Environments

Should I be concerned about wearing my contact lenses on an airplane?

Commercial airline cabins expose passengers to reduced atmospheric pressure, reduced oxygen availability, reduced humidity, and dry air.^1,2,3 These conditions can lead to discomfort with contact lens wear, especially on flights lasting longer than three hours.^4,5

Instillation of lubricating eye drops approved for use with contact lenses may help relieve some eye dryness during your flight.6 Keep in mind that the United States Department of Homeland Security's Transportation Security Administration (TSA) limits the size of any liquid container carried onboard an airplane to a 3.4 ounce (100ml) bottle or less unless the liquids are medically necessary. ^3,7 Contact lens solution is considered a medically necessary liquid, so full-size bottles must be declared separately at the entry to the security checkpoint. ⁷ The solution is then subject to further screening. Solution manufacturers do tend to sell 2 oz. travel size containers of solution for those still wary of TSA restrictions. In the absence of a smaller manufacturer-supplied container of solution, do not attempt to transfer contact lens solution to a smaller container. This allows for contamination of the solution during transfer, which can lead to a serious eye infection.³

You may find your eyes are most comfortable wearing glasses when traveling by plane, particularly on longer flights.

1. DeHart RL. Health issues of air travel. Annu Rev Public Health 2003; 24:133-51.
2. Backman H, Haghighat F. Air quality and ocular discomfort aboard commercial aircraft. Optometry 2000; 71(10):653-6.
3. Sindt CW. “The Traveling Contact Lens Patient.” Review of Cornea and Contact Lenses. June 2009. Available: http://reviewofcontactlenses.com/CMSDocuments/2009/0609-RCCL.pdf (Accessed May 2015).
4. Nagda NL, Hodgson M. Low relative humidity and aircraft cabin air quality. Indoor Air 2001; 11(3):200-14.
5. Muhm JM, Rock PB, McMullin DL, Jones SP, Eilers KD, Space DR, et. al. Effect of aircraft-cabin altitude on passenger discomfort. N Engl J Med 2007; 357(1):18-27.
6. Ozkan J, Papas E. Lubricant effects on low Dk and silicone hydrogel lens comfort. Optom Vis Sci 2008; 85(8):773-7.
7. United States Department of Homeland Security - Transportation Security Administration. “3-1-1 Liquids Rule.” Updated Aug 28, 2014. Available http://www.tsa.gov/traveler-information/3-1-1-liquids-rule. (Accessed May 2015).

Should I be concerned about wearing my contact lenses in the car when the vent is blowing on my face or wind is coming in from the window?

Air blowing on your eyes, whether from a car vent or an open car window, can cause the eyes to feel dry. Contact lenses exposed to flowing air have been shown to become dry at a faster rate.1 This dryness can result in discomfort and/or blurry vision. Perhaps the most effective steps to take to keep your eyes comfortable in the car are to turn down the heat or air conditioning, direct air vents away from your eyes, and close the outside windows.

Some contact lens materials may perform better in windy environments.^1,2,3 Lubricating eye drops approved for use with contact lenses can also be helpful.⁴ Consult with your doctor of optometry regarding the best contact lenses for your needs and the best drops to use with your brand of lenses. Do not attempt to instill any drops in the eyes while driving.

1. Martin-Montanez, Lopez-Miguel A, Arroyo C, Mateo ME, Gonzalez-Meijome JM, Calonge M, et. al. Influence of environmental factors in the in vitro dehydration of hydrogel and silicone hydrogel contact lenses. J Biomed Mater Res Part B Appl Biomater. 2014; 102(4):764-71.
2. Ousler GW, Anderson RT, Osborn KE. The effect of senofilcon A contact lenses compared to habitual contact lenses on ocular discomfort during exposure to a controlled adverse environment. Curr Med Res Opin. 2008; 24(2):335-41.
3. Jones L, May C, Nazar L, Simpson T. In vitro evaluation of the dehydration characteristics of silicone hydrogel and conventional hydrogel contact lens materials. Cont Lens Anterior Eye 2002; 25(3):147-56.
4. Ozkan J, Papas E. Lubricant effects on low Dk and silicone hydrogel lens comfort. Optom Vis Sci. 2008; 85(8):773-7.

Is it safe to shower in contact lenses?

It is recommended not to shower while wearing contact lenses.^1,2 It would be preferable to apply your contact lenses after showering. The United States Food and Drug Administration (US FDA) has recommended that contact lenses not be exposed to any form of water.² Although rare, a sight-threatening eye complication known as Acanthamoeba keratitis is caused by an organism present in all forms of impure water (i.e., swimming pools, tap water, saunas, wells, and showers).^3,4,5,6

If lenses are being worn while showering, it is recommended to keep the eyes firmly closed.⁷ If lenses are accidentally exposed to water, instill a lubricating drop to help loosen the lens on the eye then remove the lens with clean, dry hands. Next, clean and disinfect the lens before re-inserting, or discard the lens. Never sleep in a lens that has been exposed to water without first cleaning and disinfecting it. ⁸

