1. Care and Maintenance of
Soft Contact Lenses
Vishakh G Nair
M.Optom,FIACLE

2. Outline of the presentation
• Why care for contact lenses?
• Deposits & Types
• Lens care regimen
• Components of lens care solution
• Functions
• Steps in lens care and maintenance
• Types of disinfectants
• Do-s & Don’t-s

3. Outline of the presentation
• Why care for contact lenses?
• Deposits & Types
• Lens care regimen
• Components of lens care solution
• Functions
• Steps in lens care and maintenance
• Types of disinfectants
• Do-s & Don’t-s

4. Purpose of Care and Maintenance
• Clean lenses:
– To prevent/minimize deposits
– To maintain hydration and wettability
– To provide comfort and clear vision
– To prevent or reduce the risk of ocular
infection/inflammation

5. Purpose of Care & Maintenance
• Failure to prescribe proper
lens care regimen
• Failure of compliance
Failure of
 Reduced comfort
 Reduced vision
 Increased risk of contamination 
complications/ infections
CL wear
 Dissatisfied patient

6. Outline of the presentation
• Why care for contact lenses?
• Deposits & Types
• Lens care regimen
• Components of lens care solution
• Functions
• Steps in lens care and maintenance
• Types of disinfectants
• Do-s & Don’t-s

7. Deposits & Types
• “… Any lens surface coating or matrix
formation which is not flushed or rinsed from
a lens by tears during blinking”
Types of deposits:
• External
– eye make-up, air pollutants , etc.
• Internal
– tear components - protein, lipid, mucin, etc.

8. Contact Lens Deposits
• How do deposits form on contact lens
surface?
– Interaction between lens and content of tears
– Evaporation of tears leaves residue on lens
– Lens chemistry attracts tear film constituents
(proteins, lipids, mucin, calcium)

9. Protein Deposits

10. How do protein deposits get denatured?
Environmental
Factors:
• Heat
• Drying
• Oxidation
• UV light
Native Protein Denatured Protein
• Transparent • Translucent/opaque
• Natural part of tears • Strongly binds to lens
• Beneficial to eyes surface
(anti-microbial activity) • Harmful to eyes

11. Lipid Deposits

12. Jelly Bumps

13. Other Deposits
Calcium Deposit Fungal Contamination
Rust Spots

14. Deposit Complications
• Reduced visual acuity
• Lens dryness - proteins repel water & the lens may dry
up more easily
• Irritation and reduced comfort  shortened wear time
• Cause allergic response (e.g. GPC)
• Micro-organism’s attachment to deposits may cause eye
infection

15. Non-wetting SCL surface

16. FDA Classification of Lens Materials
Group Water Content Charge
I Low (< 50%) Non Ionic
II High (> 50%) Non Ionic
III Low Ionic
IV High Ionic

17. Outline of the presentation
• Why care for contact lenses?
• Deposits & Types
• Lens care regimen
• Components of lens care solution
• Functions
• Steps in lens care and maintenance
• Types of disinfectants
• Do-s & Don’t-s

18. Components of Care and Maintenance
½ Daily cleaner
½ Rinsing solution
½ Disinfecting solution
½ Protein removers
½ Lubricating/
rewetting
solution
½ Lens storage case

19. Compliance Vs Non- Compliance
Simple system and Instruction
- Better compliance
- Easy and convenient
Complicated System
- Confusion
- Non-compliance
- Lens wear complications

20. Essential Steps of Care & Maintenance
½ Cleaning
½ Rinsing
½ Disinfecting
½ Extra Steps - Protein Removal
- Lubricating / Re-wetting

21. Daily Cleaning and / or Rinsing removes
majority of Micro-organisms

22. Essential Steps of Care & Maintenance
½ Cleaning
½ Rinsing
½ Disinfecting
½ Extra Steps - Protein Removal
- Lubricating / Re-wetting

23. Daily Cleaner - Functions
To Remove
½ Loosely bound foreign matter
- Cell debris
- Mucus, lipid, protein
- Cosmetic or other surface contamination
½ Majority of micro-organisms

