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Doctors of Optometry Urge Contact Lens Wearers to Be Vigilant with Lens Hygiene and Compliance in Flood Areas

ST. LOUIS, MO - JUNE 19, 2008 - As flooding continues to expand across much of the Midwest, the American Optometric Association (AOA) reminds contact lens wearers to closely follow hygiene and compliance instructions issued by their eye doctor. Higher temperatures combined with standing water can mean an increase in the number of cases of eye infections. In particular, the Acanthamoeba parasite and other micro-organisms can contaminate the lens case and infect the cornea. Water contaminated with Acanthamoeba can come from lakes, rivers, and swimming pools. Acanthamoeba infections are rare, but can be dangerous and threaten a person’s vision if not properly detected and treated.

Doctors of optometry recommend that lens wearers take the following precautions to avoid exposing their eyes to Acanthamoeba or other flood-related eye infections:

• Remove contact lenses prior to entering flood waters or before other water activities including swimming
• Contact lens wearers who regularly sleep in contact lenses as prescribed should refrain from doing so if exposed to water
• Always sterilize contact lens cases and wash and dry hands prior to handling lenses

"Contact lenses are among the safest forms of vision correction," said Dr. Louise Sclafani, chair of the AOA's Contact Lens and Cornea Section. "Patients can and should take an active role in protecting themselves from eye infections by carefully following their optometrist's instructions regarding care of contact lenses."

According to the AOA, proper lens hygiene and compliance includes using fresh cleaning or disinfecting solution each time lenses are cleaned and stored. Additionally, most solutions are approved for use without rubbing; however, optometrists are recommending that patients rub their lenses to enhance cleaning for additional safety.

A Food and Drug Administration (FDA) advisory panel met last week to address contact lens safety and compliance issues related to past Acanthamoeba and Fusarium keratitis incidences among lens wearers. The FDA regulates contact lenses and lens care products as medical devices, a classification that requires the lens and product makers to obtain the agency's approval before marketing and sales. The AOA is working with the FDA to take a closer look at contact lens safety and compliance, improve product testing procedures and enhance labeling of eye care products. The panel heard testimony from AOA representatives Dr. William J. Benjamin and Dr. Louise Sclafani, among other eye care experts, to discuss stricter standards for contact lens solutions. The FDA is considering changes in current no-rub policies, the pre-market testing of products, and changes in labeling of products.

"We are supportive of the FDA in making changes to help protect the sight of Americans," said Dr. William J. Benjamin, speaking on behalf of the AOA's Commission on Ophthalmic Standards" "We support the FDA in requiring that products be tested under more realistic conditions, when feasible, and in situations where lens wearers are not compliant with a doctor's instructions. We also support the agency's review of labeling requirements for care products."

Since more than 80 percent of all contact lens wearers go to an optometrist for their eye care (according to the Contact Lens Institute), AOA doctors of optometry have taken an active role in educating patients and working with federal health officials to improve lens wear and care instructions.

"We are also asking the FDA to require an expiration date on bottles of solution. Currently, the FDA does not require a mandatory discard date after opening," said Dr. Sclafani. "The only current requirement is that the solution must have a preservative or be packaged to reduce contamination. This has been confusing for both patients and doctors."

Additionally, AOA leaders are asking the FDA to include Acanthamoeba on their list of parasites that they test for in products. Currently, the Acanthamoeba parasite is not included as part of the FDA's standard testing process.

According to the AOA, there are measures contact lens wearers can and should take to reduce their risk of infection.

Recommendations for Contact Lens Wearers from the American Optometric Association

1. Always wash your hands before handling contact lenses.
2. Carefully and regularly clean contact lenses, as directed by your optometrist. Rub the contact lenses with fingers and rinse thoroughly before soaking lenses overnight in sufficient multi-purpose solution to completely cover the lens.
3. Store lenses in the proper lens storage case and replace the case at a minimum of every three months. Clean the case after each use, and keep it open and dry between cleanings.
4. Use only products recommended by your optometrist to clean and disinfect your lenses. Saline solution and rewetting drops are not designed to disinfect lenses.
5. Only fresh solution should be used to clean and store contact lenses. Never re-use old solution. Contact lens solution must be changed according to the manufacturer's recommendations, even if the lenses are not used daily.
6. Always follow the recommended contact lens replacement schedule prescribed by your optometrist.
7. Remove contact lenses before swimming or entering a hot tub.
8. See your optometrist for your regularly scheduled contact lens and eye examination.

Contact lens wearers who are at higher risk for Acanthamoeba include those in areas with heavy flooding or lens wearers exposed to water while wearing contacts. It is important that contact lens users consult their optometrist immediately if they notice changes in their eyes or vision.

Key Symptoms of Acanthamoeba include:

• A red, (frequently) painful eye infection-especially if the patient reports that it is not improving with treatment.
• Keratitis symptoms such as foreign body sensation, tearing, light sensitivity, and blurred vision.
• Red, irritated eyes lasting for an unusually long period of time after removal of contact lenses.

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