1. Bennett ES, Wagner H. Lens care and patient education. In Bennett ES, Henvy VA. Clinical Manual of Contact Lenses (3rd ed.). Philadelphia, Lippincott Williams & Wilkins, 2009:139-166.
2. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/ContactLenses/ (Accessed May 2015).
3. Joslin CE, Tu EY, Shoff ME, Booton GC, Fuerst PA, McMahon TT, et. al. The association of contact lens solution use and Acanthamoeba keratitis. Am J Ophthalmol. 2007; 144(2):169-180.
4. Butcko V, McMahon TT, Joslin CE, Jones L. Microbial keratitis and the role of rub and rinsing. Eye Contact Lens 2007; 33(6):421-3.
5. Beattie TK, Tomlinson A, McFadyen AK. Attachment of Acanthamoeba to first- and second-generation silicone hydrogel contact lenses. Ophthalmology 2006; 113(1):117-25.
6. Chin J, et al. Acanthamoeba keratitis: 10-Year study at a tertiary eye care center in Hong Kong. Contact Lens Anterior Eye 2014: http://dx.doi.org/10.1016/j.clae.2014.11.146
7. Sweeney D, Holden B, Evans K, Ng V, Cho P. Best practice contact lens care: a review of the Asia Pacific Contact Lens Care Summit. Clin Exp Optom. 2009; 92(2):78-89.
8. Stapleton F, Keay L, Jalbert I, Cole N. The epidemiology of contact lens related infiltrates. Optom Vis Sci. 2007; 84(4):257-72.

Is it safe to wear my contact lenses in a bathtub or hot tub?

It is recommended not to wear contact lenses while in a bathtub or hot tub. ^1,2,3 The United States Food and Drug Administration (US FDA) has recommended that contact lenses not be exposed to any form of water. ² Although rare, a sight-threatening eye complication known as Acanthamoeba keratitis is caused by an organism present in all forms of impure water (i.e., swimming pools, tap water, saunas, wells, and showers).^4,5,6 Acanthamoeba and certain forms of bacteria present in water can become attached to contact lenses, resulting in potential infection.^7,8

If lenses are worn while in the bathtub or hot tub, care should be taken to avoid water being splashed into the eyes. Recent studies have recommended use of tight-fitting swim goggles to limit eye exposure to water while swimming. ^9,10 If lenses are accidentally exposed to water, instill a lubricating drop to help loosen the lens on the eye then remove the lens with clean, dry hands. Next, clean and disinfect the lens before re-inserting, or discard the lens. Never sleep in a lens that has been exposed to water without first cleaning and disinfecting it.¹¹ If lenses were removed prior to getting in a bathtub or hot tub, they must be properly cleaned and disinfected before being re-inserted.³

1. Bennett ES, Wagner H. Lens care and patient education. In Bennett ES, Henvy VA. Clinical Manual of Contact Lenses (3rd ed.). Philadelphia, Lippincott Williams & Wilkins, 2009:139-166.
2. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/ContactLenses/ (Accessed May 2015).
3. Sweeney D, Holden B, Evans K, Ng V, Cho P. Best practice contact lens care: a review of the Asia Pacific Contact Lens Care Summit. Clin Exp Optom. 2009; 92(2):78-89.
4. Joslin CE, Tu EY, Shoff ME, Booton GC, Fuerst PA, McMahon TT, et. al. The association of contact lens solution use and Acanthamoeba keratitis. Am J Ophthalmol. 2007; 144(2):169-180.
5. Butcko V, McMahon TT, Joslin CE, Jones L. Microbial keratitis and the role of rub and rinsing. Eye Contact Lens. 2007; 33(6):421-3.
6. Chin J, et al. Acanthamoeba keratitis: 10-Year study at a tertiary eye care center in Hong Kong. Contact Lens Anterior Eye.2014: http://dx.doi.org/10.1016/j.clae.2014.11.146
7. Beattie TK, Tomlinson A, McFadyen AK. Attachment of Acanthamoeba to first- and second-generation silicone hydrogel contact lenses. Ophthalmology. 2006; 113(1):117-25.
8. Rice SA, van den Akker B, Pomati F, Roser D. A risk assessment of Pseudomonas aeruginosa in swimming pools: a review. J Water Health. 2012; 10(2):181-96.
9. Wu, Yvonne T., et al. "Do swimming goggles limit microbial contamination of contact lenses?." Optometry & Vision Science 88.4 (2011): 456-460.
10. Choo, Jennifer, et al. "Bacterial populations on silicone hydrogel and hydrogel contact lenses after swimming in a chlorinated pool." Optometry & Vision Science 82.2 (2005): 134-137.
11. Stapleton F, Keay L, Jalbert I, Cole N. The epidemiology of contact lens related infiltrates. Optom Vis Sci. 2007; 84(4):257-72.

Is it safe to swim in contact lenses?

