How can contact lens wearers prevent and manage infections?

From the Guidelines

Contact lens wearers can prevent and manage infections by following proper hygiene and care routines, as outlined in the most recent guidelines from 2024 1. To minimize the risk of infection, it is crucial to wash hands thoroughly with soap and water before handling lenses, and to dry them with a lint-free method. The United States Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) have made recommendations for contact lens wearers regarding proper lens care practices, which include:

• Washing hands with soap and water, and drying before handling contact lenses every time
• Not sleeping in contact lenses unless instructed by an eye doctor
• Never storing contact lenses in water
• Keeping water away from contact lenses, and taking them out before showering, swimming, or using a hot tub
• Rubbing and rinsing contact lenses in disinfecting solution each time they are removed
• Rubbing and rinsing the case with contact lens solution, drying it with a clean tissue, and storing it upside down with the caps off after each use
• Not topping off solution, and using only fresh contact lens disinfecting solution in the case
• Wearing and replacing contact lenses according to the schedule prescribed by a doctor
• Following the specific contact lens cleaning and storage guidelines from a doctor and the solution manufacturer
• Keeping the contact lens case clean and replacing it every 3 months
• Removing contact lenses and consulting a doctor immediately if symptoms such as redness, pain, tearing, increased light sensitivity, blurry vision, discharge, or swelling occur.

It is also essential to be aware of the risks associated with contact lens wear, particularly when traveling, as outlined in a 2023 study 1. This study highlights the importance of daily disposable contact lenses in reducing the relative risk of microbial keratitis compared to planned replacement soft contact lenses and rigid gas permeable contact lenses. Therefore, daily disposable contact lenses are recommended to minimize the risk of infection, and contact lens wearers should avoid swimming, showering, or sleeping in their lenses. If signs of infection occur, such as redness, pain, light sensitivity, discharge, or blurred vision, lenses should be removed immediately, and an eye care professional should be contacted. Treatment typically involves antibiotic eye drops, and severe infections may require more intensive treatment. These precautions are essential because contact lenses can accumulate microorganisms and debris that can cause serious eye infections like bacterial keratitis, which may lead to permanent vision damage if not properly treated.

From the FDA Drug Label

5.3 Avoidance of Contact Lens Wear Patients should be advised not to wear contact lenses if they have signs and symptoms of bacterial conjunctivitis or during the course of therapy with gatifloxacin ophthalmic solution, 0.5%

To prevent and manage infections, contact lens wearers should be advised to:

• Avoid wearing contact lenses if they have signs and symptoms of bacterial conjunctivitis
• Not wear contact lenses during the course of therapy with gatifloxacin ophthalmic solution, 0.5% 2

From the Research

Preventing and Managing Infections

To prevent and manage infections associated with contact lens wear, several strategies can be employed:

• Proper contact lens hygiene is essential, including regular cleaning and disinfection of lenses and storage containers 3, 4
• Avoiding overnight wear of contact lenses can reduce the risk of microbial keratitis (MK) 4, 5
• Not topping off contact lens solution can also decrease the risk of infection 6
• Following the recommended lens replacement schedule is crucial for maintaining eye health 6
• Regular check-ups with an eye care provider can help identify potential issues early on 6

Risk Factors for Infections

Several risk factors can increase the likelihood of developing an infection while wearing contact lenses:

• Poor hygiene practices, such as not cleaning and disinfecting lenses and storage containers regularly 3, 4
• Overnight wear of contact lenses, which can increase the risk of MK 4, 5
• Using tap water to clean or rinse contact lenses, which can introduce bacteria and other microorganisms into the eyes 7
• Not replacing contact lenses as recommended by the manufacturer or eye care provider 6

Treatment and Management of Infections

If an infection does occur, prompt treatment is essential to prevent long-term damage:

• Antibiotic, antifungal, or antiprotozoal therapy may be necessary to treat the infection, depending on the causative organism 5
• In severe cases, surgical management may be required to eradicate the infection 4, 5
• Regular follow-up with an eye care provider is crucial to ensure the infection is fully resolved and to prevent future occurrences 6