Contact Lens Hygiene — How to Wear Contacts Safely
Why hygiene is the whole game
Contact lenses are worn safely by millions of people every day. The complications that do occur are not random: they cluster around a short list of behaviours, and nearly all of them are avoidable. The one that matters most is microbial keratitis, an infection of the cornea. It is uncommon, but it can be serious and it can permanently affect vision, which is why the unglamorous rules below are worth following exactly.
The rules that actually matter
Wash and dry your hands before you touch a lens. Soap and water, then dry them on a clean towel. Wet hands mean water near the lens, which leads straight to the next point.
No water, ever. This is the single most important rule. Never rinse lenses with tap water, never store them in water, never use water in the case, and do not wear lenses in the shower, the bath, a hot tub or a swimming pool. Tap water is not sterile, and it can carry organisms — Acanthamoeba in particular — that are far more dangerous to the cornea than anything on your hands. Contact lens solutions are formulated to be safe for the eye. Water is not.
If you swim, the practical approach is daily disposable lenses plus tight-fitting goggles, then throw the lenses away immediately afterwards. Rigid lenses are no safer in water.
Never sleep in your lenses. Not a nap, not "just until I get home". Overnight wear is one of the strongest risk factors for keratitis, because a closed eyelid reduces the oxygen reaching the cornea and holds organisms against it. The only exception is a lens specifically prescribed for extended or continuous wear, and even then the schedule is the one your practitioner set.
Do not top up the solution. Adding fresh solution to the old solution already sitting in the case is one of the most common habits and one of the worst. That old solution is not a preservative bath — by the end of the day it is contaminated. Tip it out, rinse the case with fresh solution, and refill. Never reuse solution, and never store lenses in a case you did not refill today.
Rub and rinse. Even with solutions labelled "no-rub", gently rubbing the lens with solution in your palm and then rinsing it removes significantly more biofilm than soaking alone. It takes a few seconds.
Replace on schedule, not on feel. A monthly lens expires a month after the package is opened, not after thirty wears. A two-weekly lens is two weeks. Lenses that still feel comfortable are not necessarily still clean or still passing oxygen properly, and stretching the schedule is a risk factor rather than a saving.
Replace the case every three months. Rinse it with fresh solution after each use — not water — and let it air-dry open and upside down on a clean tissue. A case that never dries grows biofilm.
Check the dates on your solution. Discard solution past its expiry, and follow the label on how long it keeps after opening. Do not decant solution into a travel bottle: the bottle is not sterile and the solution is no longer guaranteed.
Makeup order. Insert lenses first, then apply makeup. Remove lenses before you take makeup off. Waterproof mascara, and eyeliner applied inside the lash line, both raise the chance of debris getting under a lens.
Skip lenses when your eyes are unhappy. Red or irritated eyes, a stye, or a cold or flu are all reasons to wear glasses for a few days. Wearing lenses through an active infection or illness increases the risk of something worse.
Rigid gas permeable lenses
Hard and rigid lenses use a different care system. Never use soft lens solutions on them, and never use a rigid lens cleaner or wetting solution on soft lenses. Follow the regimen your practitioner gave you for that specific lens, and remember that rigid lenses should not be rinsed or stored in tap water either.
Warning signs: act now, not tomorrow
Remove the lens immediately and seek urgent eye care if you have:
- Pain in the eye, rather than simple discomfort
- Redness that persists after the lens is out
- Light sensitivity that is new or getting worse
- Discharge, or a white spot on the coloured part of the eye
- Blurred vision that does not clear when you blink or remove the lens
- A feeling that something is trapped under the lid and will not wash out
Keep the lens and the case and take them with you — it helps identify the organism if there is an infection. Do not simply switch to glasses and wait a few days to see whether it settles. Keratitis is treatable, and outcomes are far better when it is caught early.
Keep a pair of glasses current
Everyone who wears contact lenses should have glasses with an up-to-date prescription. It is your backup if a lens tears, your recovery option after an infection, and the sensible choice on days when your eyes are dry or irritated. A backup pair that is three prescriptions out of date is not a backup.
None of this is complicated, and it adds about thirty seconds to your day: clean hands, no water, fresh solution, replace on schedule, and never sleep in them. That is the difference between contact lens wear that stays comfortable for decades and the kind that ends with a trip to an eye clinic.