It is recommended not to wear contact lenses while swimming.^1,2,3,4 The United States Food and Drug Administration (US FDA) has recommended that contact lenses not be exposed to any form of water.² Although rare, a sight-threatening eye complication known as Acanthamoeba keratitis is caused by an organism present in all forms of impure water (i.e., swimming pools, tap water, saunas, wells, and showers).^5,6,7 Acanthamoeba and certain forms of bacteria present in water can become attached to contact lenses, increasing risk for infection and possible vision loss.^8,9

If contact lens wear while swimming cannot be avoided, it is strongly recommended to wear tight-fitting goggles over the lenses to prevent water exposure.^3,10,11 If accidentally exposed to water, instill a lubricating drop to help loosen the lens on the eye then remove the lens with clean, dry hands. Next, clean and disinfect the lens before re-inserting, or discard the lens. Never sleep in a lens that has been exposed to water without first cleaning and disinfecting it.¹² If lenses are removed prior to swimming, they should be properly cleaned and disinfected before being re-inserted with clean, dry hands.³

1. Bennett ES, Wagner H. Lens care and patient education. In Bennett ES, Henvy VA. Clinical Manual of Contact Lenses (3rd ed.). Philadelphia, Lippincott Williams & Wilkins, 2009:139-166.
2. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/ContactLenses/ (Accessed May 2015).
3. Sweeney D, Holden B, Evans K, Ng V, Cho P. Best practice contact lens care: a review of the Asia Pacific Contact Lens Care Summit. Clin Exp Optom. 2009; 92(2):78-89.
4. CDC. Acanthamoeba Keratitis — Multiple States, 2005-2007. MMWR Morb Mortal Wkly Rep. 2007; 56(21):532-4.
5. Joslin CE, Tu EY, Shoff ME, Booton GC, Fuerst PA, McMahon TT, et. al. The association of contact lens solution use and Acanthamoeba keratitis. Am J Ophthalmol. 2007; 144(2):169-180.
6. Butcko V, McMahon TT, Joslin CE, Jones L. Microbial keratitis and the role of rub and rinsing. Eye Contact Lens. 2007; 33(6):421-3.
7. Chin J, et al. Acanthamoeba keratitis: 10-Year study at a tertiary eye care center in Hong Kong. Contact Lens Anterior Eye 2014: http://dx.doi.org/10.1016/j.clae.2014.11.146
8. Beattie TK, Tomlinson A, McFadyen AK. Attachment of Acanthamoeba to first- and second-generation silicone hydrogel contact lenses. Ophthalmology. 2006; 113(1):117-25.
9. Rice SA, van den Akker B, Pomati F, Roser D. A risk assessment of Pseudomonas aeruginosa in swimming pools: a review. J Water Health. 2012; 10(2):181-96.
10. Choo J, Vuu K, Bergenske P, Burnham K, Smythe J, Caroline P. Bacterial populations on silicone hydrogel contact lenses after swimming in a chlorinated pool. Optom Vis Sci. 2005: 82(2):134-7.
11. Wu YT, Tran J, Truong M, Harmis N, Zhu H, Stapleton F. Do swimming goggles limit microbial contamination of contact lenses? Optom Vis Sci. 2011; 88(4):456-60.
12. Stapleton F, Keay L, Jalbert I, Cole N. The epidemiology of contact lens related infiltrates. Optom Vis Sci. 2007; 84(4):257-72.

Is it safe for pregnant women to wear contact lenses?

Although pregnancy has been shown to result in many potential changes affecting the eye, contact lens wear during pregnancy is generally considered safe.^1,2 One subset of pregnant women, those who have acquired herpes simplex viral infection (HSV) of the eye, may have a mild increase in the risk of recurrence of the condition with contact lens wear.³

While contact lens wear is generally safe, hormonal changes in pregnancy may lead to an increase in nearsightedness causing blurred vision.⁴ In addition, decreased tolerance to contact lens wear has been reported during pregnancy.⁵ This may be related to a reported increase in dry eye experienced by pregnant women.⁶ Conflicting information exists regarding changes to the shape of the cornea during pregnancy.^7,8 Despite the variability in reports, there is reason to believe these changes may also contribute to contact lens discomfort during pregnancy.⁹

If you are pregnant and are experiencing vision fluctuations, it is best to visit your doctor of optometry to determine if a change to your contact lenses is necessary and also to rule out other causes for the vision changes.

1. Samra KA. The eye and visual system in pregnancy, what to expect? An in-depth review. Oman J Ophthalmol 2013; 6(2):87-91.
2. Mackensen F, Paulus WE, Max R, Ness T. Ocular changes during pregnancy. Dtsch Arztebl Int 2014; 111(33-34):567-75.
3. Reddy SV, Koffler BH. Relationship of contact lenses, pregnancy, and herpes simplex virus. CLAO J 2002; 28(2):105-6.
4. Sharma S, Rekha W, Sharma T, Downey G. Refractive issues in pregnancy. Aust N Z J Obstet Gynaecol 2006; 46(3):186-8.
5. Pilas-Pomykalska M, Czajkowskii J, Oszukowski P. Ocular changes during pregnancy. Ginekol Pol 2005; 76(8):655-60.
6. Schechter JE, Pidgeon M, Chang D, Fong Yc, Trousdale MD, Change N. Potential role of disrupted lacrimal acinar cells in dry eye during pregnancy. Adv Exp Med Biol 2002; 506(Pt A):153-7.
7. Efe YK, Ugurbas SC, Alpay A, Ugurbas SH. The course of corneal and intraocular pressure changes during pregnancy. Can J Ophthalmol 2012; 47(2):150-4.
8. Goldich Y, Cooper M, Barkana Y, Tovbin J, Lee Ovadia K, Avni I, et. al. Ocular anterior segment changes in pregnancy. J Cataract Refract Surg 2014; 40(11):1868-71.
9. Park SB, Lindahl KJ, Temnycky GO, Aquavella JV. The effect of pregnancy on corneal curvature. CLAO J 1992; 18(4):256-9.

