The look I get when I tell people I had an ulcer on my eye makes it ALMOST worth it
June 2, 2010 12:23 PM   Subscribe

After a bad experience I am finally ready to wear contact lenses again... but this time I want to be absolutely, totally, 100% safe and sterile about it. What steps should I take to minimize my chances of infection?

For years I wore the type of lenses which are (supposedly) fine to leave in for a month at a time. You wear them for a month, throw them away, ta-da. I had no issues until January, when (at the very end of the month) I developed irritation in my right eye. After a day (still wearing the lens) my eye was bright red and very painful and my pupil was the size of a pinhead. Bright light was unbearable.

I took the lens out and went to the doctor. They said I had an ulcer on my iris, that if I had waited another day or two I probably would have lost most or all vision in the eye, and that I was "still not out of the woods" and might still lose my vision. Oh, did I mention that this is my right eye, the eye I had recurring nightmares about losing for years previous to this event?

Well, medicated eye drops cleared it all up within a few days. They said, wait a month, then you can wear contacts again- just take them out every night without fail. I asked if I could use the monthly ones if I took them out at night (because I have $200 worth sitting around in an unreturnable box). They said sure, just make sure your lens case is clean, replace it often, don't touch the tip of the solution bottle, etc.

Well, it's June and I still haven't started wearing them again, because I was so freaked out by what happened. But now I'm ready. I think.

So I want the best practices for contact lenses- no matter how extreme. If I have to throw out my lens case every week I'll do it, wear gloves, whatever. Tell me what I can do to be absolutely safe here.

(BTW- my doctor was a medical student who has since moved on, so I can't really contact her and ask her.)
posted by showbiz_liz to Health & Fitness (31 answers total) 10 users marked this as a favorite
Are the 1-day disposable contacts not an option for you for some reason? Seems like the most obvious answer and you don't mention it at all...
posted by Perplexity at 12:26 PM on June 2, 2010

Response by poster: I have already spent $200 on the ones I have, and I can't return them. Since the doctor said it was fine to use the ones I have, I figured it would be fine. But if everyone tells me I'm being an idiot, I will just consider it money wasted and go get one-days.
posted by showbiz_liz at 12:29 PM on June 2, 2010

IANAED, but I have worn contacts for 30+ years. I've had cornea ulcers as well.

1) Wash your hands.
2) You want daily wear lenses, meaning you take them out every night before bed. Long term use lenses are super thin and harder to put on/off.
3) Wash your hands.
4) Never sleep in contacts.
5) Wash your hands.
6) Use lubricant drops in your eyes during the day.
7) Wash your hands.
8) If your eyes feel tired, take out your contacts.

Did I mention to wash you hands well before handling your case, lenses, or touching your eye?

Good luck!
posted by Argyle at 12:31 PM on June 2, 2010

My eye doctor recommends a combination of the ClearCare cleaning system plus saline solution for rewetting over the all-in-one solutions like Optifree. I use Target's generic version and in my experience it's true -- they feel a lot cleaner and more comfortable since I switched.
posted by susanvance at 12:46 PM on June 2, 2010

Oh boy. I wear Acuvue 1-a-day. Except they're costly, and so I don't wear them unless I have special occasions.
posted by dustoff at 12:50 PM on June 2, 2010

Wow creepy - just this last week this very same thing happened to me. I'm back in glasses for now, fearing that I will damage my vision permanently. I tossed the contacts thinking that they were contaminated somehow, since it happened after I switched to a new set (I use disposable monthlies). It happened a few weeks back and I went off contacts for a few days, then it happened again so I'm sticking to glasses for a bit while I wait for the new ones to arrive.
posted by msbutah at 12:51 PM on June 2, 2010

I have already spent $200 on the ones I have, and I can't return them... I want the best practices for contact lenses- no matter how extreme. Tell me what I can do to be absolutely safe here.

Items owned (A) is incompatible with desired goal (B). If you want to absolutely minimise the risk of infection and are willing to sacrifice cash and convenience to get there, get one-days.
posted by DarlingBri at 12:51 PM on June 2, 2010

I use "monthlies" as well, but I have always taken them out every night. Although it is kind of a pain, I recently started using a different kind of cleaning and disinfecting solution. It has bright red warnings all over the bottle stating that you 1) cannot squirt it into your eye as a re-wetting drop 2) cannot use it with typical contact cases and 3) must wait 6 hours after you start soaking the lenses in their special case to allow the solution to neutralize.