24. Daily Cleaner Composition
• Surfactants
• Buffers
• Osmolality adjusting agents
• Preservatives
• Water

25. Surfactant Cleaners - Functions
• 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

26. Daily Cleaner Procedures
½ Wash hands
½ Place lens in the palm of the hand
½ Place 2-3 drops of cleaner on each lens surface
½ Rub with fore-finger for about 10-15 sec per side
using to and fro and circular action
½ Rolling the fore-finger in both directions
½ Clean lens periphery
½ Rinse well

27. Daily Lens Care Procedures
Wash hands Either Rub + Rinse
Disinfect Or Rinse Only

28. Hand washing
- Reduce bio-burden
- With water-based soaps
- Often forgotten step

29. Rubbing the lens
• 10-15 sec on each side
• To and fro action
• Removal of
environmental & protein
deposits
• Reduces risks of
infections

30. Consumer’s perception of No Rub
• Simply put the lenses into lens case after
removal
• No digital cleaning, No rinsing
• Simple, carefree, convenient lens care
• Reduced usage of lens care solution

31. Essential Steps of Care & Maintenance
½ Cleaning
½ Rinsing
½ Disinfecting
½ Extra Steps - Protein Removal
- Lubricating / Re-wetting

32. Rinsing
• Wash off loosened debris
• Decrease risk of deposit
related problems

33. Essential Steps of Care & Maintenance
½ Cleaning
½ Rinsing
½ Disinfecting
½ Extra Steps - Protein Removal
- Lubricating / Re-wetting

34. Disinfecting System
½ Kill or Deactivate potentially pathogenic
organisms including
-Bacteria
-Fungi
-Viruses
-Amoebas
½ Maintain lens hydration  stable parameters

35. Disinfection
• Store the lenses for
at least 4 hours in
FRESH solution
• Decreases the risk
of infections

36. Types of Disinfection
Heat
- Thermal Unit
- Microwave
Chemical
- Oxidative
- Hydrogen peroxide
- Chlorine
- Cold Chemicals
- Various disinfectants

37. Thermal Disinfection
• Original form of disinfection - discontinued in the
market
• Procedures
– Clean and rinse lenses
– Place lenses in fresh saline in lens case
– Heat to 70° - 80°C for 10-20 minutes
– After heat cycle, allow lenses to cool before use

38. Thermal Disinfection
Advantages:
• Short disinfection cycle times
• Highly effective antimicrobial action
• Low risk of toxic or allergic reactions
Disadvantages:
• Incompatible with some lenses, e.g. high water content;
may cause deformation & discoloration
• Increased protein deposition (cook the protein onto the
lens) & causes allergic response
• Suitable electrical power for heat units may not always
be available

39. Chemical Disinfection

40. Chemical Disinfection
½ Disinfection achieved by the presence
preservative
- Thiomersal, Chlorhexidine, Sorbic acid
½ Disinfection depends on the concentration
and type of preservative
½ Preservatives are potential irritants though
rare

41. Modern Chemical Disinfectants
• Used in Multi-Purpose (All-in-one) Solutions:
• Polyaminopropyl biguanide (PABA, PHMB)
• Quaternary-ammonia (Polyquad) & Aldox
Much less incidence of solution
sensitivity than older generation of
disinfectants. Because the
molecules specifically bind to cell
membrane of micro-organism rather
than human cells.
Bacteria Human eye

42. Multipurpose Solutions
Single bottle of solution for cleaning, rinsing,
disinfection, & removing protein
Advantages:
• Simple, convenient, easy transport
• Enhanced safety due to lower toxicity & complications
• Doesn’t cause protein denaturation
• Improved compliance
Disadvantages:
• Small incidence of mild sensitivity reactions

43. Hydrogen Peroxide
Advantages:
• Preservative free – theoretically less allergy
• Effective disinfection
Disadvantages:
• Inflexible neutralization time (lens must be fully
neutralized before use)
• H2O2 concentration decreased rapidly (3% to 1% in
<10mins) - decreased anti-microbial efficacy
• Not suitable for all lens types
• Potential for irritation on incomplete neutralization
• Possible recontamination

