Contact Lens Hygiene Is Lacking

Contact lens-related keratitis is on the rise, according to a recent CDC report.

Approximately 41 million US individuals wear contact lenses, and almost 99% of contact lens wearers surveyed reported at least one behavior that puts them at risk for an eye infection.

Keratitis (cornea inflammation) is a common eye infection that can be caused by viruses, bacteria, fungi, or parasites that enter the eyes as a result of poor contact lens hygiene.

Contact lenses are classified as medical devices and regulated by the FDA. Between 2005 and 2015, there were a total of 1075 contact-lens related adverse events reported, of which:

• 213 (19.8%) discussed patients with corneal scars, decreased vision, and corneal transplant surgery.
• 270 (25.1%) discussed risk factors for corneal infections, including sleeping in contact lenses, extended wear, using expired lenses or products, storing lenses in tap water, or wearing lenses while swimming.
• More than 10% demonstrated that adverse events resulted in emergency department visits or immediate care.

Tips for Safe Use

Proper contact lens hygiene is extremely important to prevent infections. Since 2006, there have been 3 US outbreaks of Acanthamoeba keratitis (a rare cornea infection that can cause blindness) and Fusarium keratitis (fungal cornea infection).

Pharmacists can encourage good contact lens hygiene with the following tips:

• Wash your hands with soap and water and dry them well before handling contact lenses.
• Avoid sleeping in your contact lenses.
• Keep water away from contact lenses. For example, patients shouldn’t shower in contact lenses, and they should be removed before swimming.
• Rub and rinse contact lenses with disinfecting solution. Water and saliva should never be used to clean contact lenses.
• Never store contact lenses in water. If water touches contact lenses, it’s important to remove them as soon as possible. Discard or clean and disinfect them overnight before wearing them again to reduce the risk of infection.
• Rub and rinse the contact lens case with solution and never water. Empty and dry the case with a clean tissue and store upside down with the caps off after each use.
• Don’t “top off” solution. It’s important to use only fresh contact lens disinfecting solution in the case.
• Carry a backup pair of glasses with a current prescription in case you need to remove your contact lenses.
• Visit your eye care provider yearly or sooner if you notice any eye problems.

Let patients know to remove contact lenses and contact a health care professional if they’re experiencing irritation, worsening eye pain, light sensitivity, sudden blurry vision, or unusually watery eyes or discharge.

Pharmacists can play an important role in counseling patients on appropriate contact lens use to help prevent corneal infections. Additionally, it’s important to report contact lens-related adverse events to the FDA.

Reference

Cope JR, et al. Contact lens-related corneal infections-United States, 2005-2015. Morb Mortal Wkly Rep. 2016;65:817-820.