Let me tell you that you want to heed these warnings. This stuff burns unlike anything else when used improperly.

However, my lenses feel fantastic all day long, my eyes are consistently less tired, and I feel a marked difference in comfort compared to more typical contact solutions.

I am sure there are other comparable products. This happens to be the one I use. This is the case it comes with, which I find easier to keep clean than the flat cases with lids.

(I assume you're talking about soft lenses right?)
posted by juliplease at 12:51 PM on June 2, 2010 [1 favorite]

You should find out if you have an allergy to your solution. I have, over the years, become allergic to particular brands of contact lenses and different solutions, and I am not the only person I know that this has happened to.

I would second ClearCare (a friend uses the same) and REGULAR, PLAIN saline. Something like Unisol. No preservatives, nothing fancy, nada - JUST saline.

Other than that, wash your hands, don't touch the tip of the bottle, all that stuff from above. But, if you feel any discomfort and you are using the ClearCare and Unisol, be aware that you may be allergic to your contact lenses, and you will have to replace them. You're just allergic to whatever they're made out of, not all contact lenses ever, don't panic. Just take your supply with you to the ophthalmologist/optometrist, and if the lenses are still in good condition, they can probably trade them in with their rep or use them as samples (and hence, trade with you for $200 of new lenses).
posted by Medieval Maven at 12:56 PM on June 2, 2010 [1 favorite]

Totally agree with everyone about Clear Care. I had a problem with my lenses about a year ago just from being dumb and not taking them out consistently at night. My doctor said Clear Care was the way to go. He also told me if I didn't start taking my lenses out at night the infection wasn't going away and I would damage my eyes irreversibly. That was enough for me! So the lenses come out every night and go straight into the Clear Care. No problems since and my lenses feel so nice all the time. FWIW, I wear Acuvue Oasys and I change to a new pair about once a week.
posted by fresh-rn at 1:01 PM on June 2, 2010

You probably never do this, but don't rewet them in your mouth. Apparently this is a (gross, awful, nasty) thing people have been known to do, and it's really not okay.
posted by fairytale of los angeles at 1:04 PM on June 2, 2010

Nthing Clear Care. After a second optometrist recommended them, I switched over from my generic saline solution, and couldn't believe the difference. All my eye irritation and discomfort vanished, and I didn't have to do my daily ritual of sitting in a dark room for five minutes after putting my contacts in.

I think the hydrogen peroxide that's used in Clear Care will help alleviate your concerns about infection/contamination, too.
posted by punchtothehead at 1:14 PM on June 2, 2010

I was one of the original guinea pigs for soft lenses - I started wearing them in around 1974, back when we had to mix our own saline, boil the lenses every night to disinfect, and walk 3 miles in the snow, uphill both ways, to buy the distilled water to make the saline solution with. Ok, just kidding about the last part, but it really was a pain in the butt back then! No one knew about the potential for protein buildup on the lenses, and I was one of the reasons they found out about it. I had a corneal ulcer in about 1983, and ended up with scar tissue on my cornea.

Protein deposits on the lenses lead to irritation; irritation leads to you rubbing your eyes; rubbing your eyes leads to infection; infection leads to corneal ulcer.

I still wear contacts every single day, and I wear the monthly lenses, but I take them out every night. I'm fastidious about washing my hands before touching them, and I also heartily recommend Clear Care; it does a great job of keeping down protein deposits. (It's basically hydrogen peroxide, which eats protein. That's why hydrogen peroxide is used to remove blood stains.) I haven't had any problems with my lenses or eyes since they came out with products to remove the protein build up. But if I do feel any irritation in my eyes, I take out the lenses and rinse them with saline, and I make a point of not rubbing my eyes. That corneal ulcer hurt far worse than giving birth to my 9 lb., 4 oz. daughter did, and I never want to go through it again!
posted by MexicanYenta at 1:16 PM on June 2, 2010

I have the daily disposables and love them, and it does seem to me to be the most surefire way of preventing infection.

