Caring for Soft Contact Lenses
Enter the contact lens care aisle of most supermarkets and drugstores, and you'll find a confusing array of products.
Though daunting, it's essential to understand lens care: Not caring for your contact lenses properly can lead to a variety of eye infections, including some that cause blindness.
Actually, contact lens care is easier than ever. One-bottle care systems and disposable contact lenses mean that proper lens care involves much less time, expense and trouble than it did years ago.
Before we get started, understand that you should not switch care regimens without asking your eye doctor first. Some products are not compatible with each other, or with certain contact lenses. Using incompatible products can ruin your contact lenses or harm your eyes.
To make sense of all the bottles and boxes, it helps to know what steps are required to care for soft contacts.
It's particularly important to follow guidelines for safe handling of soft contact lenses in light of recent outbreaks of serious fungal eye infections associated with a popular (now discontinued) brand of contact lens cleaning/disinfecting solution.
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The Basics of Soft Contact Lens Care: Clean, Rinse and Disinfect
- Wash your hands so that you don't transfer dirt and germs to your eye. Try to avoid moisturizing soaps, as they are not good for contact lenses. Dry your hands with a lint-free towel.
- Remove one lens and clean it with the recommended solution. Cleaning removes eye-produced buildup, cosmetics and other debris that impairs lens comfort. The FDA recommends that you rub the lens in the palm of your hand with a few drops of solution, even if you are using a "no-rub" product.
- Rinse the lens again to remove the loosened debris, making sure to take as long as the package directs: Rinsing is an important step.
- Place the lens in your clean lens case or lens holder and fill with fresh solution; don't "top off" your old solution. Disinfecting kills microorganisms on the lens. Disinfection time varies from product to product; check the package for details.
- Repeat steps two through four for your other lens.
Beyond Clean, Rinse and Disinfect
Protein. Depending on what kind of contact lenses you wear and how much protein your eyes deposit on your contacts, your doctor may recommend you use a product for protein removal.
If your eyes feel dry, you may want to re-wet your contact lenses with lubricating drops.
While cleaning them does remove some protein, it can still build up on your lenses and make them uncomfortable. That's why the longer you wear lenses before replacing them, the more likely you are to need a protein remover.
For example, if you wear disposables, you probably won't need one; but if you wear the kind of lenses that are replaced only once or twice a year, you definitely will. Products for removing protein include enzymatic cleaner and daily protein removal liquids.
Eye dryness and irritation. Use contact lens eye drops to lubricate your eyes and rewet your lenses.
Eye sensitivity and allergies. A small percentage of lens wearers develop an eye allergy to the chemicals present in contact lens solutions. If this is the case with you, you don't need an additional product: You just need to switch products to those marked "preservative-free."
The Products: Cleaning, Rinsing and Disinfecting Solutions
Saline solution is for rinsing and storing contact lenses, when you're using a heat or UV disinfection system. You also may need it for use with enzymatic cleaning tablets or cleaning/disinfecting devices. Never use saline products for cleaning and disinfection.
Hydrogen peroxide systems may help wearers who are sensitive to preservatives used in multipurpose solutions.
This "extra strength" daily cleaner works for all soft contacts, including silicone hydrogel. It requires rinsing with sterile saline or a multi-purpose solution afterward. As with hydrogen peroxide solutions, this product should never be placed directly in your eye.
Daily cleaner is for cleaning your contact lenses. You place a few drops in the palm of your hand and carefully rub the lens for as long as directed, usually around 20 seconds, making sure to clean both sides. Use other products for rinsing and disinfection.
Multipurpose solution is for cleaning, rinsing, disinfecting and storing your contact lenses. Clean your lenses as you would with daily cleaner, then rinse (as long as directed) and disinfect, all with the same solution; or rinse the lenses twice, then place them in the clean lens case with solution to clean and disinfect. When you are ready to wear the lenses, rinse them again. With multipurpose solutions, no other lens care products are necessary.
Hydrogen peroxide solution is for cleaning, disinfecting, rinsing and storing your contact lenses. With this product, you place your lenses in the provided basket and rinse them, then place the basket in its cup and fill the cup with solution to clean and disinfect your lenses.
Some lens holders for hydrogen peroxide systems have a built-in neutralizer (to convert the hydrogen peroxide to water, so it doesn't sting your eyes), but with others you need to add a neutralizing tablet.
After the disinfection and neutralizing step is completed, you can remove the lenses from the case and put them on.
Never rinse your contacts with hydrogen peroxide solution and apply them directly to your eyes without completing the entire disinfecting and neutralizing step. Doing so can cause a painful chemical injury to the eye.
Cleaning/disinfecting devices will, as you would expect, both clean and disinfect your contact lenses. Depending on how the brand is designed, cleaning is accomplished with either ultrasonic waves or subsonic agitation, whereas disinfection occurs via multipurpose solution or ultraviolet light.
The instructions for the devices are all a little different. In general, you first rinse the lenses, using either saline or multipurpose solution as directed. One brand requires rubbing with the saline, but most are no-rub.
Then, put your contact lenses in the device and fill it with the same type of solution as for the rinse. Place the lid on the device and plug it in to clean and disinfect your lenses.
