Do frequent eye infections due to contact lens use affect the safety of continuing to wear contact lenses?

From the Guidelines

Frequent eye infections due to contact lens use significantly affect the safety of continuing to wear contact lenses, and it is recommended to temporarily discontinue lens wear until the infection resolves completely. If you experience recurrent infections, consult an eye care professional to reassess your contact lens use 1. During an active infection, remove your lenses immediately and use prescribed antibiotic eye drops such as moxifloxacin, ciprofloxacin, or tobramycin as directed, typically 1-2 drops 4-6 times daily for 7-10 days. After recovery, your eye doctor may recommend switching to daily disposable lenses, reducing wearing time, improving cleaning routines, or changing lens solutions.

Some key considerations for contact lens wearers include:

• Washing hands with soap and water, and drying them before handling contact lenses every time 1
• Avoiding sleeping in contact lenses unless approved by an eye doctor 1
• Never storing contact lenses in water and keeping tap water away from them 1
• Removing contact lenses before showering, swimming, or using a hot tub 1
• Rubbing and rinsing contact lenses in disinfecting solution each time they are removed, and 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 1

Frequent infections suggest that your current contact lens system is compromising your eye health, as infections occur when microorganisms bypass your eye's natural defenses, often due to microscopic tears from lens wear, improper cleaning, or extended wearing times. Continuing to wear contacts during or immediately after infections increases the risk of serious complications like corneal ulcers or vision-threatening conditions. The most recent and highest quality study, published in 2024, emphasizes the importance of proper contact lens care and hygiene to prevent infections 1.

It is essential to follow the specific contact lens cleaning and storage guidelines from your doctor and the solution manufacturer, and to replace the solution in contact lens cases each time the lenses are disinfected 1. Additionally, daily disposable lens wear has been shown to have a lower rate of complications compared to daily wear of reusable lenses 1.

Overall, prioritizing proper contact lens care and hygiene, and being aware of the potential risks and complications associated with contact lens wear, can help minimize the risk of eye infections and ensure safe and healthy contact lens use.

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 or symptoms of bacterial conjunctivitis.

The answer to whether frequent eye infections due to contact lens use affect the safety of continuing to wear contact lenses is yes, they do. According to the label, patients with signs or symptoms of bacterial conjunctivitis should be advised not to wear contact lenses 2. This implies that continuing to wear contact lenses in the presence of frequent eye infections could pose a risk to the patient's safety. Frequent eye infections can be a sign of an underlying issue that may be exacerbated by contact lens wear, and the label advises against wearing contact lenses in such cases.

From the Research

Frequent Eye Infections and Contact Lens Usage

• Frequent eye infections due to contact lens use can affect the safety of continuing to wear contact lenses 3, 4, 5.
• The annual incidence of contact lens-associated keratitis is 2-4/10 000, and it is due to bacteria in 90% of cases, and much less commonly to acanthamoebae and fungi 4.
• Deficient contact lens hygiene can lead to corneal infection, and contact lens-associated keratitis usually has a highly acute presentation and can cause long-term visual loss 4.

Risk Factors for Contact Lens-Related Eye Infections

• Risk factors for contact lens-related eye infections include sleeping in lenses, exposing lenses to water, not adhering to replacement schedules, and reusing disinfecting solution 3, 5, 6.
• Approximately 99% of contact lens wearers reported at least one contact lens hygiene risk behavior, and nearly one third of contact lens wearers reported having experienced a previous contact lens-related red or painful eye requiring a doctor's visit 5.
• Adolescent and young adult contact lens wearers have been reported to be more likely than older adult contact lens wearers to develop eye infections and more likely to have poor contact lens hygiene practices 6.

Treatment and Prevention of Contact Lens-Related Eye Infections

• The use of scleral contact lenses as antibiotic reservoirs could be an alternative for antibiotic impregnation and treatment of infectious keratitis 7.
• Targeted prevention messages aimed at contact lens wearers, such as keeping all water away from contact lenses, discarding used disinfecting solution from the case and cleaning with fresh solution each day, and replacing their contact lens case every 3 months, can help reduce the risk of contact lens-related eye infections 3, 5, 6.
• Eye care providers play an important role in the health of their contact lens-wearing patients and can share health communication messages with their patients to help educate them about healthy wear and care habits 3.