In today’s issue of Contact Lenses Today, optometrist and contact lens specialist Morris Lehrfeld, OD, shares the following tips he gives to his patients to help keep their eyes healthy when wearing contact lenses:

1. Use only solutions prescribed by your eye doctor. Older and generic contact lens solutions can cause compatibility issues, especially with modern silicone hydrogel contacts, says Dr. Lehrfeld.
2. Use fresh contact lens solution every day. Many contact lens wearers are guilty of “topping off” the contact lens solution left in their lens case from the previous day. This reduces the effectiveness of the disinfection process, potentially leading to serious contact lens-related eye infections.
3. Replace your contact lens case at least every three months. Even with proper lens care, bacteria and other infection-causing agents can accumulate in contact lens cases over time. Routine replacement of your lens case can reduce the risk of contamination and eye infections.

Dr. Lehrfeld is an eye care provider at Palatine Vision Center, a group optometric practice in Palatine, Illinois. Contact Lenses Today is a weekly e-mail newsletter for eye doctors sponsored by the professional journal, Contact Lens Spectrum.

In this month’s issue of Contact Lens Spectrum, editor and contact lens specialist Jason J. Nichols, OD, warns that current economic conditions may be affecting how people are wearing and caring for their contact lenses.

Dr. Nichols says hard economic times can alter people’s behavior regarding their health, including how frequently they replace their contacts and how they use contact lens solutions.

“I am hearing more and more reports of patients looking for the cheapest ‘bottle’ on the shelf, which just happens to be saline rather than an appropriate care solution,” he says. Many contact lens wearers may also be using their lenses for longer periods of time rather than discarding and replacing them according to the schedule their optometrist or ophthalmologist recommends, according to Dr. Nichols.

Internet blogs and social networking sites may be contributing to the problem: some sites feature discussion boards where contact lens wearers report how they routinely wear their disposable contacts longer than recommended.

Dr. Nichols warns that poor contact lens habits frequently lead to contact lens-related eye infections, including severe infections like Acanthamoeba keratitis. He urges eye doctors to continue educating and re-educating their patients about proper contact lens wear and care.

In a related story published in the journal, a survey released by the American Optometric Association indicates 52 percent of consumers are visiting their eye doctor less frequently due to economic reasons. The same survey says 59 percent are visiting their primary care physician less frequently.

Silicone hydrogel contact lenses, even more than conventional soft contacts, require a rubbing step when cleaning and disinfecting the lenses with “no-rub” contact lens solutions, says a prominent contact lens specialist.

Michael A. Ward, MMSc, FAAO, instructor in ophthalmology at Emory University School of Medicine (Atlanta, Ga.) and director of Emory Eye Center‘s Contact Lens Service, says adding the manual cleaning step maximizes comfort, improves vision and reduces the risk of contact lens-related eye infections.

Researchers are finding that one-step (“no-rub”) contact lens solutions often do not completely remove environmental debris, skin oils and make-up from the surface of contact lenses. These lens deposits can cause eye discomfort and vision problems, and may also decrease the effectiveness of lens disinfectants and lead to serious problems, including bacterial and fungal eye infections and Acanthamoeba keratitis.

Silicone hydrogel lenses, which allow more oxygen to reach the cornea than regular soft contacts, are as likely as regular soft lenses to accumulate lens deposits if they are not properly cleaned and disinfected after each wearing period.

If patients at Emory Contact Lens Service are not compliant with a rub-and-rinse lens care regimen and lens deposits are noted, switching to a hydrogen peroxide-based lens care system often solves the problem, Ward told online newsletter Contact Lenses Today (Oct 22).

Another option for people who are prone to contact lens deposits or fail to care for their lenses properly is to switch to daily disposable contacts, which are designed to be discarded after a single use.

New research shows several strains of bacteria can form biofilms on contact lenses, making the microbes more resistant to lens disinfection with contact lens solutions. In the September 2009 issue of the medical journal Cornea, researchers reported the results of a recent study of bacterial biofilms grown on silicone hydrogel contacts.

The researchers designed a study to determine if three types of bacteria associated with contact lens-related eye infections (Pseudomonas aeruginosa, Serratia marcescens and Staphylococcus aureus) form biofilms on silicone hydrogel contacts, and what effect this might have on the ability of contact lens solutions to effectively disinfect contacts.

Biofilms are collections or aggregates of microorganisms that adhere to a surface (such as a contact lens or contact lens storage case) and to components of the biofilm itself.

