Contact lenses and dry eye - Part 2

When is cleaning bad?

Using the “all purpose“ cleaner and conditioner solutions to take care of your contacts can be a major problem. These products are designed to kill germs and clean deposits, while also lubricating and buffering the contact lens to make it more wettable and wearable. This sounds like a good idea but it turns out to be impossible! 

Anything harsh enough to kill most common germs while cleaning the lens, is also going to be too rough and toxic for your dry and sensitive eyes. These toxins can weaken the cells on the surface while damaging the "sprinkler system tear glands." They also can’t kill every germ, because that would also kill your eyes. Think what would happen if you were to put pure Clorox into your eyes - it would destroy them (while also killing every germ). 

Another problem has to do with the containers used to store the lenses while cleaning or not using these lenses. Because these "eye-kinder" solutions can’t kill every germ, the germs that survive - like a nasty little amoeba called Acanthamoeba - then hang out and multiply in the container. Once they get to a certain concentration or once the eye's surfaces become damaged enough by the chemicals in the spongy lens, then these germs can get the foothold they need to start an infection. In the worst case, this goes on to ulcerate the cornea and can lead to blindness if not a properly care for.

Yet another problem comes from the allergies that can be aggravated by a more sensitized surface and less healthy tears. Allergies can be caused by pollen, pollutants, fragrances, products in makeup, soaps on the fingers used to insert and remove the lenses - and yes, the dander from pet hair in the air that can surround us. Such materials soaked into and onto the contact lenses can lead to rejection - so much that you may have to give up wearing contact lenses all together. Allergies cause further inflammation that contributes even more to the dryness and irritation. Giant Papillary Conjunctivitis (or GPC) is a special, more aggressive form of reaction of the membranes of the outer eye and eyelids to either the material embedded in the spongier plastics, or to the actual plastic material the lens is made from - or the irritation from the edge of the contact lens “rubbing” against the membranes when you blink, GPC can sometimes be solved by changing the type of contact lens material, finding a lens with a smother edge, determining the type of allergens (pollen, dust, dander, mites, etc) and avoiding them - but ocular allergies can be helped by having a healthy tear film, too.

So called “dailies” are contact lenses designed to be worn for a specific period of time (usually just one day, as the name implies) and then thrown away. This can get around the cleaning issues, but doesn’t necessarily help with the allergy issues. They also tend to be more fragile, since they are designed for only a one-time use - so improper handling on initial insertion or attempts at re-use can be fraught with micro-tears and surface irregularities that can affect comfort and wear time as well as risk eye injuries.

How do we properly clean our contacts?

From the above discussion, it is easy to understand why it is important to properly clean and to properly care for the contact lenses - as well as to make your best tears (and control your environment). The best way to care for contact lenses is generally to use a hydrogen peroxide solution designed specifically for cleaning your type of contact lenses. Such kits contain peroxide solutions that will completely kill the germs, but then are turned to a harmless gas and water by a catalyst provided in the container used to clean and store your lenses. This powerful disinfecting and cleaning solution becomes harmless over the time specified by your cleaning system (generally overnight). This means that you can effectively clean your lenses without hurting your eyes - and have a better way of cleaning the container for those lenses at the same time. You may need to rinse your contacts with pure saline solution before putting them into your eyes as the pure water left from the peroxide cleaning can be irritating. Make sure you use an appropriate saline solution (preferably unpreserved and often best supplied in single use vials as the preservatives in the large saline bottles can sometimes be just as bad as the preservatives in artificial tears).

From inside the industry, a timely article:

 https://www.optometrytimes.com/view/contact-lens-disinfection-methods-still-matter