CONTACT LENSES (CLs) can be safely fit if you take the proper precautions and take the time to educate patients. Continual patient education on proper hygiene and healthy lens wear is always pertinent. Patients should be instructed to wash their hands for 20 seconds with soap and water and dry with a clean paper towel prior to applying and removing CLs.

Proper wear and care of CLs is also very important. Instruct patients to replace daily disposable lenses after each wear. Patients should be told to clean and disinfect reusable lenses according to their eyecare practitioner’s recommendation. Also, remind them not to top off or reuse solutions.

A study from the Netherlands evaluated the effect of commonly used CL disinfectants on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Veugen et al, 2022). The efficacy of five different disinfectant solutions against SARS-CoV-2 was tested with and without CLs. The rub and rinse process is required for three of the solutions. Control solutions were 3% hydrogen peroxide (HP) and viral transport medium (VTM).

Silicone hydrogel, unused rigid GP, soft hydrogel, and soft silicone hydrogel CLs were tested. The lenses were infected with SARS-CoV-2 and disinfected per the manufacturer’s instructions at various time points, with and without rubbing and rinsing. Reverse-transcriptase polymerase chain reaction (RT-PCR) was used to detect SARS-CoV-2 RNA, and viability polymerase chain reaction (PCR) was used to detect viral infectivity of SARS-CoV-2.

Fortunately, no SARS-CoV-2 RNA could be detected when disinfectant solutions were used according to the manufacturer’s instructions in SARS-CoV-2–infected CLs. When the rub-and-rinse step was not applied to infected CLs, SARS-CoV-2 RNA was detected at almost every time interval with each disinfecting solution tested for both new and worn lenses.

In the absence of CLs, viable SARS-CoV-2 was detected with all disinfectant solutions except one at all time points. However, that particular solution should only be used for GP lenses.

In this study, CLs can be disinfected effectively from SARS-CoV-2 if the manufacturer’s instructions are followed. However, multipurpose disinfecting solutions show poor antiviral activity against SARS-CoV-2 when the manufacturer’s instructions are not followed.

Most publications report the disinfecting efficacy of CL solutions against bacteria, yeasts, molds, and Acanthamoeba spp (Rosenthal et al, 2004; Zhu et al, 2011; Kilvington and Lonnen, 2009; Kal et al, 2017; and others. Full list available in the reference list below.). There is scarce information in the literature about the antiviral efficacy of CL disinfecting solutions. This is likely due to regulatory requirements (Yasir et al, 2021). Yasir and colleagues (2021) recently analyzed the disinfection efficacy against a surrogate of the human SARS-CoV-2, mouse hepatitis virus (MHV), and reported that the rub-and-rinse step is essential for disinfection.

A different study compared several disinfection methods for CLs infected with adenovirus type 8 (AV-8) and adenovirus type 19 (AV-19) and found significant decreases in viral titer of both serotypes; only heat disinfection was found to eliminate the virus from soft CLs (Kowalski et al, 2001).

Another study tested the disinfection efficacy of CL solutions against various viruses, including Acanthamoeba spp, herpes simplex virus 1, and AV-8, and reported that the disinfecting efficacy of the viruses was effective with both rub-and-rinse and no-rub-and-rinse regimens (Heaselgrave et al, 2010). This study contradicts the aforementioned study, and other studies, that demonstrated the importance of applying the rub-and-rinse principle before storing CLs in the lens case (Rosenthal et al, 2004; Zhu et al, 2011).

These studies demonstrate that there is an opportunity for future research on the antiviral efficacy of various types of CL disinfecting solutions. CLS

REFERENCES

1. Veugen JMJ, Nuijts RMMA, van den Biggelaar FJHM, et al. Effectiveness of Commonly Used Contact Lens Disinfectants Against SARS-CoV-2. Eye Contact Lens. 2022 Sep 1;48:362-368.
2. Rosenthal RA, Henry CL, Schlech BA. Contribution of regimen steps to disinfection of hydrophilic contact lenses. Cont Lens Anterior Eye. 2004 Sep;27:149-156.
3. Zhu H, Bandara MB, Vijay AK, Masoudi S, Wu D, Willcox MDP. Importance of rub and rinse in use of multipurpose contact lens solution. Optom Vis Sci. 2011 Aug;88:967-972.
4. Kilvington S, Lonnen J. A comparison of regimen methods for the removal and inactivation of Bacteria, Fungi and Acanthamoeba from two types of silicone hydrogel lenses. Cont Lens Anterior Eye. 2009 Apr;32:73-77.
5. Kal A, Toker MI, Kaya S. The comparison of antimicrobial effectiveness of contact lens solutions. Int Ophthalmol. 2017 Oct;37:1103-1114.
6. Lakhundi S, Khan NA, Siddiqui R. Inefficacy of marketed contact lens disinfection solutions against keratitis-causing Acanthamoeba castellanii belonging to the T4 genotype. Exp Parasitol. 2014 Jun;141:122-128.
7. Siddiqui R, Lakhundi S, Khan NA. Status of the effectiveness of contact lens solutions against keratitis-causing pathogens. Cont Lens Anterior Eye. 2015 Feb;38:34-38.
8. Yasir M, Kumar Vijay A, Willcox M. Antiviral effect of multipurpose contact lens disinfecting solutions against coronavirus. Cont Lens Anterior Eye. 2021 Oct;27:101513.
9. Kowalski RP, Sundar-Raj CV, Romanowski EG, Gordon YJ. The disinfection of contact lenses contaminated with adenovirus. Am J Ophthalmol. 2001 Nov;132:777-779.
10. Heaselgrave W, Lonnen J, Kilvington S, et al. The disinfection efficacy of MeniCare soft multipurpose solution against Acanthamoeba and viruses using stand-alone biocidal and regimen testing. Eye Contact Lens. 2010 Mar;36:90-95.