Why Office Hygiene Matters
The contact lens fitting environment is a potential source of cross-contamination between patients. Trial lenses, diagnostic sets, instruments, and practitioner hands all contact the eye or lens surfaces and can transmit microorganisms if not properly managed. Rigorous hygiene protocols protect patients from iatrogenic (office-acquired) infections and demonstrate professional standards of care.
Handwashing
Handwashing is the single most important infection control measure in the contact lens office:
- Wash hands thoroughly before and after every patient encounter
- Wash before handling any contact lens (trial, diagnostic, or patient lens)
- Use a non-moisturizing, fragrance-free soap to avoid transferring residue to lenses or eyes
- Dry with a lint-free towel to prevent fiber contamination
- Alcohol-based hand sanitizers can supplement but should not replace soap-and-water handwashing
Trial Lens Disinfection
Trial lenses are used on multiple patients and must be disinfected between each use:
- Clean the trial lens with an appropriate surfactant cleaner to remove debris and deposits
- Rinse thoroughly to remove cleaner residue
- Disinfect using the manufacturer's recommended solution and soak time
- Hydrogen peroxide systems are commonly used for trial lens disinfection because they provide effective broad-spectrum kill without preservative residue after neutralization
- Heat disinfection may be used for some lens types but can damage certain materials
- Never insert a trial lens on a patient's eye that has not been properly disinfected since its last use
Trial lens disinfection is not optional. Every trial lens must be cleaned and disinfected after each patient use, following the manufacturer's specific protocol for the solution being used. Failure to disinfect trial lenses can transmit pathogens between patients.
Diagnostic Lens Set Management
- Organization: Maintain diagnostic sets in labeled, organized cases to prevent cross-contamination between lens types
- Inspection: Regularly inspect lenses for deposits, scratches, chips (GP), or deterioration that would affect fit assessment or patient safety
- Replace damaged lenses: Scratched GP trial lenses or deposited soft trial lenses should be replaced
- Inventory management: Track which lenses are in use, which are being disinfected, and which need replacement
- Storage: Store properly in clean, dry conditions when not in use
Expiration Date Monitoring
All products in the contact lens lab have expiration dates that must be monitored:
- Disinfection solutions: Expired solutions may not achieve adequate microbial kill. Check dates monthly
- Saline solutions: Expired saline may be contaminated. Discard after expiration
- Diagnostic drops (fluorescein, anesthetic): Topical medications lose efficacy and may become contaminated past expiration
- Fluorescein strips: While more stable than liquid fluorescein, still check expiration
- Trial lenses: Some soft trial lenses in sealed blister packs have expiration dates. Verify before opening
Using expired disinfection solutions for trial lens care. An expired solution may appear unchanged but may have reduced antimicrobial efficacy, putting patients at risk. Implement a monthly check of all solution expiration dates in the contact lens lab.
Additional Hygiene Practices
- Instrument disinfection: Slit lamp chin rests, forehead bars, and other patient-contact surfaces should be wiped with disinfectant between patients
- Single-use fluorescein: Use individual fluorescein strips rather than multi-use bottles to prevent cross-contamination
- Gloves: Consider disposable gloves when handling trial lenses for immunocompromised patients or during ocular surface procedures
- Waste disposal: Properly dispose of used trial lenses, strips, and solutions according to office protocols
Create a contact lens lab checklist that staff members complete weekly, covering solution expiration dates, trial lens inventory, disinfection supply levels, and equipment cleaning. Systematic checklists prevent oversights that could compromise patient safety.
Key Takeaways
- Handwashing with non-moisturizing soap before and after every patient is the most important infection control measure
- Trial lenses must be cleaned and disinfected after every patient use without exception
- Diagnostic lens sets should be regularly inspected and damaged lenses replaced
- Monitor expiration dates on all solutions, drops, and sealed trial lenses monthly
- Use single-use fluorescein strips to prevent cross-contamination
- Disinfect slit lamp surfaces between patients