Contact Lens Users’ Risky Eye Care Behaviors Lead to Increased Eye Infections

Contact lenses provide safe and effective vision correction for many Americans. However, contact lens wearers risk infection if they fail to wear, clean, disinfect, and store their contact lenses as directed. Over the past decade, the CDC has investigated several multistate outbreaks of serious eye infections among contact lens wearers, including Acanthamoeba keratitis. Each investigation identified frequent contact lens hygiene-related risk behaviors among patients.


Almost all of the 41 million estimated contact lens wearers in the United States may be engaging in at least one behavior known to increase their risk of eye infections, according to a report published recently by the CDC. Nearly one-third of contact lens wearers who participated in a national survey reported going to the doctor for red or painful eyes related to wearing contact lenses.


More than 99 percent of survey respondents reported at least one risky behavior. The majority of wearers reported:


  • Keeping their contact lens cases for longer than recommended (82.3 percent);
  • “Topping off” solution in the case—adding new solution to the existing solution instead of emptying the case out fully before adding new solution (55.1 percent); or
  • Wearing their lenses while sleeping (50.2 percent).


Each of these behaviors has been reported in previous studies to raise the risk of eye infections by five times or more.


An online survey was administered to a sample of contact lens wearers to determine how often contact lens wearers engaged in behaviors that could put them at risk for an eye infection. The CDC collaborated with the Contact Lens Assessment in Youth (CLAY) group, a multi-university group of researchers, to conduct the survey. A separate survey was used to estimate the number of contact lens wearers – about 41 million adults. Taken together, the survey results indicate that millions of Americans could be at risk for serious eye infections because of poor contact lens hygiene behaviors.


“Good vision contributes to overall well-being and independence for people of all ages, so it’s important not to cut corners on healthy contact lens wear and care,” says CDC Medical Epidemiologist Jennifer Cope, M.D., M.P.H. “We are finding that many wearers are unclear about how to properly wear and care for contact lenses."


To prevent eye infections, contact lens wearers should wash hands with soap and water and dry them well before touching contact lense; take contacts out before sleeping, showering, or swimming; and rub and rinse contacts in disinfecting solution each time they remove them. Contact users should rub and rinse the case with contact lens solution, dry with a clean tissue, and store the case upside down with the caps off after each use.


Contact lens cases should be replaced at least once every three months. Avoid “topping off” solution in lens case (adding fresh solution to old solution) and carry a backup pair of glasses in case contact lenses have to be taken out.


Daily disposable contact lens wearers might have a lower risk for infection if contact lenses are disposed of daily as recommended. Although 40% of daily disposable contact lens wearers did not use a case, thereby avoiding potential contamination associated with the case, a large proportion of daily disposable contact lens wearers did use a case and did so improperly, using tap water to store their lenses.


Nearly one million U.S. health care visits for keratitis (inflammation of the cornea) or other contact lens complications occur annually, at a cost of $175 million. For more information on preventing eye infections and proper contact lens wear, visit the CDCs “Healthy Contact Lens Wear and Care.”


Tens of millions of U.S. adults enjoy the benefits of contact lens wear, but many of them might be increasing their risk for complications because of poor wear and care behaviors. Prevention efforts could include vigorous health promotion activities that encourage contact lens wearers to improve their hygiene behaviors, such as keeping all water away from contact lenses, discarding used disinfecting solution from the case, cleaning with fresh solution each day, and replacing their contact lens case every three months.


See the CDC Announcement


See the CDC Report


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See also Medical Law Perspectives, March 2013: When Cataract Treatment Creates More Harm Than Cure: Malpractice Liability Issues


See the Medical Law Perspectives April 3, 2015, Blog: Contact Lens Not Subject to Recall But Manufactured in the Same Facility, and Having Same Material Defect, Could Not Be Basis for Manufacturer’s Liability