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Welcome to question of the day #295

Eyetools question of the day #295

Lots of my contact lens patients store, clean and handle their contact lenses in the bathroom/toilet. Is this a good idea?

 No this is not a good idea.

 Instructions about contact lens hygiene traditionally contain statements such as: ‘Never allow your contact lenses or lens case to come into contact with tap water, bottled water, or saliva.’ ‘Never use your lenses for swimming, hot tubs, or water sports.’ And ‘Never wear your lenses when showering.’ I haven’t yet seen instructions advising not to use the bathroom as the base in the house for inserting, removing, cleaning, and storing contact lenses.

It’s not surprising that people use the bathroom, as there is a sink for disposing of solutions, a bin for disposing of contact lenses and packaging, a mirror to assist with insertion and removal, and storage for all the contact lens paraphernalia. What is surprising is that contact lens and contact lens solution manufacturers don’t advise (strongly) against it.

Here are two good reasons for not using the bathroom as a contact lens base.

Pseudomonas is a type of germ (bacteria) found in the environment, soil and water. Of the many different types of Pseudomonas, the one that most often causes infections in humans is called Pseudomonas aeruginosa. It is also the most common pathogen in contact lens keratitis and corneal ulcer; these can lead to catastrophic vision loss. It has also been isolated from bathroom components.

Acanthamoeba is commonly found in lakes, swimming pools, heating, and air conditioning units and, tap water. It is an amoeba which is a single-celled animal that catches food and moves about by extending finger-like projections. Acanthamoeba keratitis affects roughly 1.2 to 3 million people each year, is difficult to treat with conventional medications, and may cause permanent visual impairment, due to cornea obliteration. It is nearly always associated with soft contact lens wear. Acanthamoeba has been isolated from bathroom cold taps supplied with water stored in internal roof tanks but not mains-fed kitchen cold taps.

Given this type of information, the average person in the street would think that it would be a bad idea to use the bathroom as a base for contact lenses; I would agree with them.

Get out of the bathroom and relocate to a bedroom, study, or nursery; anywhere where there isn’t any tap or toilet water. Set up a new base with absorbent paper (replaced daily), a mirror, and a bin. Wash hands with soap or detergent using hot water and dry with a lint-free towel. Then, move to the new base to deal with the contact lenses. Leave the Pseudomonas aeruginosa and the Acanthamoeba behind.