Is it safe to use Refresh Tears artificial tears and azelastine hydrochloride (azelastine) allergy eye drops while wearing contact lenses, and how should they be applied?

Using Refresh Tears and Azelastine with Contact Lenses

You can safely use Refresh Tears artificial tears with contact lenses, but you must wait at least 10 minutes after instilling azelastine hydrochloride allergy drops before inserting your contact lenses if your eyes are not red. 1

Application Protocol for Azelastine (Allergy Drops)

The FDA label for azelastine hydrochloride provides explicit guidance on contact lens use:

• Do not wear contact lenses if your eyes are red 1
• Azelastine should not be used to treat contact lens-related irritation 1
• If your eyes are not red and you wear soft contact lenses: wait at least 10 minutes after instilling azelastine before inserting your contact lenses 1
• The preservative benzalkonium chloride in azelastine may be absorbed by soft contact lenses, which is why the waiting period is necessary 1

Application Protocol for Refresh Tears (Artificial Tears)

Artificial tears are generally safe and effective for use with contact lenses:

• Preservative-free artificial tears are preferred to minimize ocular surface irritation 2
• Artificial tears can be applied before, during (while wearing lenses), and after contact lens use 3
• Recent evidence shows artificial tears applied directly to contact lens-wearing eyes significantly improve comfort without causing corneal or conjunctival damage 3
• If using preserved artificial tears, avoid products containing benzalkonium chloride or thimerosal when possible 2

Recommended Application Sequence

For optimal safety when using both products:

1. Apply azelastine allergy drops first
2. Wait at least 10 minutes 1
3. Insert contact lenses
4. Apply Refresh Tears as needed throughout the day while wearing lenses 3

Important Safety Considerations

Contact lens hygiene remains critical regardless of drop use:

• Wash hands with soap and water before handling lenses 4, 5
• Never rinse lenses or cases with water 4, 5
• Remove lenses immediately if you develop redness, pain, increased light sensitivity, blurry vision, or discharge 4, 5
• Replace lens cases every 3 months 4, 5
• Avoid sleeping in contact lenses unless specifically approved by your eye doctor, as overnight wear increases corneal infection risk fivefold 4, 5

Clinical Evidence for Artificial Tears with Contact Lenses

Multiple studies support the safety and efficacy of artificial tears for contact lens wearers:

• A 2021 randomized controlled trial found that artificial tears applied directly to contact lens-wearing eyes four times daily for two weeks caused no significant changes in corneal or conjunctival staining while significantly improving comfort scores 3
• A 2024 Cochrane review concluded that lubricating drops are a viable option for contact lens discomfort, though evidence certainty is low to very low 6
• Artificial tears may help keep contact lenses cleaner and improve ocular surface health 2