Good hygiene is essential for contact lenses wearers and following the correct guidelines for contact lens care will prevent infection and damage to the eye.
However, there is still a small increase in the risk of eye infection just by wearing a contact lens. The majority of these complications are relatively minor such as conjunctivitis and can be managed easily by your contact lens practitioner.
Keratitis, however, is an ever-present risk particularly with poor hygiene, particularly when related to poor lens case hygiene. Most corneal infection is treatable with swift intervention and good management. Acanthamoeba is a devastating ocular infection that is thankfully very rare, it occurs in roughly 1 in every 30,000 contact lens wearers and 85% of cases are linked to contact lens use. The best way to avoid the risk of Acanthamoeba keratitis is to keep your lenses away from any non-sterile fluid such as tap water and swimming pool water as this is wear Acanthamoeba lives in large quantities The following advice has been formulated as best practice for ALL contact lens wearers.
Always wash' rinse and dry your hands thoroughly with antibacterial soap and clean water before touching your eyes or your contact lenses. Fingernails should be short and smooth to avoid damaging the lenses or scratching your eye.
Do's and Don'ts
- NEVER use tap water to rinse your lenses.
- NEVER lick your lenses to clean them.
- NEVER swim or shower whilst wearing lenses.
- NEVER sleep in your lenses unless advised you can do so.
- NEVER over-wear your lenses.
- ALWAYS change your contact lens case regularly, every month is recommended.
- ALWAYS wash your hands before use. ALWAYS change your lenses at the recommended intervals. ALWAYS clean your lenses every morning/evening.
- ALWAYS keep your lenses in the recommended solution when not wearing them. ALWAYS attend your regular aftercare appointments.
Insertion - Soft & RGP Lenses
Common sense prevails in most things related to contact lenses. Try to get into the habit of working with the same lens first to avoid any confusion. Remove the lens from the case and examine it to be sure that it is clean, clear and free of any nicks or tears. If the lens appears damaged, do not use it. You can now inspect the lens to see it has turned inside out by placing it on your forefinger and checking its profile.
The lens should assume a natural, curved, bowl-like shape. If the lens edges tend to point outward (like a soldier's tin hat), the lens is inside out (see image). Another method is to gently squeeze the lens between the thumb and forefinger, the edges should turn inward. If the lens is inside out, the edges will turn slightly outward. Once you have verified the lens is the correct orientation you are ready to insert by following these steps:
- Place the lens on the tip of your forefinger.
- Place the middle finger of the same hand close to your lower eyelashes & pull down the lower lid.
- Use the forefinger or middle finger of the other hand to lift the upper lid.
- Place the lens on the eye, do not press it on. Try to make sure that the lens goes into the eye and does not get caught on your eyelashes. You may find it helpful to look into a mirror whilst you do this.
- Before blinking look up & then look down, to gently massage the air from behind the lens.
- Gently release the lids and blink. The lens will centre automatically.
A lens which is on the cornea will very rarely be displaced onto the white part of the eye during wear. This, however, can occur if insertion and removal procedures are not performed properly or if you excessively rub your eyes during lens wear. To centre a lens, follow either of these simple procedures: Close your eyelids and gently massage the lens into place through the closed lids. Gently manipulate the lens onto the cornea while the eye is open, using light pressure on the eyelids.
Removal - Soft Lenses Only
CAUTION: Always be sure the lens is on the cornea before attempting to remove it. Determine this by covering the other eye. If vision is blurred, the lens is either on the white part of the eye or it is not on the eye at all.
- Look up and gently pull down the lower eyelid.
- Place the forefinger of the other hand on the very edge of the contact lens.
- Repeatedly drag the lens slowly down towards the lower eye lid. The aim is to push the lens into the fold of the lower lid where it meets the eyeball the lens can go no further and, therefore, will fold and flop out of your eye.
- Look up, slide the lens to the lower part of the eye using the forefinger.
- Gently pinch the lens between the thumb and forefinger.
