Pediatric and Teen CL Care
Prescribed Cleaning and Care of Contact Lens Accessories, Part 2
By Pauline Cho, PhD, FAAO, FBCLA, & Sin Wan Cheung, MPhil, FAAO
In our last article, we discussed prescribed care for soft contact lens accessories. The same advice for soft contact lenses also applies to rigid contact lenses—avoid unnecessary accessories.
Avoid Suction Holders
Indeed, it is easier and faster to teach our young patients and parents how to remove their lenses with a suction holder. However, we need to remember that the prescribed suction holder can lead to problems, including contamination. Patients tend to forget to clean, disinfect, or replace it. There is also the danger of removing a lens that has been dislocated or is bound to the cornea.
Lastly, there is the problem of dependency on the suction holder. Should the item be lost or misplaced, the children or parents may not know how to remove the lenses safely. Teach children and parents how to apply and remove their lenses with their fingers. It may take longer to teach the children how to do this, but the extra time spent is worthwhile to minimize potential contamination and infection of the eye via this route.
Cylindrical Lens Cases
Although patients wearing rigid contact lenses may use flat lens cases, they may also use the cylindrical (vertical) type with holders attached to the lid of each chamber. Care of such cases can be challenging.
Because the mouths of such lens cases are small, patients can't use a toothbrush to scrub the inside of the case. The disinfection solution for rigid lenses is also usually more viscous, and it is not easy to get rid of residual solution on the inside walls of the lens case and the lens holder after pouring away the used solution. This increases the difficulty in removing the biofilm formed inside the chambers and on the lens holders. To date, there is no published report comparing different ways of cleaning cylindrical contact lens cases.
From our clinical experience, we suggested the following guidelines for cylindrical lens cases.
1. Pour away used solutions after lens application and shake off remaining fluid in the case.
2. Rinse the case with tap water (or distilled water) and then fill each chamber of the lens case up to half full with water and close the lids. Shake vigorously (to and fro) for 10 seconds to dislodge accumulated particles and/or micro-organisms.
3. Empty the contents. Rinse the case and the lids/holders thoroughly under running water (or with distilled water).
4. Vigorously shake off excessive water.
5. Place all items on a piece of paper towel and tap them dry. Do not wipe inside the chambers or the lens holders to avoid potential contamination of the chambers.
6. Place the items on a piece of clean tissue in a cool, dry place (e.g. bedroom), with the case or lids lying on their sides (horizontally). Cover these items with another piece of tissue to prevent collection of airborne dust.
7. Do not cap wet chambers. Always rinse the chambers and lids/holders with multipurpose solution before using.
Instructions on weekly disinfection of these contact lens cases are same as those for the flat contact lens cases. Soak the cleansed items in a container of just boiled water and cover for at least 10 minutes before air drying. Adults should do this rather than children as it involves the use of boiling water. Although many manufacturers recommended three-month replacement of the lens cases, we recommended monthly replacement. 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.