Caring for Soft Contact Lenses

Step into the contact lens aisle of most drugstores or supermarkets, and you encounter a bewildering array of products. Though daunting, it's essential to understand contact lens care: not caring for your lenses properly can lead to a variety of infections, including some that cause blindness.

The good news is, contact lens care is easier than ever. The advent of one-bottle care systems and disposable contact lenses means that proper lens care involves much less time, expense and trouble than it did years ago.

Before we get started, it's important to note that you should not switch care regimens without first consulting your eye doctor. Some products are not compatible with each other, or with certain contact lenses. Using incompatible products could 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 that appear associated with Bausch & Lomb's ReNu with MoistureLoc contact lens cleaning/disinfecting solution.

1. 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.
    
2. 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.
    
3. Rinse the lens again to remove the loosened debris, making sure to take as long as the package directs: rinsing is an important step.
    
4. 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.
    
5. Repeat steps two through four for your other lens.

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. 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 replace your lenses about once a year, you definitely will. Products for removing protein include enzymatic cleaner and daily protein removal liquids.

Eye Dryness and Irritation. Use contact lens eyedrops 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."
 

Saline solution is for rinsing and storing contact lenses, when you're using a heat or UV disinfection system. You may also need it for use with enzymatic cleaning tablets or cleaning/disinfecting devices. Never use saline products for cleaning and disinfection.

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're ready to wear the lenses, rinse them again. As with regular multipurpose solutions, no other products are necessary.

Hydrogen peroxide systems may help wearers who are sensitive to the preservatives in multipurpose solutions.

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. Rinse your contacts (with another product) before placing them in your eyes.

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.

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. Afterwards, 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.

If your eyes feel dry, you may want to re-wet your contact lenses with lubricating drops.

Eyedrops for contact lenses are for lubricating your eye and rewetting your contacts. Make sure to choose a brand that is safe for contact lenses. Eyedrops that aren't mean for contact lenses can temporarily alter how a lens fits your eye, or discolor the lens.

Products for sensitive eyes help people who have allergic reactions to contact lens solutions. These allergies can crop up even you've been using the same products for years without difficulty. Symptoms may include itching, tearing, foreign body sensation, burning, redness and 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. Hydrogen peroxide, for example, is a preservative, but the neutralizing step in hydrogen peroxide disinfection makes the solution eye-friendly. Other products are actually free of preservatives and may have expiration dates. Non-aerosol preservative-free saline, for example, will generally last about two weeks after you open it.

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 you.

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: the solution can become contaminated.
   
• Avoid getting tap water on your contact lenses and accessories, as it can carry a microorganism called Acanthamoeba that causes serious eye infections. While regular contact lens disinfection procedures do kill Acanthamoeba, they typically don't kill its cysts.
   
• Remember to clean your contact lens accessories (lens case, cleaning/disinfecting devices, enzymatic cleaner vials and so on) as directed.
   
• Lens cases can be rinsed with hot tap water and dried when not in use.
   
• 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 (those with extended wear contacts should clean and disinfect them when they take them out, unless the lenses are scheduled to be discarded). Not only will your eyes be safer and healthier, but your contact lenses be more comfortable to wear, too.