At what age can children begin wearing contact lenses?

Contact lens wear has been shown to be a safe and effective method of vision correction in children.^{1,2,3,4,5,6,7,8,9} Contact lens wear in young children and early teens has been shown to result in less contact lens related complications when compared to older teens and young adults.^6,7 In addition, children and young teens display better compliance with prescribed wearing schedules than their older counterparts.⁸ While parental supervision is important to healthy and successful lens wear, children as young as years old have been able to demonstrate an independent ability to care for daily disposable contact lenses.10

Not only are contact lenses safe for adolescents, but they also result in better vision-related quality of life in children and teenagers. ¹¹ Contact lens wearing children report improvements in their perception of personal appearance, performance in recreational activities, and social acceptance.^11,12,13

In the setting of certain vision related conditions, infants as young as a few months old can be fit with contact lenses.¹⁴ Contact lenses have also been used to manage diseases of the cornea and other surface tissues of the eye in affected children.¹⁵

Many factors such as maturity, personal hygiene and motivation should be considered when deciding if contact lenses are right for your child.¹⁶ Since these factors vary from child to child, there is not one specific age when all children can begin wearing contact lenses.

1. Fan L, Jun J, Jia Q, Wangqing J, Xinjie M, Yi S. Clinical study of orthokeratology in young myopic adolescents. Int Contact Lens Clin 1999; 26(5):113-116.
2. Horner DG, Soni PS, Salmon TO, Swartz TS. Myopia progression in adolescent wearers of soft contact lenses and spectacles. Optom Vis Sci 1999; 76(7):476-9.
3. Walline JJ, Mutti DO, Jones LA, Rah MJ, Nichols KK, Watson R, et. al. The contact lens and myopia progression (CLAMP) study: design and baseline data. Optom Vis Sci 2001; 78(4):223-33.
4. Jones-Jordon LA, Walline JJ, Mutti DO, Rah MJ, Nichols KK, Nichols JJ, et. al. Gas permeable and soft contact lens wear in children. Optom Vis Sci 2010; 87(6):414-20.
5. Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, Guttierrez-Ortega R. Orthokeratology vs. spectacles: adverse events and discontinuations. Optom Vis Sci 2012; 89(8):1133-9.
6. Chalmers RL, Wagner H, Mitchell GL, Lam DY, Kinoshita BT, Jansen ME, et. al. Age and other risk factors for corneal infilitrative and inflammatory events in young soft contact lens wearers from the contact lens assessment in youth (CLAY) study. IOVS 2011; 52(9):6690-96.
7. Wagner H, Chalmers RL, Mitchell GL, Jansen ME, Kinoshita BT, Lam DY, et. al. Risk factors for interruption to soft contact lens wear in children and young adults. Optom Vis Sci 2011; 88(8):973-80.
8. Jansen ME, Chalmers R, Mitchell GL, Kinoshita BT, Lam DY, McMahon TT, et. al. Characterization of patients who report compliant and non-compliant overnight wear of soft contact lenses. Cont Lens Anterior Eye 2011; 34:229-35.
9. Sankaridurg P, Chen X, Naduvilath T, de la Jara PL, Lin Z, Li L, et. al. Adverse events during 2 years of daily wear of silicone hydrogels in children. Optom Vis Sci 2013; 90:961-9.
10. Walline JJ, Long S, Zadnik K. Daily disposable contact lens wear in myopic children. Optom Vis Sci 2004; 81(4):255-9.
11. Rah MJ, Walline JJ, Jones-Jordon LA, Sinnott LT, Jackson JM, Manny RE, et. al. Vision specific quality of life of pediatric contact lens wearers. Optom Vis Sci 2010; 87(8):560-6.
12. Walline JJ, Gaume A, Jones LA, Rah MJ, Manny RE, Berntsen DA, et. al. Benefits of contact lens wear for children and teens. Eye Contact Lens 2007; 33(6):317-21.
13. Walline JJ, Jones LA, Sinnott L, Chitkara M, Coffey B, Jackson JM, et. al. Randomized trial of the effect of contact lens wear on self-perception in children. Optom Vis Sci 2009; 86(3):222-32.
14. The Infant Aphakia Treatment Study Group. Comparison of contact lens and intraocular lens correction of monocular aphakia during infancy: a randomized clinical trial of HOTV optotype acuity at age 4.5 years and clinical findings at age 5 years. JAMA Ophthalmol 2014; 132(6):676-82.
15. Gungo I, Schor K, Rosenthal P, Jacobs DS. The boston scleral lens in the treatment of pediatric patients. J AAPOS 2008; 12(3):263-7.
16. Sindt CW. “Positive opinions about kids in contact lenses.” Contact Lens Spectrum 2011; 26(1).

