Pediatric and Teen CL Care
Prescribed Cleaning and Care of Contact Lens Accessories, Part 1
By Pauline Cho, PhD, FAAO, FBCLA, & Sin Wan Cheung, MPhil, FAAO
Most published reports on noncompliance have found that patients take better care of their lenses than their lens storage cases. Indeed, instructions for care of contact lenses are much more consistent, precise, and detailed compared to instructions for the care of lens accessories. Currently, there is a slow but steady increase in the popularity of contact lens usage in children. Now is as good a time as any to revisit our prescribed cleaning and care instructions so we can educate our young patients and their parents on the correct way to care for their lenses and accessories before they develop bad habits.
Instructions for Case Care
You may remember to tell patients to clean their lens cases, but do you explain how? We advise using a soft-bristle toothbrush with liquid soap or multipurpose solution (MPS) to clean the case inside and outside, with particular attention to the screw top and caps. After thorough rinsing with water, MPS, or saline, shake off the excessive fluid, wipe the case dry with a tissue or paper towel, and leave the case to air dry. An important message to patients/parents is: Do not cap when wet.
You probably remember to instruct patients to air dry the lens cases after cleaning, but do you tell them how and where? Instruct patients to leave the case to air dry face-down on a piece of clean dry tissue to avoid settling of particles and contaminants from the air in the wells of the case. The brush should be rinsed thoroughly, excess water shaken off, and left to air dry with the case. Another piece of tissue may be used to cover these items as they are left to air dry. Accessories should be stored or left to air dry in a cool, dry place, for example, in their bedroom.
Apart from daily cleaning, it is important to disinfect contact lens cases with hot water once a week. While children can be instructed to perform daily cleaning, weekly disinfection with hot water has to be carried out by parents to avoid accidents with handling of hot water. Instruct parents to put the lens case, lids, and brush in a clean container, pour in boiling water, then cover the container and allow the items to soak (not boil) for 10 minutes. Ensure that the cases are heat resistant before giving these instructions.
You may instruct patients to regularly replace their contact lens cases, but do you tell them how regularly? Recommending replacement of contact lens cases every three to six months may encourage economical use of MPS, as patients will get a new lens case only with a new bottle of solution. A bottle of MPS should be used within about a month if used appropriately for cleaning, rinsing, and disinfection. We have shown significant levels of case contamination even when replaced monthly, so we encourage parents to remind or help their children to replace contact lens cases and brushes monthly.
Emphasize Good Case Care
Children are just as good, if not better, at taking short cuts and being forgetful compared to adults. Parents need to keep an eye on their children and check regularly that they are following the instructions properly. Just asking them if they have done so will not be good enough.
If you do not put enough emphasis on the care of the lens cases, neither will young patients or their parents. You therefore need to stress the importance of keeping lens cases clean.
In Part 2, we will discuss guidelines for usage and care of accessories for GP lenses. CLS
Dr. Cho is a professor of the School of Optometry at The Hong Kong Polytechnic University where she teaches Contact Lens Practice. You can reach her at firstname.lastname@example.org. Ms. Cheung is currently a research fellow at The Hong Kong Polytechnic University. You can reach her at email@example.com.