ALSALAMA EYE HOSPITAL

CARE AND MAINTENANCE OF CONTACT LENS

Most of the complications with contact lens are because of the poor compliance and improper usage of the care system.

Clean the lens Prevent/ minimize deposits Maintain wettability for comfort and clear vision.

Disinfect lenses to prevent ocular

Inflammation.

Irritation and reduced comfort

Reduced visual acuity Shortened lens life Increased potential for infection

Increased incidence of GPC

Clean • Rinse • DisinfectExtra Steps: • Protein removal • Lubricating / re-wetting drops

Surfactants

• Buffers

• Osmolality adjusting agent(s)

• Preservatives

• Water

Remove deposits by:

- interacting with deposits

- displacing deposits from lens surface

• Emulsify oils and lipids

• Destroy/dislodge micro-organisms

• Prepare lens for rinsing and disinfection

Daily cleaners

Weekly cleaners

Proper cleaning removes 90% of

organisms.

Mostly contains surfactants,viscocity

agent Buffering agent ,preservatives

Enzymatic cleanersEffectively remove protein deposits

Have no effect on most other

deposits React by breaking proteins into smaller molecules

Derived from papaya plant Binds to contact lens materials and can cause sensitivity reactions

Short 15 minute soaking time

possible

• Pig pancreas derivative

• Cleaning efficacy similar to

papain

• Derived from Bacillus bacteria• Low toxicity, used in food products• Less specific binding characteristics

• May be more effective than papain

Removal of loosened lens contaminants

• Removal of residual cleaner

• Rehydrate lens

• Dissolve enzyme tabs

Isotonic

• Buffered

• pH similar to ocular environment

Micro-organism can attach to deposits

Use Thermal & chemical disinfection systems

Soaking time 4 hours to overnight or as

recommended

• Preservatives incorporated

• Thermal (heat)

• Chemical

◦ - conventional

◦ - polymeric

◦ - tablet

• Hydrogen peroxide

Original form of disinfection.

High temperatures kill micro-organisms by:

◦ • Denaturation of cell components

◦ • Disruption of plasma membranes

◦ • DNA damage

Clean and rinse lenses

Place lenses in fresh saline in lens case

Secure lid(s) and place lens case in thermal

disinfecting unit

After heat cycle allow lenses to cool before

use.

• Thimerosal

• Chlorhexidine

• Sorbic Acid

• ATAC

• Isopropyl alcohol

• One-bottle system (OBS)

• Combination of cleaning, disinfecting and soaking functions

• Convenient

• Also known as conditioning solutions

• Functions - disinfection - wetting - storage

Composition:• Antimicrobial agents(s)• Wetting agent• Viscosity-enhancing agent• Buffer system• Salts(s)

Used regularly, after the daily cleaner and rinsing step.

• Lenses should be soaked in enzyme dissolved in solution/saline for 15mins to overnight, depending on manufacturer

• Lenses should be thoroughly rubbed and rinsed again afterwards

Improve the wetting characteristics of thelens surface:

• Convert hydrophobic surface to hydrophilic

• Assist tear film to spread more easily and

evenly on lens surface

• Increase comfort on insertion

Non wetting areas can be due to: • Deposits • Manufacturing process • Polishing compounds • Surface combination

Used during lens wear to: Increase comfort Clean lens surface Maintain lens wettability

Other common solution ingredients:

• Viscosity-enhancing agent(s)

• Buffer(s) - PH

• Osmolality-adjusting agents(s)

Solution toxicity: rare

• Punctuate corneal staining: uncommon

• Viscous solution:

- blurry/fluctuating vision on lens insertion

- may leave residue on lashes

Replace lenses at least annually

Residual deposits can irritate lids, especially the upper lids

Before dispensing:

• Clean and soak lenses overnight

• Verify lenses• Check wettability

Clean with alcohol-based cleaner immediately

after use Place in clean vial (suspending lens if possible)

Wet-store in disinfecting/storage conditioning

solution when not in use (change regularly)

lenses easier to care for

Clean, Rinse And Disinfectant Lenses Every time (CRADLE)

Scrub with a new toothbrush and CL cleaning solution weekly

Rinse with saline or disinfecting solution

Air dry upside-down Replace regularly

Do not mix solution types and brandsReview patient compliance Ask patient to repeat instruction and demonstrate technique and procedure

Observe recommend storage conditions