Can I wear my friend's contact lenses? What if I clean them before I put them in?

Wearing contact lenses that were not prescribed to you by a licensed eye care professional is strongly discouraged. This includes wearing contact lenses that belong to a friend or family member. Contact lenses are medical devices regulated by the United States Food and Drug Administration (US FDA) and require a prescription from a health care provider.¹ It is imperative that you receive your fitting, follow-up, and lens care instructions through a qualified eye care professional.^2,3

When contact lenses are worn by someone other than the wearer for which they were prescribed, they might not fit appropriately, which can result in damage to the front surface of the eye.⁴ Additionally, you are placing yourself at increased risk of infection, even if the lenses are cleaned before wear. Numerous reports detail infections resulting in significant vision loss in individuals using contact lenses obtained from improper sources and used without medical supervision.^5,6,7 In addition, sharing contact lenses may result in an inappropriate vision correction causing you to experience blurred or strained vision.

1. Saviola JF, Hilmantel G, Rosenthal AR. The U. S. Food and Drug Administration’s role on contact lens development and safety. Eye Contact Lens 2003; 29(1S):S160-5.
2. Joint Statement from the American Academy of Optometry Section on Cornea, Contact Lenses and Refractive Technologies and the American Optometric Association Contact Lens and Cornea Section. “Concern regarding cosmetic “circle” contact lenses”: July 27, 2010.
3. Steinemann TL, Fletcher M, Bonny AE, Harvey RA, Hamlin D, Zloty D. Over-the-counter decorative contact lenses: cosmetic or medical devices? A Case Series. Eye Contact Lens 2005; 31(5):194-200.
4. Young G, Coleman S. Poorly fitting soft lenses affect ocular integrity. CLAO J 2001; 27(2):68-74.
5. Snyder RW, Brenner MB, Wiley L, Yee RW, Gradus MS, Mackman GS. Microbial keratitis associated with plano tinted contact lenses. CLAO J 1991; 17(4):252-5.
6. Singh S, Satani D, Patel A, Vhankade R. Colored cosmetic contact lenses: an unsafe trend in the younger generation. Cornea 2012; 31(7):777-9.
7. Young G, Young AGH, Lakkis C. Review of complications associated with contact lenses from unregulated sources of supply. Eye Contact Lens 2014; 40(1):58-64.

Are there any problems with wearing "circle lenses" or other tinted or colored contact lenses?

Wearing contact lenses that were not prescribed to you by a licensed eye care professional is strongly discouraged. This includes wearing “circle” or other tinted or colored contact lenses.1 Contact lenses are medical devices regulated by the United States Food and Drug Administration (US FDA) and require a prescription from a health care provider.² It is imperative that you receive your fitting, follow-up, and lens care instructions through a qualified eye care professional.^3,4 There is no such thing as an “over-the-counter” contact lens.

When contact lenses do not fit appropriately, they can result in damage to the front surface of the eye.⁵ Bacteria are more easily able to attach to cosmetic contact lenses than traditional clear lenses placing wearers at an increased risk of infection.⁶ There are numerous reports detailing infections resulting in significant vision loss in individuals using cosmetic contact lenses obtained from improper sources without medical supervision.^7,8,9,10 These infections include not only common infections and complications but also more rare sight-threatening condition such as Acanthamoeba keratitis or rare bacterial infections.^11,12,13 There are many prescription cosmetic contact lenses available through your doctor of optometry that have been shown to be safe when properly prescribed and monitored by an eye care professional.¹⁴ Consult your eye care provider to discuss healthy cosmetic contact lens options and to review the best strategies for care and handling of these lenses.

1. United States Food and Drug Administration - Consumer Health Information. “Improper use of decorative contact lenses may haunt you”. Updated 4/17/2011. Available: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048902.htm (Accessed May 2015).
2. Saviola JF, Hilmantel G, Rosenthal AR. The U. S. Food and Drug Administration’s role on contact lens development and safety. Eye Contact Lens 2003; 29(1S):S160-5.
3. Joint Statement from the American Academy of Optometry Section on Cornea, Contact Lenses and Refractive Technologies and the American Optometric Association Contact Lens and Cornea Section. “Concern regarding cosmetic “circle” contact lenses”: July 27, 2010.
4. Steinemann TL, Fletcher M, Bonny AE, Harvey RA, Hamlin D, Zloty D. Over-the-counter decorative contact lenses: cosmetic or medical devices? A Case Series. Eye Contact Lens 2005; 31(5):194-200.
5. Young G, Coleman S. Poorly fitting soft lenses affect ocular integrity. CLAO J 2001; 27(2):68-74.
6. Chan KY, Cho P, Boost M. Microbial adherence to cosmetic contact lenses. Cont Lens Anterior Eye 2014; 37:267-72.
7. Snyder RW, Brenner MB, Wiley L, Yee RW, Gradus MS, Mackman GS. Microbial keratitis associated with plano tinted contact lenses. CLAO J 1991; 17(4):252-5.
8. Singh S, Satani D, Patel A, Vhankade R. Colored cosmetic contact lenses: an unsafe trend in the younger generation. Cornea 2012; 31(7):777-9.
9. Young G, Young AGH, Lakkis C. Review of complications associated with contact lenses from unregulated sources of supply. Eye Contact Lens 2014; 40(1):58-64.
10. Fogel J, Zidile C. Contact lenses purchased over the internet place individuals potentially at risk for harmful eye care practices. Optometry 2008; 79(1):23-35.
11. Gagnon MR, Walter KA. A case of acanthamoeba keratitis as a result of a cosmetic contact lens. Eye Contact Lens 2006; 32(1):37-8.
12. Lee JS, Hahn TW, Choi SH, Yu HS, Lee JE. Acanthamoeba keratitis related to cosmetic contact lenses. Clin Experiment Ophthalmol 2007; 35(8):775-7.
13. Ray M, Lim DK. A rare polymicrobial keratitis involving chryseobacterium meningosepticum and delftia acidovorans in a cosmetic contact lens wearer. Eye Contact Lens 2013; 39(2):192-3.
14. Rah, MJ, Schafer J, Zhang L, Chan O, Roy L, Barr JT. A meta-analysis of studies on cosmetically tinted soft contact lenses. Clin Ophthalmol 2013; 7:2037-42.

