’t diminish the intensity of your smolder as you lock eyes with your love interest across the room. But as with many things, these benefits come with some additional responsibility.

Contact lens handling

Handwashing is a big deal. Bacteria or dirt and impurities from your hands can transfer onto the contact lens during either insertion or removal, making it important to thoroughly wash and dry your hands before handling the lens. Any bacteria caught on the lens surface, which is subsequently placed on the delicate cornea of the eye, then has several hours to burrow its way through the cornea’s defenses and spark an infection. Using a soap free of moisturizers is ideal as these soaps often leave residual chemicals on the hands. Hand sanitizer is not a good idea as these usually contain alcohol and the eye is not a fan of alcohol.

Dry your hands with a lint-free towel. Tap water is known to contain a nasty parasite known as acanthamoeba, a protozoan microbe with the potential to cause devastating visual loss if it manages to make its way into the eye. In the US, 85% of acanthamoeba eye infections (known as acanthamoeba keratitis) occur in contact lens wearers; this links to a conservative estimate of one to two cases of acanthamoeba keratitis per one million contact lens wearers. Even contact lens wearers who follow the rule book to the letter may be unlucky enough to experience this eye infection but dangerous behaviors such as bringing a lens into contact with non-sterile tap water greatly increases this risk.

While on the subject of non-sterile water, other dangerous bodies of water include the ocean (yup, fish poop), swimming pools (even grosser: human poop), and hot tubs. This concept applies to both daily disposable and reusable contact lenses.

Contact lens hygiene

There’s more to be said on the fun topic of contact lens hygiene. An estimated 50% of contact lens users do not rub their lenses during their cleaning routine. This is almost akin to holding toothpaste in your mouth without brushing your teeth. The step of rubbing the lens helps to dislodge deposits of proteins and lipids from the lens surface, allowing for a more thorough disinfection as the lenses sit in the contact lens solution overnight. All it takes is placing the lens in the palm of your clean hand, applying a few drops of contact lens solution, and giving the lens a gentle rub with the pad of your finger for about ten seconds per side. Properly cleaning the contact lenses can also help improve the comfort of the lenses as you wear them over the following weeks and in some cases also keeps the vision clear as the lens gets older.

Any solution left in the contact lens case the next day should be discarded once the lenses have been inserted into the eye. Avoid just “topping up” the solution every night; that’s like washing the dishes with the same water you used to wash yesterday’s dishes. Once you’ve poured out the leftover solution, the case should be rinsed with fresh solution and left to air dry until ready to again receive your well-rubbed lenses from your thoroughly washed and dried hands later in the day into fresh new contact lens solution.

Saline is not an adequate substitute for contact lens cleaning, disinfection, or storage. Neither is saliva (disgusting, yes, but you’d be surprised).

Contact lens red flags

We all like to think common sense is common but unfortunately a quick glance at the news tells us this isn’t always the case. Here’s a bit of contact lens common sense: if you put a lens into the eye and the vision becomes blurry, the whites of the eye turn red, or the eye becomes painful, remove the lens. Occasionally, removing the lens may fix the issue, for example, if there was a piece of fluff from your non-lint-free towel caught under the lens. However, if the eye and/or vision continue to deteriorate despite taking the lens out of the eye, it is important to see an eye care practitioner as soon as possible to rule out a sight-threatening infection or injury.

Other contact lens top tips

If the lens is a daily disposable contact lens, dispose of the lens daily; the material is not designed to be worn again.

If the contact lenses feel dry and a little irritated during the day, use lubricant drops which are safe to be combined with contacts; the packaging of the eye drop will typically clarify this.

Novelty and cosmetic contact lenses purchased from flea markets or online carry all the same risks as using a prescription contact lens. Eye infection and injury rates in these cases are potentially higher due to the lack of a proper contact lens fitting and review by an eye care practitioner.

Return for regular reviews with your prescribing eye doctor even if the contacts seem to be working well. Some future problems can be mitigated before they even become noticeable to you.

Remember that contact lenses are a medical device and should be treated with respect. Don’t let an eye infection get in the way of your smoulder.

References
Acanthamoeba keratitis fact sheet for health professionals. https://www.cdc.gov/parasites/acanthamoeba/health_professionals/acanthamoeba_keratitis_hcp.html
Rub vs no-rub. https://www.clspectrum.com/issues/2001/september-2001/rub-vs-no-rub