Why Proper Lens Care Matters
Proper contact lens care is the single most important factor in preventing contact lens-related infections and complications. As a COA, you will spend considerable time educating patients on correct cleaning routines, solution selection, and case maintenance. Poor compliance with care regimens is the leading contributor to serious conditions like microbial keratitis.
Multi-Purpose Solutions (MPS)
Multi-purpose solutions are the most widely used contact lens care system. A single solution handles cleaning, rinsing, disinfecting, and storing soft contact lenses. Despite the convenience, proper technique is still essential.
The correct MPS routine:
- Wash and dry your hands thoroughly before handling lenses
- Place the lens in your palm
- Apply several drops of MPS to both sides of the lens
- Rub gently for 5-10 seconds on each side (the "rub and rinse" step)
- Rinse the lens thoroughly with fresh MPS
- Place the lens in a clean case filled with fresh solution
- Soak for the minimum time specified on the solution label (typically 4-6 hours)
Hydrogen Peroxide Systems
Hydrogen peroxide (H2O2) systems provide stronger disinfection than MPS and are preservative-free, making them ideal for patients with solution sensitivities or allergies. The 3% hydrogen peroxide effectively kills a broader spectrum of organisms, including Acanthamoeba.
The critical step is neutralization. After the lens soaks in peroxide solution, a platinum disc in the special case catalyzes conversion of H2O2 into water and oxygen. This process takes a minimum of 6 hours. The lens must never be placed directly on the eye before complete neutralization.
| Feature | Multi-Purpose Solution | Hydrogen Peroxide |
|---|---|---|
| Steps | Rub, rinse, store | Rinse, soak with neutralizing case |
| Soak time | 4-6 hours | 6+ hours |
| Preservatives | Contains preservatives | Preservative-free after neutralization |
| Disinfection strength | Good | Superior |
| Best for | Most patients | Sensitive eyes, allergy-prone patients |
Lens Case Hygiene
The lens case is one of the most commonly overlooked sources of contamination. Studies consistently show that a large percentage of lens cases harbor bacteria, even among compliant patients. The case is essentially a miniature petri dish if not maintained properly.
Proper case care guidelines:
- Empty the case completely after inserting lenses each morning
- Rinse the case with fresh solution (never tap water)
- Air dry the case upside down on a clean tissue with caps off
- Replace the case every 1-3 months, or with each new bottle of solution
- Never store cases in the bathroom where humidity promotes microbial growth
Replacement Schedule Compliance
Every contact lens has a manufacturer-specified replacement schedule. Overwearing lenses beyond this schedule allows protein, lipid, and calcium deposits to accumulate on the lens surface. These deposits:
- Reduce oxygen transmission to the cornea
- Create irregular surfaces that harbor bacteria
- Trigger inflammatory and allergic responses
- Decrease visual clarity and comfort
Educate patients that even if a lens "still feels fine" after its replacement date, the deposits and material degradation are occurring at a microscopic level they cannot see or feel until complications develop.
Water Avoidance
Patients should never expose contact lenses to water from any source: tap water, swimming pools, hot tubs, lakes, or showers. Water harbors Acanthamoeba, a parasite that causes severe, difficult-to-treat corneal infections. Even municipal tap water is not sterile enough for contact lens use.
Key Takeaways
- Always rub and rinse lenses with MPS; never skip the rubbing step
- Never top off old solution; empty, rinse, and refill with fresh solution daily
- Hydrogen peroxide systems require full neutralization (6+ hours) before lens insertion
- Replace lens cases every 1-3 months and air dry them daily
- Follow replacement schedules exactly, regardless of how the lens feels
- Never expose contact lenses to any water source