44. Choice of Lens Care System
SCL Heat MPS Hydrogen
Peroxide
Low water,   
Non-ionic
High water, Some  *
Non-ionic
Low water,   
Ionic
High water,   *
Ionic
* Bleaches color
in cosmetic CLs

45. Recommendations
½ Discard solution everyday
½ Rub and Rinse step is essential with
combination solution
½ Keep nozzle closed
½ Narrow openings
½ Clean and rinse well
½ Soak for recommended time

46. Essential Steps of Care & Maintenance
½ Cleaning
½ Rinsing
½ Disinfecting
½ Extra Steps - Protein Removal
- Lubricating / Re-wetting

47. Protein Removers
½ Effectively remove protein deposits
½ Have no effect on most other deposits
½ React by breaking protein molecules
½ For heavy depositors; conventional lens user

48. Protein Removal Procedure
½ Use regularly after daily wear and rinsing step
½ Lenses should be soaked in enzyme, dissolve
in solution / saline for 15 min or over night
depending on manufacturer
½ Lenses should be thoroughly rubbed and
rinsed again afterwards

49. Essential Steps of Care & Maintenance
½ Cleaning
½ Rinsing
½ Disinfecting
½ Extra Steps - Protein Removal
- Lubricating / Re-wetting

50. Rewetting or Lubricating Drops
½ Alleviating signs of dryness and discomfort
½ Flushing irritation particles from eye and CL
½ Rehydrating lens

51. Care for Lens Cases
½ Scrub with new tooth brush using cleaning
solution weekly
½ Rinse with saline or disinfecting solution
½ Air dry up-side down
½ Replace case regularly

52. Dos and Don'ts of
CL care and maintenance

53. Do-s

54. Always wash your hands
before handling contact
lenses
Check the position
of lenses before
insertion

55. Cosmetics/Make-up
Put your contact
lenses in
• after applying hair
products like
hairspray
• before applying
cosmetics,
especially eye
makeup.

56. Instruction for eye makeup
• Insert your lenses before applying
make up
• Remove your lenses before taking
your makeup off.

57. Avoid Harmful or Irritating Fumes
while the Lenses Are on

58. Do Rinse the Lenses
• Always before inserting the lens and
after removing it from the eye
• Rinse the lens with contact lenses
solution suggested by your practitioner

59. Clean and change the solution
in the lens case Daily
Keep your contact
lenses either in your eyes
or in your lens case

60. Don’t-s

61. Do not let hair spray or
other cosmetic aerosols
come in contact with
your lenses.
Avoid Long and Dirty
Nails

62. Do not Swim with contact lenses
if Yes with swimming goggles only

63. Don’t sleep with contact lenses
• Remove your lenses
before going to
sleep
Your cornea may not
get the necessary
oxygen* while you
are sleeping.
* Continuous wear lenses or Extended wear lenses with High
Dk can be used upon practitioner’s recommendations

64. Additional Tips for Hygienic CL Wear
• Do not mix solution types and brands
• Never soak/store lenses in saline or tap water
• Don’t put your solutions and lens case in the toilet or
refrigerator
• Don’t touch the tip of the any contact lens solution
• Don’t use any topical eye drops when wearing lenses

65. Dirty lenses can cause
infection / inflammation

66. Immediate contact with ECP
• If your eyes get red and irritated or if you feel
any pain remove your lenses and contact
your eye care practitioner

67. How to avoid infection?
• Deposits can be avoided by maintaining a
good lens care regimen
• Cleaning
• Disinfection
• Following the instruction
• Shorter is better – Disposables, small packs
of solution (120ml or 360ml rather than
500ml)

68. Why disposable ?
• More comfortable
• Healthy
• More hygeinic
• Convenience of spare pair at hand
• Longer wearing time
• Contact lenses related infection & complication
reduces in disposables

69. How to enhance compliance?
• Educate staff & the patient
- Simple written & verbal instructions
- Reinforce few key points many times
- Practical demonstration/visuals
• Review lens care at every visit
• Keep patients coming back for more
- Compliance packs/offers
- Recall system
- Regular contact through mailers

70. Summary
Minimized adverse reactions achieved by :
• clean, well fitted lenses
• adequate physiological performance
• appropriate choice of care system
• regular monitoring of patient
• patient compliance