science of us

Am I Going to Blind Myself With My Contacts?

Photo: Paula Daniëlse/Getty Images

Eyes are terrifying. They are soft, and squishy, and seem like they could be injured easily at any moment. Their scariness is multiplied by the fact that many of us use our dirty little fingers to put tiny pieces of plastic inside of them every day in order to see out of them clearly.

But could our various negligent little eyeball routines — not changing our solution, spending the night without a contacts case, dropping our contact on the basketball court and then putting it, oh no, right back into our eye — cause us serious damage? To answer these and various other contact-lens-related fears, we had a chat with Stephanie Marioneaux, a cornea specialist and clinical spokesperson for the American Academy of Ophthalmology.

Is there any truth to the belief that contact lenses can get stuck “behind” your eye?
This is a concern a lot of people have, and believe it or not — it is unfounded. There is an actual barrier there, the conjunctiva, that lines the eyelid and covers the white part of the eye, so that you cannot — you will never lose a contact lens behind your eye. There is a physical barrier that protects anything from getting behind the eye.

So, a contact lens can fold up, it can get behind the lid, it can be hard to find, and people think maybe it has disappeared, but typically if you have a folded-up contact in your eye … you tend to know it.

Is it dangerous to use contact lenses past their “expiration date” — like, if they’re meant to be replaced every two weeks, and you use them for two months?
What happens with the lenses that are supposed to be used for two weeks at a time, or maybe a month, and then discarded, is they will often change shape. They’ll shrink, they’ll become a little tight, they may not fit well. And that would increase your risk of an infection or corneal abrasion, or some sort of injury that could perhaps lead to a vision-threatening eye condition. We recommend that you don’t try to save money on your eyes. You only have one pair.

It’s almost like eating food that has expired — sometimes you might be lucky, but other times you may not be. Respect your eyes and pay the money to get fresh contacts. You may regret it if you don’t.

How dangerous is it to use the same solution for a few days?
Oh my God! That’s awful. That’s a big no-no. In fact, if you’re not wearing the contacts, and they’re just sitting in the solution, we actually recommend that you change the solution every day … even if you’re not wearing the contacts. Because keep in mind, the environment that these contacts are being kept in — it could be warm, it could be moist, it could be dark. It’s a wonderful culture medium. And you’ve got all the bacteria from your hands — it has nothing to do with your cleanliness, but the bacteria from your hands are now on the contacts, which are now in the solution. Some will be killed by the solution, some will not, but the potency of the solution decreases after a certain number of hours. It’s not as though if you keep them in longer it’s gonna kill more germs. No. The potency of the fluid actually declines in time.

And also in terms of contact lens cases, do not wash them in tap water, because there is a terrible amoeba called Acanthamoeba that’s in the tap water that can burrow into your eye. It loves contact lenses and tap water.

Oh my God.
So you should be cleaning your contact lens case with contact lens solution. And when you wash your hands, you should dry them with something disposable, like a tissue, before touching the contact lenses. You don’t know how clean towels are, if they’re hanging up there, so use a tissue and dry your hands thoroughly. You don’t want to stick wet hands into your contact lens solution, because you can transfer Acanthamoeba from the tap water into the solution.

Acanthamoeba is very hardy. It has two forms, one is a cystic form that is tough — a cyst can actually resist antibiotics. And then there’s the trophozoite form that, once the organism feels like the coast is clear, like the infection is under control, the trophozoite burrows even deeper into the eye, making it even more difficult to treat. So, just be very mindful that tap water is not your friend. And if you do water sports you can get your prescription put in a swim goggle — that’s what we recommend. You should not be in the shower wearing your contacts, you should not be in hot tubs, you should not swimming, you should not be surfing wearing your contact lenses. You must remove them.

That’s terrifying!
Well, it’s something that you need to know! People don’t know that.

That sort of leads to my next question, which is newly scary — if you get caught without contact solution but you need to put your contacts in something overnight, is there anything that can sub in for contact solution? It seems like definitely not water.
Well, you could put sterile saline, but the saline would only be a temporary measure so you don’t end up having to throw them away. But you should not put the contact lens in the eye if it’s only been soaking in sterile saline. It’s really only a transfer solution, so it doesn’t dry out before you get your real solution. Then you do the appropriate soaking in the disinfectant solution for the amount of time that is required. Because the saline doesn’t have anything to clean the bacteria that you just put in there from your hands, or any bacteria that are already on your case. That’s really just so it doesn’t shrivel up and you have to throw it away. Or if you have a bottle of artificial tears, you can use that, but again only for holding purposes because it doesn’t disinfect.

If you go to the emergency room and are put into an artificial coma, do you know if they check to see if you have contacts in your eyes?
That’s a great question, and I’ve been called into the ICU to see patients who have, you know, various eye issues when they’ve been comatose. They do look in the eyes.

I can’t say they routinely check for contact lenses — I really can’t comment on that because that’s more of a nursing issue, and I honestly don’t know. But I do know they pay attention to the eyes when you are in a coma or intubated, or whatever the situation, because we do get consults to come to the intensive care unit and evaluate patients’ eyes. So if you are a contact lens wearer, hopefully one of your relatives will know that you routinely wear contact lenses. And, after a while, trust me, you’ll be able to see that the contacts dry out. They’ll come out. They may even sort of shrivel up.

Is there anything else we should be scared of?
Just respect the fact that you have one pair of eyes. If your eye is red, if you have pain, the contact should come out immediately. Do not tough it out. As a contact lens wearer, you should always have your glasses with you so that in the event something happens and the contact is not comfortable you can take it out immediately. Toughing it out is the worst thing you could do, because you could end up with a very bad infection, which could lead to blindness.

And you want to make sure you’re being evaluated by your MD in order to insure that your contact lenses are fitting well and that there are no other issues. You don’t want to just get them online and never see anybody. You want to make sure you have a complete and thorough dilated eye exam on an annual basis.

This interview has been condensed and lightly edited for clarity.

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