Is a person who wears contact lenses more likely to suffer from computer vision problems? 

Computer use has been shown to cause feelings of eye strain, irritation, burning, and dryness.¹ Decreased blink rate and incomplete blinking have been observed in individuals viewing computer screens.^2,3 These factors likely contribute to end of day dryness reported by computer users.⁴

Individuals who wear contact lenses while using the computer report higher levels of dryness and irritation when compared to non-contact lens wearers.⁵ Discomfort may be most pronounced in those people who work at the computer for longer than four hours at a time.⁶

The use of lubricating eye drops designed for use with contact lenses has been shown to improve symptoms of dryness and improve tear stability.^7,8 It has also been demonstrated that individuals who properly replace their lenses as directed by their eye care provider report increased comfort versus those who wear their lenses longer than directed.⁹ These factors combined with general considerations such as taking frequent breaks while using the computer, maintaining a proper distance between yourself and the computer, and placing the computer screen below eye level may help you feel more comfortable while using the computer with and without your contact lenses.¹⁰

1. Yazici A, Sari ES, Sahin G, Kilic A, Cakmak H, Ayar O, et. al. Change in tear film characteristics in visual display terminal users. Eur J Ophthalmol 2015; 25(2):85-9.
2. Patel S, Henderson R, Bradley L, Galloway B, Hunter L. Effect of visual display unit use on blink rate and tear stability. Optom Vis Sci 1991; 68(11):888-92.
3. Schlote T, Kadner G, Freudenthaler N. Marked reduction and distinct patterns of eye blinking in patients with moderately dry eyes during video display terminal use. Graefes Arch Clin Exp Ophthalmol 2004; 242(4):306-12.
4. Himebaugh NL, Begley CG, Bradley A, Wilkingson JA. Blinking and tear break-up during four visual tasks. Optom Vis Sci 2009; 86(2):E106-14.
5. Jansen ME, Begley CG, Himebaugh NH, Port NL. Effect of contact lens wear and a near task on tear film break-up. Optom Vis Sci 2010; 87(5):350-7.
6. Kojima T, Ibrahim OMA, Wakamatsu T, Tsuyama A, Ogawa J, Matsumoto Y. The impact of contact lens wear and visual display terminal work on ocular surface and tear functions in office workers. Am J Ophthalmol 20011; 152(6):933-40.
7. Acosta MC, Gallar J, Belmonte C. The influence of eye solutions on blinking and ocular comfort at rest and during work at video display terminals. Exp Eye Res 1999; 68(6):663-9.
8. Calvao-Santos G, Borges C, Nunes S, Salgado-Borges J, Duarte L. Efficacy of 3 different artificial tears for the treatment of dry eye in frequent computer users and/or contact lens users. Eur J Ophthalmol 2011; 21(5):538-44.
9. Dumbleton K, Woods C, Jones L, Richter D, Fonn D. Comfort and vision with silicone hydrogel lenses: effect of compliance. Optom Vis Sci 2010; 87(6):421-5.
10. Agarwal S, Goel D, Sharma A. Evaluation of the factors which contribute to the ocular complaints in computer users. J Clin Diagn Res 2013; 7(2):331-5.

Is it safe to sleep in contact lenses?

