CONTACT LENS CARE & MAINTENCE

1. ALSALAMA EYE HOSPITAL
CARE AND MAINTENANCE OF
CONTACT LENS

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

3.  Clean the lens
 Prevent/ minimize deposits
 Maintain wettability for comfort and
clear vision.
 Disinfect lenses to prevent ocular
Inflammation.

4.  Irritation and reduced comfort
 Reduced visual acuity
 Shortened lens life
 Increased potential for infection
 Increased incidence of GPC

6.  Clean
 • Rinse
 • Disinfect
 Extra Steps:
 • Protein removal
 • Lubricating / re-wetting drops

7.  Surfactants
 • Buffers
 • Osmolality adjusting agent(s)
 • Preservatives
 • Water

8.  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

9. Daily cleaners
Weekly cleaners

10.  Proper cleaning removes 90% of organisms.
 Mostly contains surfactants,viscocity agent
Buffering agent ,preservatives

11. Enzymatic cleaners
 Effectively remove protein deposits
 Have no effect on most other deposits
 React by breaking proteins into smaller
molecules

12. 
Derived from papaya plant
 Binds to contact lens materials and can
cause sensitivity reactions
 Short 15 minute soaking time possible

13. • Pig pancreas derivative
• Cleaning efficacy similar to papain

14. • Derived from Bacillus bacteria
• Low toxicity, used in food products
• Less specific binding characteristics
• May be more effective than papain

15.  Removal of loosened lens contaminants
 • Removal of residual cleaner
 • Rehydrate lens
 • Dissolve enzyme tabs

16.  Isotonic
 • Buffered
 • pH similar to ocular environment

17.  Micro-organism can attach to deposits
 Use Thermal & chemical disinfection systems
 Soaking time 4 hours to overnight or as
recommended
 • Preservatives incorporated

18.  • Thermal (heat)
 • Chemical
◦ - conventional
◦ - polymeric
◦ - tablet
 • Hydrogen peroxide

19.  Original form of disinfection.
 High temperatures kill micro-organisms by:
◦ • Denaturation of cell components
◦ • Disruption of plasma membranes
◦ • DNA damage

20.  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.

21.  • Thimerosal
 • Chlorhexidine
 • Sorbic Acid
 • ATAC
 • Isopropyl alcohol

22.  • One-bottle system (OBS)
 • Combination of cleaning, disinfecting and
soaking functions
 • Convenient

23.  • Also known as conditioning solutions
 • Functions - disinfection
- wetting
- storage

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

25.  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

26. Improve the wetting characteristics of the
lens surface:
 • Convert hydrophobic surface to hydrophilic
 • Assist tear film to spread more easily and
evenly on lens surface
 • Increase comfort on insertion

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

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

29. Other common solution ingredients:
 • Viscosity-enhancing agent(s)
 • Buffer(s) - PH
 • Osmolality-adjusting agents(s)

30.  Solution toxicity: rare
 • Punctuate corneal staining: uncommon
 • Viscous solution:
- blurry/fluctuating vision on lens insertion
- may leave residue on lashes

31.  Replace lenses at least annually
 Residual deposits can irritate lids, especially
the upper lids

32. Before dispensing:
• Clean and soak lenses overnight
• Verify lenses
• Check wettability

33.  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)

34.  lenses easier to care for
 Clean, Rinse And Disinfectant Lenses Every
time (CRADLE)

35. Scrub with a new toothbrush and CL
cleaning solution weekly
Rinse with saline or disinfecting
solution
 Air dry upside-down
 Replace regularly

36. Do not mix solution types and brands
Review patient compliance
 Ask patient to repeat instruction and
demonstrate technique and procedure
 Observe recommend storage conditions