Eye Infections

Contact lens wear should be a safe and pleasant experience. After all, contact lenses improve vision, are excellent for most sports, and are more convenient than glasses for such things as using a camera or walking outside in cold or rainy weather. Many people feel they look better in contact lenses; and some people even have fun with them, using them to change their eye color. Still, your eye is a delicate organ, and a contact lens is a piece of foreign material in the eye. Because the lens is a foreign body, and because lens wear exposes the eye to extra handling, contact lenses increase your risk of getting an irritated or infected eye. But sensible lens care, regular checkups, and a good-fitting lens will keep that risk to a minimum. This pamphlet is designed to introduce you to some of the problems that can be associated with contact lens wear and to help you prevent those problems. Our aim is to make your contact lens wear safe and problem-free.

What is an eye infection?

Many people use the term "pinkeye" to describe a bloodshot, irritated eye. Pinkeye (or even red eye) can be caused by many things: allergy, pollution, even a speck of dirt in the eye. But sometimes the cause is a viral or bacterial infection; and this is much more serious. When the eye is infected, the problem may persist and get worse. Along with increasing redness, the infection may cause pain, tissue swelling, blurred vision, and an oozing that forms a crust on eyelids and lashes. An infection may affect the conjunctiva (the tissue that covers the white of the eye and the inside of the eyelids) or the cornea (the clear central "window" of the eye through which we see). Infection of the cornea is more serious than a simple conjunctival infection.

Do contact lenses cause infections?

Studies show clearly that contact lens wearers are more likely than non-wearers to suffer from irritated eyes. In most cases, the irritation comes from drying of the eye, rubbing of the lens against the eye, or reactions to the solutions used in lens care. However, contact lens wearers may also have a higher rate of conjunctival infection than non-wearers; and serious corneal infection definitely occurs more frequently in contact lens wearers than non-wearers. Corneal infection is usually much more painful; and corneal infection may cause blurred vision and sensitivity to light. If not treated quickly, corneal infection can cause scarring of the cornea and loss of vision. In a few very rare cases the corneal infection can spread to the inside of the eye, causing blindness. Corneal infection must be taken seriously. Prompt diagnosis and treatment are very important.

The bottom line is this: Although contact lens wear is generally safe and comfortable, people who wear contact lenses have a greater risk of eye problems, including serious problems like infection. If you wear contact lenses, you owe it to yourself to take good care of your eyes and your lenses.

Are some contact lenses safer than others?

Yes. It appears that rigid gas permeable lenses are a bit safer than soft lenses.

But before you select a lens solely on that basis, remember that choosing a lens material is determined by many factors in addition to safety. Since both rigid and soft lenses are very safe (though rigid lenses are a bit safer), other factors may determine the best choice for your eyes. Much more important than the lens is when and how you wear it. Wearing contact lenses during sleep (called extended wear or flexible wear) is associated with a greater risk of corneal infection than lens wear in which the lenses are removed each night before sleep (called daily wear).

We don't yet know exactly why this happens, but it is believed to be related to the fact that there is much less oxygen available to the cornea when the eye is closed during sleep. Because of the added risk, the decision to wear contact lenses overnight is a serious one that should be made only after thorough discussion with your contact lens practitioner. Special lenses are needed for extended wear, so you must have the correct lenses and your practitioner's approval before wearing lenses overnight. It is important to balance the convenience and other benefits of overnight wear against the added risk. A recent addition to the contact lens field is that of Continuous Wear contact lenses. These lenses have exceptionally high oxygen permeability and the FDA has approved these lenses for up to 30 days of continuous wear (day and night). Your eye care practitioner can provide more information for you on these new lenses.

What can I do to increase the safety of contact lens wear?

No matter what kind of lenses you use, the following steps will help you increase the safety and enjoyment of your contact lens wear:

  1. Begin with a thorough eye examination. Your practitioner will tell you if you are a good candidate for contact lens wear. If your eyes require that you take some special measures to ensure safe wear, your practitioner will advise you.
  2. Lens fit is important. Your practitioner will take the time required to make sure your lenses fit properly. The fitting process usually requires several evaluations, made on separate visits to the practitioner's office. Though it takes time, these steps will assure that the lenses selected fit correctly and provide the best possible vision.
  3. After fitting, be sure to keep all scheduled follow-up appointments with your practitioner, even if some of these aren't covered by insurance.
  4. Unless you are taking fresh lenses from sealed packages, be sure to clean, rinse, and disinfect your lenses each time before you put them in your eyes. This requires using solutions specifically labeled for cleaning, rinsing, and disinfection. Make sure you know how to take care of your lenses and follow your practitioner's directions. If you have a question, do not hesitate to ask.
  5. Follow the wearing schedule your practitioner gives you. If you are limited to a specific number of hours per day, do not exceed the limit. If you are on daily wear, do not sleep in your lenses. If you are on extended wear or flexible wear, be sure to give your eyes a "night off," as your practitioner instructs.
  6. If you wear disposable or frequent replacement lenses, be sure to replace them on schedule as prescribed.
  7. Use the lens care solutions your practitioner recommends. Not all solutions work with all other solutions; and some solutions cannot be used with certain lenses. Ask your practitioner before switching solutions.
  8. When you take your lenses out of their case, rinse the case with solution and leave it open to air dry. Wash and boil the case once a week. Most importantly, replace the case on a regular basis as recommended by your practitioner.
  9. Wash your hands thoroughly with a deodorant-free, cold cream-free soap before handling your lenses and wipe with a lint-free towel.
  10. Never use home-made saline.
  11. Do not swim while wearing contact lenses. Contact lenses should not be worn in hot tubs.

What do I do if I think I may have an eye infection?

An eye infection is an emergency. If you think you may have an eye infection, remove your contact lens right away. If the problem is mild irritation and the eye does not get better in 1-2 hours after lens removal, call your practitioner right away. If an eye that is painful and red, with blurred vision, does not improve almost immediately on lens removal, call your practitioner right away. When you go in for examination, bring your contact lenses, your lens case, and the open bottles of solutions you are using. If you have an infection, these may help pinpoint the cause.

Most importantly: do not delay. Prompt treatment gives the best chance for success in dealing with corneal infections.

The above information is taken from the CLAO Patient Information Pamphlet titled CONTACT LENSES AND EYE INFECTIONS. Pamphlet Advisor was Susan M. Stenson, MD. Copyright 1996-2004 Contact Lens Association of Ophthalmologists, Inc.