- Remove the lens.
Removal - RGP Lenses Only
Rigid gas permeable lenses can easily be removed by opening your eye wider than the lens diameter then pulling the corner of your eyelid towards the top of your ear then blinking. Be careful as the lens is likely to shoot out of your eye. It is best practice to cup your hand below your eye whilst your do this.
If this method does not work you can place the two index fingers of each hand on your upper & lower lid respectively and gently squeeze them together effectively pushing the eyelids underneath the edges of the lens. The lids should push the lens out of your eye
If a lens sticks (stops moving) on your eye, apply a few drops of the recommended lubricating solution. You should wait until the lens begins to move freely on the eye before removing it.
Insertion is slightly different with these lenses as they require to be filled with solution, preferably non-preserved saline, prior to insertion. This creates the difficulty of having to insert the lens vertically instead of in front of a mirror. A small applicator can be used to rest the lens on or you can group your index and middle fingers with your thumb to form a tripod to rest the fluid filled lens upon. The lens can then be slowly applied directly to the cornea ensuring that the eyelids are stretched wide enough to accommodate the whole lens using the other hand.
Removal is fairly simple. You can either remove the lens similarly to the RGP method remembering that the lens is rather larger than a conventional RGP lens. If this is difficult, the fluid tension needs to be broken by gently applying pressure to the very edge of the lens or by dragging the lens off the cornea. Dragging the lens is easily achieved with a dry finger placed onto the lens and then looking towards your temple, but keeping your finger stable. This should allow the lens to drop out of the eye.
Insertion as above with mini-scleral lenses.
Removal of hybrid lenses is achieved with a technique whereby the patient gently pinched the thumb and index finger together at the very bottom on the soft skirt of the lens ensuring that your thumb and finger are very dry. Then gently lift the lens off the eye.
Cleaning Your Lenses
This should performed before you insert the lenses or after you remove them, either way you should be cleaning your lenses every time you wear them.
With some RGP and hard lens forms the solutions typically come with a two step solution regimen, one solution cleans and scrubs debris from the lenses whereas the other sterilises them. Be sure to rinse all of the cleaner off the lenses before you insert them.
Most soft lens solutions only require a one-step solution. These come in two different varieties, hydrogen Peroxide based solutions with a neutralising agent and the other is chemically based. The Peroxide treatment is excellent for those people with allergic responses to some chemicals; however, you MUST make sure that you read the instructions on the packaging and leave the solution long enough to neutralise before using your lenses. They typically require a six hour sterilisation and neutralisation cycle. With chemical disinfection there are lots of different brands on the market and most of them claim to be a "no rub" formula. This has been shown to be an over-exaggerated claim, therefore, we would urge everybody to rub and rinse their lenses when cleaning them.
With regard to eye health it is always recommended to attend an appropriate practitioner for your continued contact lens aftercare. Some complications are "silent" meaning you will not necessarily know that your lenses are causing your eye harm and fitting poorly. In case of emergency, redness of the eyeball, pain reduced vision, or discharge you should cease lens wear contact your lens practitioner. Following professional advice properly will greatly minimise the risks of contact lens wear and as long as you follow some simple common sense rules then it is very likely you will never have a contact lens related problem.
Ask yourself periodically:
- Do my eyes look good?
- Do my eyes feel good?
- Do I see well?
If you cannot answer 'yes' to all of these, or you have any other doubts concerning your contact lenses, remove your lenses immediately and seek the advice of your contact lens practitioner.
- Go to bed with a painful red eye - seek advice immediately.
- Bring any contact lens in contact with tap water.
- Wet your lenses with saliva.
- Wear your lenses for swimming (unless you use goggles) or showering.
If you have been affected by any of the symptoms mentioned above, please don't hesitate to give us a call.
We have a team of experts on stand-by who are ready to take your call at our Manchester (0161 907 2685) Clinic or our Blackpool (01253 308 031) Clinic.