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
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