contact Lenses – Ask Eye Doc

Written by: Dr. Stephanie Mulick, OD While searching on the internet for common contact lens solution questions, I came across storing contact lenses in water and saliva. Ok, first off storing a contact lens in saliva is just plain gross, not to mention unsanitary. I feel like this goes without question, but apparently, it is something that people do. The main reason that we use contact lens solution is to kill micro-organisms that can cause potential blinding eye infections. Contact lens solutions not only kill micro-organisms, but they also provide moisture to the contact lens to keep it comfortable and safe to wear on your eyes. Contact lens wearers are at an increased risk for developing potential blinding eye infections. According to a study in the journal American Society for microbiology, patients who wear contact lenses account for 95% of acanthamoeba corneal infections, a potentially blinding infection. Why can’t I just use water to store my contact lens? Tap water contains several micro-organisms included bacteria, fungi, and parasites. When these micro-organisms infect the eye they can lead to potential vision-threatening eye infections. Water from any source, bottled, tap water or filtered water can all cause a contact lens to swell and dry out making it very uncomfortable on the eye. Water does not have anti-bacterial or anti-parasitic properties. In fact, it is quite the opposite. There have been several cases of patients with parasitic or bacterial eye infections that have been caused by not cleaning contact lenses properly. We only get two eyes, make sure to take care of them! So, how do you choose which contact lens solution is best? Your eye doctor knows best. Follow the instructions of your eye care professional. Not all contact lens solutions are created equally. There are different preservatives in contact lens solutions. Some people are sensitive to one preservative and not another. If you find that your eye becomes itchy or red with the use of a certain contact lens solution then it is best to try a different brand. There is a preservative-free option for contact lens solutions including hydrogen peroxide solutions (Clear Care) and Saline solutions. Keep in mind that saline solutions do not have anti-bacterial properties and are best used for rinsing but not for storing the contact lens. Hydrogen peroxide solutions are preservative-free and the best choice for sensitive eyes. Hydrogen peroxide does have anti-microbial properties and is a great option for patients that get dry eyes at the end of the day when wearing contact lenses. The most common hydrogen peroxide solution on the market is Clear Care. Contact lens case for hydrogen peroxide-based solution with catalytic disc How to use Clear care or other Hydrogen peroxide Contact lens solutions Hydrogen peroxide solutions cannot go directly into your eye, but instead, they have a special case with a catalyst at the bottom. After six hours in the special case, the hydrogen peroxide turns into sterile water. Again, you cannot rinse your lens with Clear care (or any other hydrogen peroxide solution). After six hours in the special case, the contact lenses can be put directly into your eyes. When in doubt if the lens was not in the solution for six hours make sure to rinse it with saline or multipurpose contact lens solution prior to inserting the contact into your eye. If you have your contact lens out of your eyes for less than 6 hours do not use a hydrogen peroxide solution. 6 hours is the least amount of time that the contact lenses need to be stored in Clear care or other hydrogen peroxide solutions to become sterile water and not burn your eyes. What to do if you put Clear Care or other Hydrogen peroxide solution into your eyes by accident. If Clear care (or other hydrogen peroxide solution) gets into your eyes do not panic! I’ve done this myself and it is not pleasant, but your eye will heal. You will experience intense burning. Rinse your eye immediately with saline, sterile eyewash, or tap water for 3-5 minutes. Then keep it well lubricated throughout the day, by using over-the-counter preservative-free artificial tears at least every hour. Do not wear your contact lens for 24 hours. If your eye continues to burn make sure to see your nearest eye doctor for evaluation. Not all contact lenses work well with all contact lens solutions. The Adrasko staining grid is a helpful tool to find what solution could work best with certain contact lens brands. Dr. Andrasko studied more than 100 contact lenses and solution compatibility and came up with the Adrasko Staining grid. As a patient, looking at this grid may seem confusing. The contact lens solutions are on the top horizontal column and the contact lens brands are on the left vertical row. The red boxes are the combination of contact lenses and solutions that cause the most corneal irritation after wearing the contact lenses for 2 hours. It is best to avoid the combination of solution and brand in red. For instance, the Purevision Contact lens and BioTrue solution is not a good combination as this has a high rate of corneal irritation after 2 hours of contact lens wear. As you can see from the Andrasko staining grid, the private label contact lens solutions have the most negative effect on corneal irritation. However, you can see that Acuvue 2 contact lenses and Biofinity contact lenses seem to do well with all of the solutions. This grid also demonstrates that Clear care and Optifree contact lens solutions are compatible with all the contact lenses listed. The grid shows that Saline is also compatible with all contact lenses; however, saline does not have anti-microbial properties which means you could be prone to bacterial infections. Only use Saline for rinsing your contact lens, not for storing the contact lenses. If you have any questions about this, please feel free to ask a question on my AskEyeDoc question page. Proper cleaning and storing of your contact lens To avoid serious eye infections it is vital to clean your contact lenses properly. Wearing contact lenses can be an excellent tool for patients who don’t want to be dependant on glasses and do not want eye surgery (click here to learn more about eye surgery options). It is extremely important to follow the instructions of your eye care professional when it comes to cleaning your contact lenses. Steps to cleaning and storing your contact lenses Wash your hands Use a clean contact lens case (if you see discoloration in the case do not use it)Always use fresh multipurpose solution or hydrogen peroxide solution in the proper case. (Never reuse solution).Store the contact lenses overnight in the solution as directed by the contact lens solution manufacturer.If you keep your contact lenses out for less than 6 hours then do not use hydrogen peroxide solution as there will not be enough time for the solution to catalyze into sterile water. How to sterilize a contact lens case to keep it clean After you remove your contact lens from the case, dump the used contact lens solution out. Do not put the caps back on the case as there will be moisture in the case and this can lead to bacterial growth. Rinse the case and let it air dry. You can place the case face down on top of the lids to keep air circulation through the case. Cleaning the contact lens case by putting it in boiling water for 10 minutes once a week is a great way to sanitize the case. You can also put the contact lens case into the dishwasher once a week. The Bottom Line As a general rule, if you follow the instructions of your eye doctor and use Multipurpose contact lens solution, Clear Care, or other hydrogen peroxide solutions then you have less risk for developing a potentially blinding eye infection. The use of contact lenses is an amazing tool to improve vision without the need for glasses; however, if not used properly there is a high risk of infection that can cause serious damage to the eyes. Cleaning, storing and sterilizing your contact lenses and the case that is used to store them is vital to keeping healthy eyes and maintaining excellent vision for years to come.