If you were using the lenses as directed, as it seems you were, and were injured by them, do you think the manufacturer might be willing to do a refund? I mean, it seems to me they could be sued for this, so maybe they'd be happy to give you your $200 back.
posted by palliser at 1:21 PM on June 2, 2010

I wear extended wear lenses (silicone hydrogel) as daily wear (take them out when I sleep) lenses. I've read that ulcers are slightly more common among people who sleep with the contact lenses in, extended wear or no, and I'm very wary of my eye health. (My old optometrist was approving, my current optometrist said well, yes and no -- it lets in more oxygen, but some people find them more uncomfortable because of how they wet.) So there's nothing wrong with wearing them as daily wear.

I do use that no-rub Renu, and I haven't had problems. If you follow the instructions on the bottle, I think you'll be OK.
posted by Comrade_robot at 1:25 PM on June 2, 2010

I wore soft contacts every day for about 10 years, and I never had a problem with infection (mind you, I started in 7th grade!). I never slept with them (except for on a car trip or whatever), and wasn't tempted to because my eyes would be very dry upon waking up. I think you need to just bite the bullet and try wearing them again.

One thing that can get easily contaminated is your cleaning solution. Make sure you always put the cap back on! I also like to buy smaller bottles (not the giant Costo-sized ones) so that I replace them more often. I also get a new case every time I get a new pair of lenses.

I started out with one-a-day lenses, and they were awesome. How long has it been since you've had a complete eye exam (with your vision tested)? If you're due for one, you could go to an ophthalmologist or optometrist, get your eyes tested, and ask for some samples of one-a-days. If you told him your whole situation, he might even take pity on you and give you a bunch of samples. Then maybe you could ease back to wearing the regular ones.

I also think that the moral of the story is that if you think there is a problem with your eye, RUN don't walk to the doctor! And take your lenses out immediately.
posted by radioamy at 1:40 PM on June 2, 2010

1. Always wash your hands before dealing with contacts
2. in addition to not touching the nozzle ofthe solution bottle, put the cap on it when not in use
3. no sleeping in contacts, not even for a 20 minute nap
4. use rewetting drops throughout the day
5. keep supplies where ever you are in a day - so some in the bathroom, some on your nightstand (so you dont need to walk to teh bathroom to take them out if your about to pass out), some at your work desk, etc.

For me personally, I have learned to carry around a case filled with solution so that if I need to take out my contacts for a bit or if I'm not going to be home for 16 hours I can give my eyes a rest. My doctor recommends not wearing contacts for more than 12 hours at a time, if possible. I don't know the basis for that but after 12 hours, my eyes do feel a bit worn.

This clear care stuff sounds interesting, I'll have to try it.
posted by WeekendJen at 1:41 PM on June 2, 2010

Oh I also commit the sin of never throwing away a contact lens case, but i do boil them before reusing them and rotate every month or so. also, replace your contacts on time. Mine are supposed to be replaced every 2 weeks and sometimes I would try to stretch them out for a month, but they would become unbearable.
posted by WeekendJen at 1:43 PM on June 2, 2010

Just throwing my support behind the following:

1) clean hands (most important!)
2) ClearCare (best solution I have found)
3) plain old saline solution

I think the extra step of using the saline to rub the lenses clean before using the ClearCare is going to really prevent you from having another bad experience. But first make sure to wash your hands!
posted by rageear at 1:46 PM on June 2, 2010

Shouldn't you be able to return to whatever practice you visited (that has your records) and see someone there if you have more questions?

Make sure you have a regular optometrist whom you trust.

Nthing the Clear Care. My optometrist says that this is the standard for contact lenses in Europe but we Americans are a bit more lax. Like the others say, the hydrogen peroxide stuff cleans protein really well - but for the love of dog, make really sure that you never ever mistake it for your saline. It's a mistake you'll only make once.

Get some Miraflow daily cleaner for use with your lenses, as well as some Unizyme Enzymatic Cleaner Tablets for weekly cleaning.

The big thing - do not ignore what your eyes are telling you. If they are irritated, swollen, red... wear your glasses. If it persists for more than a day, call your optometrist. Don't wear them for more than 12 hours if you can help it, and always give your eyes some lens-free time before bed.

