Contact lenses and the optical system

New York City- During the During the Global Contact Lens Forum, a partnership between Vision Expo East and the British Contact Lens Association, Milton Hom, OD, FAAO; Nick Rumney, MScO, FCO, FAAO; and Michael Ward, MMSC, FAAO; discussed how the interaction between the contact lens and the ocular system affects contact lens success.

Dr. Hom recommended using Nicox's Sjö test to identify Sjögren’s syndrome patients earlier, even in patients who may not fit the typical criteria. He says he also asks his patients about dry mouth as well as dry eye.

When it comes to solutions, Dr. Ward says the key to preservative and disinfection use is to have sufficient concentrations for antimicrobial efficacy. The latest multi-purpose solutions are very safe and effective but also differ in their chemistry. Hydrogen peroxide solutions are strong oxidants and remove proteins and lipids from the lens surface. These solutions are also very effective and are preservative-free. Hydrogen peroxide solutions are good for daily use, but not for occasional contact lens wearers.

“Contact lens wear is not a sterile environment, but it should be a clean one. However, just killing microbes is not the answer. Proper handling and personal hygienic practices remain important aspects of prevention,” says Dr. Ward.

Recommendations for lens care include:

• Wash hands

• Replace lenses as prescribed

• Do not store opened, old, spare lenses

• Do not top off solution

• Cases should be emptied, rinsed, wiped clean, and air dried daily

• Cases should be replaced often

“Do not fit people who obviously have poor hygiene,” says Dr. Ward.

Risk factors for microbial keratitis in contact lens wear include:

• Sleeping in contact lenses

• Wearing contact lenses during water activities

• High ametropias

• Wearers under the age of 25 and new wearers

• Ordering contact lenses online