Although many brands of contact lenses are approved by the United States Food and Drug Administration (US FDA) for wearing overnight, sleeping in lenses does increase the risk of eye infection by approximately five times.^1,2,3,4

Although newer generation silicone hydrogel lenses, which allow more oxygen through the lens to the eye, have not been found to significantly reduce the risk of infection with overnight wear, they have been shown to reduce the risk of other complications, such as corneal swelling.⁵ There are no published rates of infection with overnight wear of gas permeable (GP) lenses; however, it is generally agreed that infection rates are lower with these more rigid materials.^4,6

1. Cheng, Kam H., et al. "Incidence of contact-lens-associated microbial keratitis and its related morbidity." The Lancet 354.9174 (1999): 181-185.
2. Poggio, Eugene C., et al. "The incidence of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses." New England Journal of Medicine 321.12 (1989): 779-783.
3. Schein, Oliver D., et al. "The relative risk of ulcerative keratitis among users of daily-wear and extended-wear soft contact lenses." New England Journal of Medicine 321.12 (1989): 773-778.
4. Stapleton F, Keay L, Edwards K, Naduvilath T, Dart JK, Brian G, Holden BA. The incidence of contact lens-related microbial keratitis in Australia. Ophthalmology 2008;115:1655-62.
5. Steffen, Robert B., and Cristina M. Schnider. "The impact of silicone hydrogel materials on overnight corneal swelling." Eye & contact lens 33.3 (2007): 115-120.
6. American Academy of Optometry Section on Cornea, Contact Lenses and Refractive Technologies: Information for Eyecare Practitioners. Position Paper: “Continuous and Extended Wear Contact Lenses.” March 2008.

Is it okay to nap in my contact lenses for 20-30 minutes?

Some lenses on some patients may be safely worn for short naps. Ask your doctor of optometry if it is appropriate for you and your lens type.

The eye needs oxygen from the atmosphere to stay healthy. How much oxygen is needed varies from person to person. ¹Closing the eye, as when napping, reduces the amount of oxygen supplied to the eye, resulting in swelling of the cornea.^2,3 Additionally, contact lenses can further reduce this oxygen supply to the cornea, but some contact lens types are better than others at allowing oxygen through the lens to the eye.⁴

1. Quinn, T. G., and J. P. Schoessler. "Human corneal epithelial oxygen demand--population characteristics." American journal of optometry and physiological optics 61.6 (1984): 386-388.
2. Mertz, G. W. "Overnight swelling of the living human cornea." Optometry - Journal of the American Optometric Association 51.3 (1980): 211-214.
3. Read, Scott A., and Michael J. Collins. "Diurnal variation of corneal shape and thickness." Optometry & Vision Science 86.3 (2009): 170-180.
4. Hamano, Hikaru, et al. "Corneal thickness change induced by dozing while wearing hydrogel and silicone hydrogel lenses." Eye & Contact Lens 34.1 (2008): 56-60.

Are there any problems with wearing eye makeup with my contact lenses?

It is recommended that if you are a soft contact lens wearer, that you put on your lenses before applying your makeup. If you wear gas permeable (GP) lenses, you can put your makeup on first and then apply your lenses.¹

Some mascaras, especially solvent-based products, may lead to irritation of the skin around the eye.² Avoid eyelash-extending mascara, which contains fibers that can irritate the eyes. Keep false eyelash cement, perfume, and cologne away from contact lenses as they can cause damage to the lenses.¹

Application of eyeliner along the inside rim of the eyelid, behind the eyelashes, can lead to migration of makeup into the tear film. ^3,4 For this reason, eyeliner should always be placed below the lash line. Always remove your contact lenses before removing makeup.

1. American Optometric Association. “Contact Lenses and Cosmetics.” Available: http://www.aoa.org/patients-and-public/caring-for-your-vision/contact-lenses/contact-lenses-and-cosmetics?sso=y (Accessed May 2015).
2. Loden, M., and C. Wessman. "Mascaras may cause irritant contact dermatitis." International Journal of Cosmetic Science 24.5 (2002): 281-285.
3. Hunter, Morgan, et al. "Pilot Study of the Influence of Eyeliner Cosmetics on the Molecular Structure of Human Meibum." Ophthalmic Research 53.3 (2015): 131-135.
4. Ng, Alison, et al. "Migration of Cosmetic Products into the Tear Film." Eye & Contact Lens (2015).

Are there recommendations to help contact lens wearers who suffer from eye allergies, especially during peak allergy season?

Prescription allergy eye drops have been shown to improve contact lens wearing comfort during allergy season.¹ How long to wait after instilling a drop before applying your contact lenses can vary, depending on the medication and preservatives in the drop. The consensus of the medical community suggests drops should be instilled 10 to 15 minutes before the application of contact lenses or anytime after they are removed.^2,3,4 Allergy tablets taken by mouth can also help relieve allergy symptoms, but may also lead to increased eye dryness.⁵ Studies have also found that applying a new lens each day helps promote comfortable contact lens wear during allergy season.⁶ You may wish to discuss whether these daily disposable lenses are an option for you when you visit a doctor of optometry.

It is sometimes necessary to discontinue contact lens wear at the peak of allergy season, so it is always advisable to have a reliable pair of spectacles to wear in lieu of your contact lenses.