I can't wear one a days. I wish I could. My vision is such that glasses are a big step down, and my quality of life would suffer if I were ever to end up unable to wear contact lenses.
posted by canine epigram at 1:56 PM on June 2, 2010 [1 favorite]

Another vote for ClearCare, or something like. You can tell if your case needs to be replaced because it will bubble more slowly when you put in new solution -- change cases regularly.

I find my eyes are happier if I take at least one full day off a week from wearing contacts.

Take them out nightly, and earlier if you can. Try not to shower or bathe wearing them, when possible.

Once your eyes start feeling drier earlier, toss your lenses.
posted by jeather at 2:01 PM on June 2, 2010

Oh, one clarification - I don't always use the Daily Cleaner, but definitely at least every few days, and more often when it is allergy season!
posted by canine epigram at 2:09 PM on June 2, 2010

I started nearly a year ago on the Bausch & Lomb monthlies for astigmatism, taking them out each day, and putting them into a clean all-in-one solution. All was well for a couple of months, then in January I had some worrying problems, as you describe but not quite as bad. My eyes started to hurt, I would feel that had to take the lenses out RIGHT THIS SECOND, and I went for a few days with a huge sensitivity to light, and a feeling that one eye was swelling.

I've now changed to One-day Acuvue for Astigmatism. Expensive but so much better and so far no problems.

So, I say $200 is not worth the price of your eyesight.
posted by essexjan at 2:15 PM on June 2, 2010

One thing you might be interested in is this type of boilable contact lens case. I bought a few because I liked the colors, but now it feels so satisfying to boil the crap out of them every couple weeks, rather than tossing the case and buying a brand new one.
posted by Jemstar at 2:48 PM on June 2, 2010

Get 1-day disposable lenses. Your eyesight isn't worth cheaping out over, and the 1-days are about as convenient as it gets, next to having eye surgery.
posted by Blazecock Pileon at 3:14 PM on June 2, 2010

Just a note, depending on the OPs prescription, she might not be able to get 1-day ones. Also, quality control can sometimes be lower.
posted by canine epigram at 3:52 PM on June 2, 2010

I have had three different ophthalmologists and two opticians tell me that monthly lenses should be taken out at night even though they are labeled otherwise. Or if you do sleep in them, one night here and there, not every night. Just take them out every night, change your lens case every time you change lenses, use solution your eyes like and wash your hands religiously.
posted by biscotti at 6:48 PM on June 2, 2010

Keep yourself well hydrated. Just drinking water can prevent the dryness that promotes eye irritation.

Clean Care, definitely. You absolutely will notice a difference in clarity and comfort. It even removes protein deposits.
posted by wryly at 8:14 PM on June 2, 2010

If the office you went to said you were days away from blindness, I hope you also got a follow-up appt after treatment to verify it was successful. If not, schedule one soonest, and your file is still at the office/clinic, so the location of your Dr is not an issue.

I am an optician, and have many years of experience in dealing with CL's- my advice:
Clear Care is the best cleaner. It's what I use, and every new bottle comes with a case.

Always wash your hands before touching your CL's

Never sleep in your CL's- though the occ. nap won't hurt, with your history, I wouldn't recommend it. The contact reduces tear flow and oxygen to the eye, both of which it needs to stay healthy. Adding your eyelid to that situation is the biggest problem.

Replace your CL's as frequently as the Dr. recommends.

My two cents, but all the posts are spot on.
posted by Stellaboots at 9:02 PM on June 2, 2010

Just a quick comment that I don't see mentioned. If you usually use a hand towel after you wash your hands, but you're trying to be as sterile as possible, keep a roll of paper towels and use them when you're doing contact stuff.

I take a clean towel and lay it down under my contact case as I'm putting my contacts in/taking them out, in case I drop them. It may be a good idea to do something this with a paper towel, again in the interests of "clean as possible"--clean surface for the contacts case and everything you touch after washing your hands.
posted by galadriel at 10:35 AM on June 3, 2010

You should find out if you have an allergy to your solution. I have, over the years, become allergic to particular brands of contact lenses and different solutions, and I am not the only person I know that this has happened to.

Seconding this. I spent a summer wearing glasses because my optometrist couldn't figure out why my eyes became so irritated every time I wore my contact lenses. Then I moved and found a new eye doctor, who immediately recommended a hydrogen peroxide-based disinfecting solution (similar to ClearCare). No more problems.
posted by virago at 12:57 PM on June 3, 2010

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