The researchers found that all three types of bacteria studied form biofilms on silicone hydrogel contact lenses. When examined microscopically, the biofilms consisted of dense networks of cells arranged in multiple layers, forming a matrix with extracellular material.

The study also demonstrated that the biofilms formed by these bacteria decreased the disinfecting effectiveness of common multipurpose contact lens solutions.

This research confirms the importance of proper contact lens care and scheduled replacement of disposable contacts to decrease the build-up of bacterial biofilms on contact lenses that may increase the risk of contact lens-related eye infections.

You can learn more about contact lens biofilms here.

What is the best method for cleaning and disinfecting your contact lenses?

In a recent issue of Contact Lens Spectrum, two prominent researchers addressed this issue in a point-counterpoint debate.

Charlotte Joslin, OD, PhD, epidemiologist and assistant professor of ophthalmology and visual sciences at the University of Illinois at Chicago, prefers hydrogen peroxide-based contact lens solutions. She says that a recent study found that only a two-step hydrogen peroxide lens care system was effective against a microorganism that can cause a serious eye infection called acanthamoeba keratitis.

In addition to being proven effective against Acanthamoeba organisms, two-step hydrogen peroxide-based (HPB) contact lens care solutions also are the most effective against bacterial and fungal eye infections, according to Dr. Joslin. She also said that there have been two worldwide recalls of (non-hydrogen peroxide) multipurpose contact lens solutions due to outbreaks of amoeba and fungal eye infections associated with the use of these one-step solutions.

Dr. Joslin’s argument was countered by Craig A. Woods, PhD, research manager at the Centre for Contact Lens Research, School of Optometry, University of Waterloo (Ontario, Canada).

Dr Woods believes multipurpose contact lens care solutions offer the best combination of safety, cost and effectiveness.

He says that one-step (“no rub”) multipurpose solutions are less expensive and easier to use than HPB disinfecting solutions, and contact lens wearers are more likely to use them properly. He says that there have been “only rare reports” of complications associated with multipurpose solutions, and that they are proven safe and effective.

Dr. Woods also says that hydrogen peroxide-based lens care systems require contacts to be exposed to the hydrogen peroxide solution for a significant amount of time, and that single-step HPB systems may not allow sufficient time for complete disinfection.

He says that while the recent outbreaks of eye infections that caused global recalls of certain multipurpose care solutions were “horrendous for the individuals involved,” he believes these were isolated incidents and not representative of the overall performance of multipurpose disinfecting solutions.

The full point-counterpoint discussion of contact lens care solutions featuring Drs. Joslin and Woods appears in the June 2009 issue of Contact Lens Spectrum.

Rinsing silicone hydrogel contact lenses with an approved contact lens solution after removing them from the eye removes more than half the protein that accumulates on the lenses, according to a new study.

Researchers at The Ohio State University College of Optometry found that rinsing silicone hydrogel contacts thoroughly as part of a “no rub” lens care system removes protein deposits from the lenses significantly better than foregoing the rinse step.

Subjects participating in the study were fit with silicone hydrogel lenses manufactured by CIBA Vision and then wore the lenses on a daily wear basis for five days. They were instructed to use Aquify Multi-Purpose Disinfecting Solution (CIBA Vision) after each day of wear, following the manufacturer’s “no rub” care instructions.

The study participants then returned to the clinic and their lenses were removed by a gloved examiner. One lens was rinsed with the contact lens care solution and the other was not. Protein was then chemically removed from all lenses and quantified.

More than 50 percent more protein was chemically extracted from the lenses that did not undergo the rinse step after removal from the eye.

The results of the study suggest silicone hydrogel lenses have significantly less protein build-up if they are thoroughly rinsed with a multi-purpose contact lens care solution when removed from the eye. Including this rinse step as part of a “no rub” care system therefore may decrease the risk of contact lens discomfort and contact lens-related eye infections.

A full report of the study appears in the August 2009 issue of Optometry and Vision Science.

Bausch & Lomb Vision Care announced last month it has introduced two new contact lens solutions as part of a rebranding of its lens care products.

ReNu Fresh Lens Comfort (formerly ReNu MultiPlus) contains Hydranate, an ingredient designed to remove protein deposits from soft contacts; poloxamine, an ingredient designed to remove dirt and debris while enhancing lens wettability and moisture retention; and Dymed, a disinfecting agent.

ReNu Sensitive Eyes (formerly ReNu Multipurpose solution) contains fewer ingredients and is designed to be gentle on sensitive eyes without sacrificing a high level of contact lens cleaning and disinfection, the company says.

