Contact lens case care

Contact lens case care

Contact lens care systems are highly important to the success of your contact lens wear and also the reduction of risk for infections. A major part of any contact lens care system should include proper sanitation and replacement of contact lens cases.

The American Optometric Association has formed best practice recommendations from frequently asked questions.
Clicking the links below can save you from future infections and possibly even permanent vision lost.

The American Optometric Association recommends you replace your contact lens storage case at least every three months.1 Your contact lens solution manufacturer may recommend replacement at anywhere between one and three months of use.2,3 Failure to replace the contact lens case at the recommended interval increases the risk of complications.4,5,6

  1. The American Optometric Association. “What You Need To Know About Contact Lens Care and Compliance.” Brochure. Available http://www.aoa.org/Documents/public/AOA-contact-lens-hygiene.pdf
  2. Alcon Optifree PureMoist Multipurpose Solution Package Insert. Available: http://www.opti-free.com/pdfs/OFPureMoist_us_en.pdf
  3. AMO Revitalens OcuTec Multipurpose Solution Guidelines. Available: http://www.amo-inc.com/products/corneal/multi-purpose-solution/revitalens-ocutec-multi-purpose-disinfecting-solution
  4. Dart, J. K. G., et al. "Risk factors for microbial keratitis with contemporary contact lenses: a case-control study." Ophthalmology 115.10 (2008): 1647-1654.
  5. Stapleton, Fiona, et al. "Risk factors for moderate and severe microbial keratitis in daily wear contact lens users." Ophthalmology 119.8 (2012): 1516-1521.
  6. Kuzman, Tomislav, et al. "Lens wearers non-compliance—Is there an association with lens case contamination?" Contact Lens and Anterior Eye 37.2 (2014): 99-105.

Yes. Bacteria and other micro-organisms produce a substance called biofilm. Biofilms can form in a contact lens case, helping bacteria "hide" from the disinfectant in the contact lens solution.1,2,3,4,5 Biofilm cannot be seen by the naked eye; therefore, it is best to replace your contact lens case at least every one to three months.

  1. Wu, Yvonne T., et al. "Removal of biofilm from contact lens storage cases." Investigative Ophthalmology & Visual Science 51.12 (2010): 6329-6333.
  2. McLaughlin-Borlace, L., et al. "Bacterial biofilm on contact lenses and lens storage cases in wearers with microbial keratitis." Journal of applied microbiology 84.5 (1998): 827-838.
  3. Szczotka-Flynn, Loretta B., et al. "Increased resistance of contact lens related bacterial biofilms to antimicrobial activity of soft contact lens care solutions." Cornea 28.8 (2009): 918.
  4. Hall, Brad J., and Lyndon Jones. "Contact lens cases: the missing link in contact lens safety?." Eye & contact lens 36.2 (2010): 101-105.
  5. Willcox, Mark DP, et al. "Contact lens case contamination during daily wear of silicone hydrogels." Optometry & Vision Science 87.7 (2010): 456-464.
  6. The American Optometric Association. “What You Need To Know About Contact Lens Care and Compliance.” Brochure. Available http://www.aoa.org/Documents/public/AOA-contact-lens-hygiene.pdf
  7. Alcon Optifree PureMoist Multipurpose Solution Package Insert. Available: http://www.opti-free.com/pdfs/OFPureMoist_us_en.pdf
  8. AMO Revitalens OcuTec Multipurpose Solution Guidelines. Available: http://www.amo-inc.com/products/corneal/multi-purpose-solution/revitalens-ocutec-multi-purpose-disinfecting-solution

You should follow your solution manufacturer’s recommendations to clean and replace your lens storage case. Immediately after lenses are removed, discard the old solution from the wells of the case. The recommended steps from here may vary but usually include rinsing the case out with fresh solution and then air drying the case with the caps off.1,2,3,4 Following these guidelines can reduce the chances of infection or inflammation.

