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Contact Lenses (cont.)

Prevention and Outlook

Wearing correct-fitting lenses, using the correct care regimen, and undergoing periodic follow-up examinations by the fitter should prevent most problems.

  • Cleanliness is essential. Do not handle contact lenses without first washing your hands. Contact-lens cases must be cleaned every day. They should be discarded and replaced periodically because they may serve as a culture medium for bacteria and fungi. Once a week they should be washed with hot water and allowed to air dry afterward.
  • Any contact lens wearer must follow the general rules of good hygiene. The wearer must also be motivated and mature enough to follow the instructions for avoidance of problems. For this reason, some fitters will not fit children.
    • Children must be evaluated on a case-by-case basis.
    • In young children (younger than 8-9 years of age), contact lenses are usually prescribed for medical reasons only. For example, after congenital cataract surgery, contact lenses offer essentially normal vision without the use of thick glasses. Parents assume the responsibility for the correct care and wearing of the lenses.
  • Different types of lenses have different care routines. In general, lens care involves rinsing of the lenses upon removal, cleaning the lenses, and storing them in a disinfecting solution. Homemade or non-contact-lens saline or solutions should never be used. Only use the solutions that are recommended.
    • The lenses should be worn and discarded as directed. If lenses are to be replaced on a scheduled basis (for example, daily, weekly), it is a false economy and dangerous to try to extend the lenses by replacing them less often.
    • The safest way to wear lenses is to wear them on a daily basis and discard them every day. This avoids the use of solutions and decreases handling. However, it is slightly more expensive, and daily disposable lenses are not available in all prescriptions.
    • Overnight wear of contact lenses is available for certain prescriptions. Although approved by the U.S. Food and Drug Administration (FDA), this is not believed to be safe by many fitters because of the increased rate of infections with extended wear.
  • Most complications may be eliminated by meticulous wear and care by the wearer and following instructions meticulously as well as getting follow-up examinations by the fitter.
    • It is essential to be examined by your ophthalmologist, optometrist, or other fitter at least once a year and more often if extended wear lenses are worn. Every examination should, at a minimum, include a history as to how the lenses are cared for and to find out if there are any problems. The vision should be checked with the contact lenses, and the lenses should be observed on the eye with the slit lamp. An evaluation of the vision with glasses (after removing the contact lenses) should also be performed.
    • The examination also includes an examination of the shape of the cornea. No distortion or changes should be present. The cornea, as well as the rest of the eye, should be evaluated and measured, along with an evaluation for the possible presence of any eye diseases, such as glaucoma or cataracts.

In most cases, contact-lens problems are managed with no permanent damage. Usually the patient may return to normal contact-lens use and care.

There is constant research being carried out to develop new lens materials and designs as well as new solutions for care. It is rare to switch a patient to a new lens unless there is a reason for it (for example, a patient may no longer tolerate his or her lenses but will be able to resume lens wear with a new lens type or solution).

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