The Products: Protein Removers, Eye Drops and
Options for Sensitive Eyes
Enzymatic cleaner is for removing protein from your contact lenses, usually on a weekly basis. You use the tablets with saline solution or disinfecting solution (multipurpose or hydrogen peroxide), as directed.
Before using enzymatic cleaner, clean and rinse your contacts using other products. Fill your lens case or vials (as directed) with solution, then drop an enzymatic tablet in each lens well or vial. Wait for them to dissolve, then add your contacts. Leave them in for the required time, usually 15 minutes.
Afterward, disinfect with another product if necessary. Certain enzymatic cleaners allow you to skip the disinfection step if you use disinfecting solution rather than saline, but that's not always the case; check the enzymatic cleaner packaging to find out.
Daily protein remover also removes protein from your lenses, but it's in liquid form and you use it daily. You use it during disinfection with multipurpose solution.
Before using a daily protein remover, you clean and rinse your contacts using other products. Fill both wells of your lens case with multipurpose solution, then add a drop of daily protein remover to each. Disinfect your lenses as usual.
Eye drops for contact lenses are for lubricating your eye and rewetting your contacts. Make sure to choose a brand that is safe for contact lenses. Eye drops that aren't mean for contact lenses can temporarily alter how a lens fits your eye, or discolor the lens.
Multipurpose solutions make caring for your lenses fairly simple, but remember to rub your lenses as directed, for best results. This one is designed to retain moisture on the contact lens surface so eyes stay moist throughout the day.
Products for sensitive eyes help people who have allergic reactions to contact lens solutions. These allergies can crop up even if you've been using the same products for years without difficulty. Symptoms may include itching, tearing, foreign body sensation, burning, redness and eye discharge. It's important to see your eye doctor if you're experiencing these symptoms, as they can have many causes.
A preservative called thimerosal was found to cause problems in about 10 percent of patients, so most brands do not use it nowadays. Thimerosal-free saline is usually marked "for sensitive eyes."
However, people do have reactions to other preservatives as well and need to switch to preservative-free care products. Some of these have what's called a "disappearing" preservative that's gone before the solution comes in contact with your eyes.
Be sure to pay close attention to the expiration dates on all contact lens solutions, particularly preservative-free solutions. Non-aerosol preservative-free saline, for example, should be discarded within two weeks after you open it to reduce the risk of contamination.
What's Most Popular? Ease of Use
Nowadays, most people don't go for the multi-bottle cleaning conglomerate unless they have to. Instead, they choose a multipurpose solution for the clean, disinfect and rinse steps.
Then, if they experience any discomfort, or are not satisfied with the product, they look into the other options.
You may have noticed that stores like your pharmacy and grocer sell store-branded contact lens care products, also known as "private label" products. Often they are considerably cheaper than name-brand products. Should you use them?
These products are safe and FDA-approved, or they couldn't be sold. But there are potential problems. Sometimes private label products are made from older formulations, which don't offer the same advantages as newer products.
But here's a bigger problem: As you know, you shouldn't switch products without consulting your doctor to make sure the new solution is compatible with your lenses. Let's say that you buy a bottle of Store-brand X, bring it to your doctor, and he gives you the OK. You use the product, and everything is dandy.
Next time you buy Store-brand X, it may not be the same product. That's because the store doesn't, of course, make its own solution. They buy it from a supplier. If a better deal comes along, they might switch suppliers and even formulations but still sell the revised product under the "Store-brand X" name. And the revised formulation may or may not be right for your eyes or your particular contact lenses.
Contact Lens Care Must-Knows
Once you've decided which product you'd like to try, discuss your plans with your eye doctor. Don't switch brands until you determine that the new brand is compatible with your other products and with your contact lenses.
Regardless of which care regimen or brands you use, remember:
- Never touch solution bottle tips to any surface, including your body: this can cause contamination of the solution.
- Avoid getting tap water on your contact lenses and accessories, as it can carry a microorganism called Acanthamoeba that causes serious eye infections.
- Remember to clean your contact lens accessories (lens case, cleaning/disinfecting devices, enzymatic cleaner vials and so on) as directed.
- Lens cases should be rinsed with hot tap water and dried when not in use. (Because Acanthamoeba cysts may be present in tap water and can survive for years after drying,* some eye doctors recommend using only contact lens disinfecting or multipurpose solution for this step.)
- Recent studies** suggest that wiping your case with a clean tissue and/or placing it upside-down on another clean tissue may be additional good steps in keeping bacteria biofilms off the case. Ask your eye doctor what he or she thinks.
- Throw out your contact lens case once a month, or as directed, to reduce your risk of infection.
Most importantly, clean and disinfect your contact lenses once a day. If you wear extended wear contacts, clean and disinfect the lenses as soon as you remove them, unless they are designed to be discarded immediately after use. Not only will your eyes be safer and healthier, but your contact lenses will be more comfortable to wear, too.
*Survival of Acanthamoeba cysts after desiccation for more than 20 years. Journal of Clinical Microbiology. December 2008.
**The effectiveness of various cleaning regimens and current guidelines in contact lens case biofilm removal. Investigative Ophthalmology & Visual Science Published online April 2011. Impact of air-drying lens cases in various locations and positions. Optometry and Vision Science. July 2010.
[Page updated May 2014]