Contact Lens Care
Illness or emergency treatment may require that you insert or remove and store a patient’s contact lenses. Proper handling and lens care techniques help prevent eye injury and infection as well as lens loss or damage. Appropriate lens-handling techniques depend in large part on what type of lenses the patient wears.
All contact lenses float on the corneal tear layer. Soft lenses have diameters typically exceeding the diameter of the cornea; rigid lenses have diameters that are typically smaller than the cornea. Because they’re larger and more pliable, soft lenses tend to mold themselves more closely to the eye for a more stable fit than rigid lenses.
Modes of lens wear vary widely. Although most patients remove and clean their lenses daily, some wear lenses overnight or for several days (sometimes up to a month) without removing them for cleaning. Still other patients wear disposable lenses, which means that they replace old lenses with new ones at regular intervals (a few days to a few months), possibly without removing them for cleaning between replacements.
Keep in mind that handling contact lenses improperly can provide a direct source of contamination or injury to the eye.
Equipment
Patient’s own equipment for contact lens care, if available ▪ towel ▪ lens storage case or two small medicine cups ▪ adhesive tape ▪ gloves ▪ sterile normal saline solution or soaking solution ▪ flashlight, if needed.
Preparation of Equipment
If a commercial lens storage case isn’t available, place enough sterile normal saline solution into two small medicine cups to submerge a lens in each one. To avoid confusing the left and right lenses, which may have different prescriptions, mark one cup “L” and the other cup “R” and place the corresponding lens in each cup.
Implementation
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.1
Tell the patient what you’re about to do, perform hand hygiene, and put on gloves to help prevent ocular infection.2,3,4
Place a towel on the patient’s chest.
Inserting Soft Lenses
To see if the lens is inside out, bend it between your thumb and index finger or fill it with saline or soaking solution. If the lens tends to roll inward or the edge points slightly inward, it’s oriented correctly. If the edge points outward or the lens tends to collapse over your fingertip, it’s probably inside out and should be reversed.
Wet the lens with fresh normal saline solution and rub it gently between your thumb and index finger, or place it on your palm and rub it with your opposite index finger. Rinse well.
Place the lens, convex side down, on the tip of the index finger of your dominant hand.
Instruct the patient to gaze upward slightly.
Separate the eyelids with your other thumb and index finger, and place the lens on the sclera, just below the cornea. Then, slide the lens gently upward with your finger until it centers on the cornea.
Using the same procedure, insert the opposite lens.
Inserting Rigid Lenses