In May 2006, Bausch & Lomb voluntarily withdrew its ReNu with MoistureLoc contact lens solution from the market because the product was associated with fungal eye infections.

More information about ReNu Fresh Lens Comfort and ReNu Sensitive Eyes can be found at Bausch & Lomb’s ReNu website.

A new investigation finds that some contact lens solutions do not provide protection from Acanthamoeba — a free-living organism commonly found in soil, freshwater lakes and streams, seawater, tap water and hot tubs — that can cause a painful vision-threatening form of keratitis.

In 2007, a multi-state outbreak of Acanthamoeba keratitis led to an investigation by the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services. The investigators found an association with the use of Complete MoisturePlus multipurpose contact lens solution, manufactured by Abbott Medical Optics (formerly Advanced Medical Optics), which has since been withdrawn from the market.

Recently, researchers at CDC compared 11 different contact lens solutions for their ability to kill three Acanthamoeba species associated with the 2007 outbreak. Of the 11 solutions tested, only the two containing hydrogen peroxide showed any disinfection ability for cysts of two of the three Acanthamoeba species.

The researchers said a “systematic method for evaluating contact lens solutions will reduce the chance that inefficacious solutions are available.”

The study was reported in the July 2009 issue of the Journal of Clinical Microbiology.

Researchers at the University of California, Los Angeles (UCLA) recently performed an analysis of the types and prevalence of contact lens-related complications among patients seen in the university’s clinic.

Of the 846 eyes of 572 contact lens wearers evaluated in the study, approximately 50 percent of eyes had at least one contact lens-related complication, the researchers said. Among the findings of the study:

• Rigid gas permeable contacts had a statistically lower average number of complications than soft contact lenses.
• Conjunctival papillae and giant papillary conjunctivitis were the most prevalent complications among both gas permeable (GP) and soft contact lens wearers.
• Silicone hydrogel contact lenses had a slightly lower (though not statistically significant) rate of complications than regular soft lenses.
• Extended wear contacts had a slightly higher complication rate compared with daily wear lenses.
• Use of contact lens solutions not recommended by the wearer’s eye doctor — including generic and private label solutions — was associated with the highest rate of complications for both GP and soft contact lenses.

Conjunctival papillae are bumpy lesions on the inner surface of the eyelids that can affect contact lens comfort. Giant papillary conjunctivitis (GPC) is an allergic inflammation of these papillae characterized by redness, itching and contact lens intolerance.

The researchers said the significant prevalence of contact lens-related complications identified by this study — regardless of lens design, material and wearing schedule — highlights the importance of routine professional eye care for all contact lens wearers.

The full report of the study appears in the July 2009 issue of Eye & Contact Lens: Science and Clinical Practice.

New SofLens daily disposable contact lenses by Bausch & Lomb offer the benefits of daily disposable contacts and an advanced optical design, according to the company. The new lenses feature Bausch & Lomb’s proprietary High Definition Optics, which is designed to reduce blur, halos and glare for optimal vision.

SofLens daily disposable contact lenses also feature a thin lens design and slow-release moisture formula for all-day comfort, which is key for sensitive eyes, the company says. As with all daily disposable lenses, contact lens care is unnecessary and there is less risk of lens deposit build-up, which can lead to eye infections.

For a free trial of SofLens daily disposable lenses and a High Definition Optics lens demo, visit www.soflens.com.

In an effort to improve contact lens safety, the U.S. Food and Drug Administration (FDA) has added new information on its website about the proper use of contact lens solutions.

The new FDA Web page contains a number of dos and don’ts for contact lens wearers, and emphasizes the need to rinse and empty contact lens storage cases after each use. Failure to do so increases the risk of eye infections — including bacterial and fungal eye infections that can cause permanent vision loss.

The FDA also has developed a new video on contact lens safety, which explains the components of proper contact lens care. The video and new Web page stress that for superior lens cleaning and to lower the risk of eye infections, consumers should use a rub-and-rinse cleaning method, even if they use “no-rub” multipurpose lens care products.

The new LensAlert Contact Lens Care Kit Value Wheel makes it easy to remember when your contact lenses and lens case need to be replaced.

With the LensAlert timer, you can set two separate countdowns for your contacts and case. The display flashes “0” when it’s time for a change. Seven, colorful lens cases are also included in the kit.

Following a replacement schedule is important to reduce your risk for eye infections. The replacement schedule for your contact lenses is specified by your eye doctor.

Typically cases should be replaced at least every three months, although some doctors recommend once a month. If used for too long, lens cases can become hotbeds for bacteria and fungi.

The kit can be purchased online or at optical stores and retail outlets.