Contact Lenses Care

In addition to deposits, soft lenses can carry and introduce microorganisms to the eye. This can then lead to infections, which preclude lens wear until they are cleared up. More important, infections can lead to complications if left untreated. Using a surfactant cleaner removes some organisms, but it cannot remove them all. Those that are left behind, it is feared, may find the soft, water-containing plastic a highly desirable breeding ground. Hence the need for disinfection to kill the remaining bacteria. (Lest you become unduly alarmed: The eyes have their own natural form of protection—tear immunoglobulins and the enzyme lysozyme—that combats infection up to a point. Also, soft-lens wearers who clean and disinfect their lenses as directed suffer no higher incidence of infection than either hard-lens wearers or those who wear no contact lenses at all.)

There are two methods of disinfection used to keep soft contact lenses free of organisms that could lead to eye infections: chemical (cold) disinfection and thermal (heat) disinfection. Which one you choose to employ depends upon several factors; each method has its own advantages and disadvantages. No matter which you elect, the process is an adjunct to —not a substitute for—the daily cleaning and weekly enzyming process. Disinfection must be done every day to finish the job that surface cleaning has begun. (It’s not necessary, or even desirable, to disinfect more often than once a day. If you remove your lenses during the day and intend to reinsert them, simply clean them and then store them in sterile saline until you’re ready to reinsert them.)

It’s not recommended that you switch back and forth between the two methods because the boiling process can cause the chemicals that are absorbed by the lenses during cold disinfection to turn the lenses cloudy. Some patients do alternate methods and report no ill effects thus far. However, to perform the switch safely it is recommended that you first clean the lenses thoroughly with a surfactant cleanser and rinse with saline. Then leach the chemicals from the lenses. This purging process is accomplished by soaking the lenses, in their case, in a saline “bath” for two to three hours. Repeat the baths at least three times, changing the saline each time. Then you can proceed to sterilize them. Some experts advocate using plain distilled water instead of the saline for the purging, but using saline for the final bath. Shaking the soaking case speeds the process, and using a device called Swirl Clean is even faster.

Chemical sterilization is more popular in other parts of the world, but in the U.S. the heat method is preferred for a number of reasons: although it doesn’t kill all forms of microorganisms, it destroys a wider range of bacteria than does chemical disinfection. It has a longer track record than the cold method. There are no allergic reactions, especially if unpreserved saline is used. And with the new small heat units it is convenient and just as easy as the chemical method. (As one soft-lens wearer who opted for thermal sterilization said: “I figured that the fewer chemicals which came in contact with my eyes, the better.”)

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