Contact Lens Care and Solutions
Contact lenses are cleaned and disinfected after use, unless they are 1-day disposable lenses. Lens-care systems have been developed to remove deposits and microorganisms from lenses, enhance comfort, and decrease the risk of eye infection and irritation. They include, in 1 or more bottles, cleaning, disinfection, and storage functions (Table 5-9). Enzymatic cleaners, which remove protein deposits from the lens surface, provide additional cleaning for lenses that are not replaced frequently. Alternatively, patients whose eyes form deposits can be switched to lenses that are more frequently replaced. Serious eye infections may occur with any disinfection system, and there is more risk when patients do not follow instructions (eg, to discard and replace solutions). Lens cases must be replaced, unless they are treated with boiling water. Rinsing the lens or case with tap water risks contamination. If a practitioner uses trial lenses, one of the peroxide systems can be used for disinfection of soft and RGP lenses. Peroxide, however, does not kill Acanthamoeba species.
Several methods have been developed for disinfecting lenses, including the use of
Table 5-9 Contact Lens–Care Systems
Heat disinfection is not commonly used now. The care system selected depends on the personal preference of the fitter and patient, the simplicity and convenience of use, cost, and possible allergies to solution components. Currently, multipurpose solutions are the most popular care systems in the United States.
The fitter should instruct the patient in the care and use of contact lenses:
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Clean and disinfect a lens whenever it is removed. Rubbing cleans the lens more thoroughly.
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Follow the instructions included with the lens-care system.
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Do not use tap water, saliva, home-made solutions, and so on.
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Do not reuse contact lens–care solutions.
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Note that swimming with contact lenses increases the risk of infection.
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Do not allow the dropper tip or bottle to be contaminated.
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Clean the contact lens case daily; disinfect with boiling water and/or replace it every 2–3 months.
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Follow the recommended lens replacement schedule.
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Seek medical assistance promptly, when indicated.
In addition to teaching appropriate contact lens and case care, the fitter should instruct the patient in proper lens insertion and removal techniques, determine a wear schedule, and decide when the lens should be replaced. Insertion and handling techniques vary significantly among various lenses; manufacturers provide written information and videos to instruct staff and patients in appropriate insertion and removal techniques.
Excerpted from BCSC 2020-2021 series : Section 3 - Clinical Optics. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.