A 50-year-old Caucasian female who wears glasses came in for a complete eye exam. The last time she came in was four years ago; her insurance had changed, and she hadn’t wanted to see anybody else. Her chief complaint was that she had noticed that her near vision was getting worse, and she was interested in contact lenses. Her anterior and posterior segment examination was normal in both eyes. Her refraction was OD plano –1.25 x 080, 20/20; OS plano –1.25 x 100, 20/20; Add +2.00D 20/20 OU.

This patient always wears her glasses, because she feels that her vision is “way worse” without them. But, she notes that it is difficult to wear her glasses with her mask on at work or in any public area because of comfort issues and the fogging that occurs with the spectacle lenses.

One option for this patient was to continue with glasses, update her prescription, and use appropriate anti-fog wipes to prevent fogging. The patient was educated on how to appropriately wear a mask to prevent air from coming up to the eyes by having a wire along the nose portion of the mask. The wire helps contour the mask and prevents air from coming up toward the eyes and fogging her glasses.

The patient definitely wanted to proceed with contact lenses but had several questions about whether it was safe to wear contact lenses in light of the current pandemic. Fortunately, there is no evidence that contact lens wear increases the transmission of severe acute respiratory syndrome coronavirus-2 (SARS CoV-2, the virus responsible for coronavirus disease 2019 [COVID-19]) (Jones et al, 2020).

Coronavirus is a ribonucleic acid virus that is enveloped in a nucleocapsid, which is a lipid envelope that can be emulsified by surfactants (such as those found in simple soap), which will kill the virus. As such, general guidance for hygiene habits to prevent the spread of SARS CoV-2 hold true for non-contact lens wearers and contact lens wearers alike: 1) Wash hands frequently with soap and water for 20 seconds (especially after coughing, sneezing, etc.); 2) If soap and water are unavailable, hand sanitizer with at least 60% alcohol should be used; and 3) Avoid touching your eyes, nose, and mouth with unwashed hands (Jones et al, 2020).

It is critical to continue to promote hygienic habits with contact lens wearers by promoting handwashing prior to lens application and removal. Proper cleaning and disinfecting steps should be presented to non-daily disposable lens wearers as well.

The Verdict

I fit the patient with a monthly replacement multifocal for astigmatism lens to correct both distance and near vision. Appropriate application and removal training was performed, and the patient was dispensed diagnostic lenses. Two weeks later, at follow up, she reported loving the contact lenses and wanting to continue with them.

Masks are the new normal. With that said, it is critical to understand the opportunity that safely used contact lenses can provide for patients.

Understanding the current literature is critical for assuring patients and providing appropriate guidance for contact lens wear. Note: If you have not read the Jones et al article referenced here, you should. It provides good guidance for practitioners on contemporary thoughts surrounding COVID-19 and contact lens wear. CLS

For references, please visit www.clspectrum.com/references and click on document #300.