1. Nichols KK., et al. "Epinastine 0.05% ophthalmic solution in contact lens-wearing subjects with a history of allergic conjunctivitis." Eye & Contact Lens 35.1 (2009): 26-31.
2. Bennett ES, Watanabe RK, and Begley CG. "Preliminary Evaluation.” In: Clinical Manual of Contact Lenses. Bennett and Henry. (2009): 48-78.
3. Weisbarth RE, Henderson B. "Hydrogel Lens Care Regimens and Patient Education.” In: Clinical Manual of Contact Lenses. Bennett and Henry. (2005): 381-419.
4. Krohn J. "Treating Allergy in Contact Lens Patients." Contact Lens Spectrum 21.4 (2006): 26.
5. Ousler GW, et al. "An evaluation of the ocular drying effects of 2 systemic antihistamines: loratadine and cetirizine hydrochloride." Annals of Allergy, Asthma & Immunology 93.5 (2004): 460-464.
6. Stiegemeier MJ, and S Thomas. "Seasonal allergy relief with daily disposable lenses." Contact Lens Spectrum 16.4 (2001): 24-29.

Are contact lenses safe to wear in an industrial work environment?

The industrial work environment may present several hazards to the eye including, but not limited to exposure to harmful agents and mechanical trauma from projectiles. Despite these risks, contact lenses can be worn safely and may offer some protective benefit.

When working around toxic chemicals or vapors, a major concern is trapping harmful material underneath the lens and the inability to easily remove the lens from the eye. Studies have shown, however, that a contact lens may actually function as an additional barrier to the eye. ^1,2 When exposed to a toxic agent, the eye’s blink reflex causes the contact lens to form a tight seal, which reduces the amount of contact with the cornea. The contact lens can then be flushed out of the eye with proper irrigation. ³

Another popular concern is that a contact lens may fuse to the cornea when exposed to the ultraviolet (UV) radiation and thermal energy from arc welding. However, there have been no studies or case reports published in the literature that demonstrate a mechanism for this to be possible. Heat or thermal energy can cause a contact lens to partially dehydrate, but arc flashes do not reach levels high enough to completely evaporate the entire tear layer, which would be required for fusion.^1,4 Additionally, when wearing a welder’s shade number 10 tint, less than 0.0001% of ultraviolet radiation is transmitted, which further eliminates this risk.⁴

The general consensus of regulatory agencies and professional organizations, like the American Chemical Society and American Optometric Association, is that contact lenses alone cannot be considered protective equipment; however, when worn with approved safety eyewear they do not pose additional risk to the industrial worker. ^2,4

1. Tyhurst K, McNett R, Bennett E. The safety and efficacy of contact lens wear in the industrial and chemical workplace. Optometry 2007; 78:596-604.
2. Messana K. The last word on contacts. Occup Health Saf 2001;70: 68-70.
3. Blais BR. Contact lenses in industry: The ongoing discussion. Chem Health Safety 1997;4:22-6.
4. Nichols JJ, Good GW. “Contact lenses and the work environment.” Contact Lens Spectrum. November 2003. Available: http://www.clspectrum.com/articleviewer.aspx?articleID=12462 (Accessed May 2015).

Flood-Related Eye Care Precautions

When flooding occurs, the American Optometric Association (AOA) reminds consumers to be vigilant with eye protection and eye care, particularly for contact lens wearers. Flooding causes an increase in the incidence of water-borne pathogens. These pathogens-including amoeba, parasites, bacteria, and viruses can be dangerous to the eye and may lead to infections, other complications and even loss of sight. The AOA recommends that persons in flood areas with possible compromised water delivery systems pay attention to public messages about water safety/contamination, especially if using this water to wash hands for contact lens use.

Recommendations for contact lens wearers to avoid exposure to flood-related eye infections and complications

• Avoid contact with floodwaters. If contact cannot be avoided, remove contact lenses prior to exposure to water. If contact lenses are unavoidable, wear goggles.
• Don't assume treated tap water is safe. Avoid using tap water to wash or store contact lenses or contact lens cases.
• Always wash and dry hands before touching the eye or handling contact lenses. Use hand disinfectants frequently.
• Use only sterile products recommended by your doctor of optometry to clean and disinfect lenses. Saline solution and rewetting drops are not designed to disinfect lenses.
• Only fresh solution should be used to clean and store contact lenses. Never re-use old solution. The contact lens solution must be changed according to the manufacturer's recommendations, even if the lenses are not used daily.
• Rub and rinse the surface of the contact lens before storing using a Food and Drug Administration (FDA)-approved contact lens disinfecting solution.
• Store lenses in the proper lens storage case and replace the case at least every three months. Clean the case after each use by rubbing each well for at least 5 seconds, rinse with contact lens disinfecting solution, then wipe with a clean cloth. Store the case upside down with caps off between cleanings.
• Contact lens wearers who regularly sleep in contact lenses as prescribed should refrain from doing so if exposed to water
• Replace lenses using your doctor's prescribed schedule.
• Never put contact lenses in the mouth or moisten them with saliva, which is full of bacteria and a potential source of infection.
• Never use contacts that have not been prescribed by an eye doctor. Never wear lenses prescribed for another person. Contact lens wearing is not an option for everyone; consult with an doctor of optometry to see if contact lenses are an appropriate choice for vision correction.

Symptoms to Watch For

If you experience any of the following conditions, contact your doctor of optometry immediately:

• Red and irritated eyes lasting for an unusually long period of time after lens removal.
• Pain in and around the eyes especially if it progressively worsens.
• Increased sensitivity to light.
• Sudden blurred or fuzzy vision.
• Excessive eye tearing or discharge.