Recent research also suggests that adding a rub and a wipe step can assist with biofilm and bacteria removal in lens cases.5 Immediately after lenses are removed, discard the old solution from the wells of the case. Rub the case with clean fingers for at least five seconds, rinse with the contact lens disinfecting solution, then wipe dry with a clean tissue.5 Air dry the case face down on a tissue with the caps off.4

Avoid washing the case with tap water as this has been linked with an increased risk of development of Acanthamoeba keratitis, a severe corneal infection that can lead to permanent vision loss.6

  1. The American Optometric Association. “What You Need To Know About Contact Lens Care and Compliance.” Brochure. Available http://www.aoa.org/Documents/public/AOA-contact-lens-hygiene.pdf
  2. Alcon Optifree PureMoist Multipurpose Solution Package Insert. Available: http://www.opti-free.com/pdfs/OFPureMoist_us_en.pdf
  3. AMO Revitalens OcuTec Multipurpose Solution Guidelines. Available: http://www.amo-inc.com/products/corneal/multi-purpose-solution/revitalens-ocutec-multi-purpose-disinfecting-solution
  4. Wu, Yvonne T., et al. "Impact of air-drying lens cases in various locations and positions." Optometry & Vision Science 87.7 (2010): 465-468.
  5. Wu, Yvonne T., et al. "Removal of biofilm from contact lens storage cases." Investigative Ophthalmology & Visual Science 51.12 (2010): 6329-6333.
  6. Mutoh, Tetsuya, et al. "A retrospective study of nine cases of Acanthamoeba keratitis." Clinical Ophthalmology (Auckland, NZ) 4 (2010): 1189.

Contact lens cases should be stored to air dry in a clean, dry location. The case can be placed on a clean tissue with the case face down and the caps off.1,2

  1. Wu, Yvonne T., et al. "Impact of air-drying lens cases in various locations and positions." Optometry & Vision Science 87.7 (2010): 465-468.
  2. Wu, Yvonne T., et al. "Removal of biofilm from contact lens storage cases." Investigative Ophthalmology & Visual Science 51.12 (2010): 6329-6333.

Your lenses need to be completely immersed in solution. To ensure enough disinfectant is present and that your lenses are not damaged, each lens well should be completely filled to the top with fresh solution for each cleaning cycle.1,2,3

  1. Alcon Optifree PureMoist Multipurpose Solution Package Insert. Available: http://www.opti-free.com/pdfs/OFPureMoist_us_en.pdf
  2. AMO Revitalens OcuTec Multipurpose Solution Guidelines. Available: http://www.amo-inc.com/products/corneal/multi-purpose-solution/revitalens-ocutec-multi-purpose-disinfecting-solution
  3. Bausch + Lomb Biotrue Multipurpose Solution FAQs. Available: http://www.bausch.com/our-products/contact-lens-care/soft-lens-multi-purpose-solutions/biotrue-multi-purpose-solution/biotrue-solutions-faq

Adding additional solution to a contact lens case containing used solution (known as "topping off") has been linked to serious eye infections and is associated with the development of contact lens-related complications.1,2,3 To reduce this risk, recent research recommends contact lens wearers discard all used solution, rub the lens case with clean fingers for at least five seconds, rinse the case with a steady stream of contact lens disinfection solution, and then wipe the case wells dry with a clean tissue.4 Air dry the case face down on a tissue with the caps off.5

Avoid washing the case with tap water as this has been linked with increasing the risk of developing Acanthamoeba keratitis, a corneal infection that is resistant to treatment and cure.6

  1. Kilvington, Simon, et al. "Antimicrobial efficacy of multi-purpose contact lens disinfectant solutions following evaporation." Contact Lens and Anterior Eye 34.4 (2011): 183-187.
  2. Verani, Jennifer R., et al. "National outbreak of Acanthamoeba keratitis associated with use of a contact lens solution, United States." Emerging infectious diseases 15.8 (2009): 1236.
  3. Joslin, Charlotte E., et al. "The association of contact lens solution use and Acanthamoeba keratitis." American journal of ophthalmology 144.2 (2007): 169-180.
  4. Wu, Yvonne T., et al. "Removal of biofilm from contact lens storage cases." Investigative ophthalmology & Visual Science 51.12 (2010): 6329-6333.
  5. Wu, Yvonne T., et al. "Impact of air-drying lens cases in various locations and positions." Optometry & Vision Science 87.7 (2010): 465-468.
  6. Mutoh, Tetsuya, et al. "A retrospective study of nine cases of Acanthamoeba keratitis." Clinical Ophthalmology (Auckland, NZ) 4 (2010): 1189.

Contact lens cases are at greatest risk for becoming contaminated when stored in humid environments, such as bathrooms.1 Cases should also be stored away from toilets, which can generate contaminated spray droplets.2 A clean, low humidity area is best for storage of your lens case while your lenses are disinfecting.

  1. Wu, Yvonne T., et al. "Impact of air-drying lens cases in various locations and positions." Optometry & Vision Science 87.7 (2010): 465-468.
  2. Barker, J., and M. V. Jones. "The potential spread of infection caused by aerosol contamination of surfaces after flushing a domestic toilet." Journal of applied microbiology 99.2 (2005): 339-347.

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