6 Contact lens no-no's


About 41 million adults in the United States wear contact lenses and most of them have at least one habit that puts them at risk of developing a serious eye infection.

That’s why one of the main things we as eye professionals work toward every day is keeping the eyes healthy while wearing contact lenses. This includes preventing infections like microbial keratitis, an infection on the surface of the eye that can lead to scarring and permanent vision loss. Poor compliance with contact lenses can also cause overall inflammation of the eye.

If you’ve worn contact lenses for a while, it’s understandable that you may have gotten into a routine, forgotten or just don’t remember proper hygiene, so I revisit several key points with my patients during each appointment.

1. Don’t nap or sleep in contact lenses

Contact lenses are basically sponges that can hold a lot of bacteria and other debris against the eyes. When you sleep in contact lenses, you’re preventing the movement of tears, which helps eliminate some of the bacteria. Catching a few Z’s in your contacts also prevents oxygen from getting to the cornea.
While there are contact lenses approved for overnight wear, we’re very conservative in prescribing this type of lens because of an increased risk of contact lens-related infections. If you know you’re going to take a nap or fall asleep, please take your contact lenses out to prevent any issues.

2. Don’t top off your solution

Contact lens solutions have disinfecting properties. You put a contact lens in solution to soak and eliminate bacteria. When you top off solution or put more in, it’s like adding clean water to dirty bath water. You’re putting contact lenses into a contaminated environment that is no longer cleaning or disinfecting your lenses.

Use solutions properly. Put fresh solution in a clean, dry case daily. Make sure you close the lid on the solution and that you’re not leaving the bottle open on your counter.

3. Replace your contact lens case regularly

If you have a contact lens case, change it monthly. I know it may be surprising to some people, but lens cases are easily contaminated. Cases can hold a lot of bacteria from you handling the case, inside and out. If a patient gets an infection, we often culture the case to see what’s growing inside to give us a clue as to what type of bacteria is growing in the eye. 
After inserting the contact lenses in your eyes, dump out the solution, rinse the case with contact lens solution and turn it over to air-dry on a paper towel. Don’t leave solution sitting in the case. Solution left in the case throughout the day can lead to bacterial growth in the case.

4. Replace your contact lenses as recommended

The Food and Drug Administration has regulations and replacement schedules of contact lenses put in place to help prevent problems. When contact lenses aren’t changed or replaced as recommended, patients are at much higher risk to develop redness, inflammation, blurred vision or infections.

Mucus and debris in our tears can deposit on the lenses. If your eyelid is blinking over deposited lenses throughout the day, your eye and eyelid can become increasingly irritated and sometimes cause giant papillary conjunctivitis. GPC is a condition caused by deposits on the front surface of a contact lens irritating the eyelid. This leads to multiple bumps forming under the lid that usually will prevent you from wearing your lenses and requires a prescription for eye drops to reduce the inflammation. 
I prescribe most of my patients contact lenses that you replace daily. This means you’ll have a fresh lens every day. Daily disposable lens wearers have the lowest risk for any problems related to irritation and inflammation. This type of lens also eliminates the need for cases and solutions, further reducing the risk of infection or inflammation.
Remember to always wash your hands with soap and water before handling your contact lenses. 

5. Get an annual eye exam

Contact lenses are considered a medical device, and the prescription expires in one year. They’re different from eyeglass prescriptions that must be renewed every two years. 
The yearly appointment is a time to make sure your eyes are staying healthy in the contact lenses. During the annual exam, we check to see if the lens fits well and make sure the daily wear time is appropriate for your eyes. We also look for things the contact lenses could cause that you can’t feel.

For example, if your eyes aren’t getting enough oxygen, they can produce blood vessels that grow onto the cornea where you put your contact lenses. Blood vessel growth isn’t something you can see or feel, but it can cause problems with your eye that could lead to the inability to wear contact lenses.

6. Don’t expose your contact lenses to water

Water puts contact lens wearers at risk of getting an infection called Acanthamoeba keratitis. It’s a very severe infection that causes extreme pain, permanent blurred vision and scarring of the eye. Because of the increased risk of infection, I recommend no swimming or hot tub use in contact lenses and never to expose your lenses or cases to water. If my patients are swimmers and absolutely need to swim with their lenses in place, I recommend a daily lens that they wear once and immediately throw away after swimming.
If you notice any redness, blurred vision or irritation while wearing your contact lenses, please visit your optometrist to investigate the cause and determine how to make your experience wearing contact lenses better. 

Dr. Stephanie Pisano is an optometrist and assistant professor at Havener Eye Institute at The Ohio State University Wexner Medical Center.