With the introduction of so many new types of contact lenses and millions of Americans wearing them, there has been a dramatic increase in the number of eye health problems with contact lens wearers. Contact lenses are now available for high amounts of nearsightedness, farsightedness, astigmatism, prism, bifocal and multifocals, disposable and conventional, hard, gas permeable and soft, all in a full array of colors. To most consumers, it is overwhelming and they must rely on their eye doctor’s recommendation on which one is best for them. The problem begins when these individuals leave the doctor’s office and must now fend for themselves. Here are some simple rules that can prevent that expensive and often painful return to the office or the emergency room in the middle of the night.

All contact lenses, even the best ones will result in corneal swelling when worn. The most common problem faced by patients is the result of this swelling. When a cornea, the clear part in front of the eye, swells, the bonds between the cells spreads apart creating an easy entrance point for micro-organisms like bacteria and viruses. These openings frequently result in infections and ulcers that have the potential of causing reduced vision and even scarring. In addition, this swelling disrupts the very specific arrangement that the cells are in causing haziness and glare in one’s vision. Many contact lens patients complain that they see haloes at night and are very sensitive to light and air in the evenings. These symptoms are indicative of corneal swelling. The answer is obvious. Reduce the number of hours of wear and the problem is solved. A good wearing schedule is about 12 hours per day. That gives the eyes time while you are awake to breath with out a contact lens in. Even the newest silicone based contacts reduce oxygen flow to the eye and the best way to let the eye heal, is to take the lens off. As a general statement, I will even go so far as to say that no one should sleep in any contact lens. That always results in excessive corneal swelling which leads to the red, painful eyes that we all dislike so much. So, rule number one is to limit the hours of wear.

Next comes common sense. Contact lenses should always be comfortable. If when wearing a lens it becomes uncomfortable or the eye gets red, the vision becomes hazy or it begins to move too much, then remove it. Try cleaning it and reinserting it. If the symptoms persist, then do not wear the lens and see your eye doctor. Most problems are eliminated by simply taking the lens off. If there is damage to the lens, there is something under it or the eye is irritated, taking the lens off will solve the problem. Keeping it in will always result in bad thins happening to the eye. During allergy season when the eyes get red and itchy, limit wear to a comfortable number of hours and see your eye doctor for an allergy prescription for Patanol or Zaditor. They will dramatically increase you wearing comfort.

If under normal conditions, a contact lens results in a red ring around the eye that means that the lens it too tight and must be removed. Perhaps it is drying out or simply does not fit. Return to the eye doctor for a new type of lens. Conversely, if a lens moves too much and slides all over the eye, it is too loose, and should also be refit.

Finally, we come to contact lens solutions. Most of the multipurpose solutions are very similar, but there are differences. If you are using one and your eyes itch, then you are allergic to something in it and you must change. The least allergic type is a Hydrogen peroxide system like Ciba vision’s AOSept. It breaks down to water and there for can not create any allergies. On the multipurpose side, Alcon’s Optifree is very good because the preservative is a very large molecule that can not penetrate the contact lens matrix. There fore it washes out of the eye moments after the lens is inserted. All other single step systems have preservatives that can impregnate the lens and thus will be in contact with the eye for an extended period of time resulting in a reaction. The best saline available is Unisol. It has a Ph of 7.4 which is exactly what our eyes are and there for will sooth even the angriest of eyes. Soaking contact lenses in that will increase comfort as well. It goes with out saying that hands should always be clean before touching a lens and should be free of any oils or perfumes. Anything that gets on your hand will contaminate the lens. Lenses should never go in a mouth, glass of water or a close, warm, personal friends eyes either.

If you follow these simple recommendations, most contact lens related eye problems will be eliminated. Anything that still occurs should result in a visit to your eye doctor.

This article was authored by: Dr. Jay B Stockman, a practicing partner at New York Vision Associates Inc in NYC, a senior examiner for the National Board of Examiners in Optometry, and former Clinical teaching assistant at the Boston Eye Clinic in Boston, Mass.