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Contact lenses
Eying the risks

Contact lens on finger by eye.
QUITTING IS COMMON   Our survey found that many people have stopped wearing contacts because of dry or irritated eyes, which can stem from cutting corners in caring for the lenses.
If you’ve ever tried contact lenses, you might be reading this with glasses instead: An online reader survey of some 7,700 corrective-lens wearers, conducted last spring by the Consumer Reports National Research Center, found that 45 percent who tried contacts in the past decade have quit wearing them. And more than one-fourth of current contact users said they now wear them less than they used to.

You can boost your chances of sticking with your contacts by using them properly, which helps prevent infection as well as dryness and irritation, the two most common reasons for giving up contacts. It’s particularly important not to cut corners in cleaning and storing your lenses. That apparently contributed to the 2006 outbreak in 35 states of fungal infections linked to the use of Bausch & Lomb’s ReNu with MoistureLoc multipurpose lens solution, which the company withdrew from the U.S. in April 2006 and recalled worldwide a month later. Public-health authorities say the product’s unique formulation might have increased the chance of problems caused by sloppy care--specifically, reusing the solution (see Dangerous fungus lurks in homes).

“It’s critical that contact wearers take responsibility for proper lens care,” says Thomas Steinemann, M.D., a spokesman for the American Academy of Ophthalmology. But “contacts and solutions should perform even if lens wearers don’t always follow directions,” he says. Some experts say the Food and Drug Administration, which regulates contacts as medical devices, should require manufacturers to prove that their products are safe under real-world conditions, where consumers often slip up. But Daniel Schultz, M.D., director of the FDA’s Center for Devices and Radiological Health, calls that “an almost impossible standard.”

Despite the importance of carefully following instructions, most contact users in our survey didn’t: Some 60 percent who were supposed to replace their lenses regularly said they had worn them longer than recommended in the past year. Not surprisingly, dry or irritated eyes was a very common complaint.

Here’s our eye consultants’ advice on choosing and caring for contact lenses.


HOW TO CHOOSE

Discuss your contact-lens options with your optometrist or ophthalmologist, based on the results of your eye exam and our conclusions about comfort and safety (see Lens lingo). If you want to use contact lenses while playing sports, as did 54 percent of those we surveyed, ask about larger lenses for better stability. If you are a new patient or are changing the lens type, inquire about wearing a trial pair for a few weeks so that your eye doctor can check the fit, which may require several visits.

Ask the doctor for your lens prescription and for any special requirements. That provides all the information needed to create the proper lens fit and visual correction. Then shop around for the best price. Half of our survey respondents bought contacts from their eye doctor. But you might pay less for the lenses elsewhere, such as at online outlets, mail-order companies, or wholesale clubs. And you might reap additional savings by purchasing the lenses in bulk.


FIND THE RIGHT SOLUTION

Ask your eye doctor which cleaning product to use for your contact lenses. Different solutions have different ingredients that can interact with your lenses and eyes in unexpected ways. While our survey respondents may not be nationally representative, 13 percent said that in the previous six months they developed allergies connected to their use of contact lenses. Moreover, some multipurpose solutions--designed for cleaning, storing, and disinfecting your contacts--should not be used with certain lenses. That’s because the combination could cause “staining,” microscopic defects on the cornea that might increase the chance of infection. Check the label or package insert for information about inappropriate solution-contact combinations.

Some evidence suggests that multi-step cleaning-and-disinfecting systems that contain hydrogen peroxide may disinfect lenses better than single-step methods that use multipurpose solutions. Some also have fewer potentially irritating preservatives. Ask about the multistep option if you’re particularly concerned about contact-lens safety or have allergies or sensitive eyes.


CLEAN CAREfully

The risk of serious eye infection is small, ranging from about 4 to 20 cases per 10,000 wearers each year, depending largely on the type of lens. But eye infections can threaten your vision, so it’s essential to take protective steps.

Don’t touch the tip of the open bottle, and keep it capped when not in use. The chance of inadvertent contamination is so great that our consultants recommend replacing the solution and contact-lens case every three months.

Clean your contacts before storing them. Our eye experts recommend rubbing soft lenses in the solution for about 20 seconds to help remove germs--even if it’s one of the newer products labeled "no rub." But don’t overdo it: One in four people we surveyed said a lens had torn in the previous six months.

Use fresh solution for storing your contacts. Never “top off” by adding a squirt to the liquid already used for storage or overnight cleaning. That won’t make up for the old solution’s reduced efficacy.

After popping the lenses back in your eyes, rinse the case. Since tap water could harbor microbes, the safest approach is to use the solution. Then air-dry the case in a clean, dry area.


GET TIMELY CHECKUPS

Contact users should see their eye doctor at least annually. If you often wear lenses overnight, consider semiannual checkups. In our survey, 28 percent of contact users said they hadn’t had an eye exam in the past 11 months.


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