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Invisible demand and popularity

The numbers speak for themselves: there are 125 million contact lens wearers out there in the world today. I am one of them, and if you are reading this so must you be too.

Contact lenses are simply fantastic….. and pretty safe if looked after properly. But there are rare risks of sight-threatening complications which should focus the mind in an endeavour to avoid. Contact lens wearers are subject to safety lapses as time and routine go by. Corneal infections such as Acanthamoeba, Pseudomonas can be very bad news; corneal ulcers, over wear, tight fit, protein deposits and hypersensitivity aren’t great; a background of allergy or dry eye can be limiting, and stress the eye.

As an ophthalmologist, I have seen my fair share of such problems. Here I present a series of suggestions and strategies, which I hope will make contact lens wear routines as safe as possible for your eyes.



Don’t give bacteria a head start, they already have smart attack systems. Be particular.  Always wash your hands thoroughly. Store case and solutions in a clean area.


Wear time

It is rather easy to become too dependent on contact lenses which can result in over wear.  Many people are wearing lenses up to 18 hours a day, 7 days a week. This will inevitably takes its toll on the cornea over the years. I once met an elderly lady who had been wearing contact lenses for 55 years and her corneas were in a pretty rough state. Fortunately sleeping in extended wear lenses seems to be rare these days.

My advice is to reduce dependency to the minimum if possible. Aim for a wear time of less than 10 hours per day (contacts in the last thing before you go out, contacts out when you get home). Try for 1 or 2 rest days per week. This substantially cuts wear time, which can only add to the corneal health preserves. To help get this underway you need a good pair of spectacles: in which your vision is top-notch spot-on, and in which you also feel confident in appearance.

Know that as we get older, we tend to feel more relaxed about wearing spectacles compared with when we are younger. I really like the old wise but funny saying which goes something like ‘When you’re 20 you care what everyone thinks, when you’re 40 you stop caring what everyone thinks, when you’re 60 you realize no one was ever thinking about you in the first place’. I would recommend increasing the rest days slowly and try and wean off out of contact lenses by a target age of say 50.


Cleaning regime


There are many different types of disinfectants, most new systems being one step, one time (don’t ever be tempted to re-use). If your optician has no objection, I would inquire whether hydrogen peroxide would be suitable for you - it is still considered the gold standard.

I would prefer manufacturers to go back and make a 2 step hydrogen peroxide system (I liked the idea of a rinsing step) but I’m not sure that is going to happen without a lot of lobbying.


Surfactant soapy rub cleaners, used before the disinfection step, were another good idea in my opinion which for some reason has also gone by the wayside in marketing.

I would strongly recommend protein removal tablets used weekly so long as your optician does not disapprove.

Contact lenses suffer from protein deposit build up from the tears; this makes wear increasingly uncomfortable and degrades vision clarity. The denatured proteins can also provoke allergic type hypersensitivity sterile corneal ulcers and a chronic papillary conjunctivitis, especially common in monthly disposable contact lens wearers.

Use only the disinfectant and never tap water to rinse either the contact lenses or case - this is where Acanthamoeba infection can originate. Showering and swimming in contact lenses is not recommended for the same reason.

Rinse and air dry the contact lens case after each use. Change the contact lens case regularly, at least every 3 months.


Warning signals

It sounds obvious but it needs stating and reinforcing: only wear contact lenses if they are comfortable and your vision is ok. If a lens becomes uncomfortable take it out; if an eye becomes red or your vision drops seek professional review.

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