sleeping with contact lenses
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A study recently published in the Morbidity and Mortality Weekly Report reveals the effects of sleeping with contact lenses on eye health.

Contact lenses are a popular alternative to corrective spectacles, with approximately 45 million Americans choosing to use them. Despite their popularity, using contact lenses can lead to serious eye infections if they are not properly cleaned and maintained, or if they are not used as recommended.

Typically, it is the front layer of the eye—the cornea—that becomes infected. If left untreated, complications can develop that can lead to vision loss and permanent eye damage. This risk is considerably increased by six- to eight-fold simply by keeping contact lenses in while sleeping, which is cause for concern for the 33% of the American population who report sleeping with contact lenses.

The serious impacts of sleeping with contact lenses were recently published by the Centers for Disease Control and Prevention (CDC) in Morbidity and Mortality Weekly Report. This article highlighted the need for strategies that will not only encourage contact lens users to adopt better habits associated with wearing and maintaining contact lenses but also encourage them to report related health issues to the relevant regulatory agency.

Problems caused by contact lenses should be reported to regulatory agencies

In the USA, all contact lenses, whether for medical or decorative purposes, are regulated by the Food and Drug Authority (FDA) as medical devices. This means that you need a valid prescription to purchase contact lenses. In the USA, prescriptions are generally valid for up to two years. Regular visits to an eye health professional not only monitor eye health but also reinforces correct wear and care procedures for contact lenses.

The FDA relies on members of the public and healthcare professionals, as well as manufacturers, to report any adverse events associated with contact lenses. However, unless the public or eye health professionals report adverse incidents caused by contact lenses to the FDA, manufacturers will remain unaware of any issues associated with their products and will not be able to make improvements.

Sleeping with contact lenses can cause eye infections

The CDC article described six contact lens users aged between 17 and 59 years old, who had developed eye infections after sleeping with soft contact lenses used for correcting vision or for aesthetic reasons. Some slept with their contact lenses for as little as two nights, while others consistently slept with their contacts in. Some individuals also admitted to not changing their contacts as regularly as they should, and others purchased their contacts without a valid prescription.

Eye problems included eye pain, blurry or reduced vision, redness, and light sensitivity. The symptoms experienced by three of the individuals were so severe that they went to their closest hospital emergency department for care. All six individuals were diagnosed with bacterial eye infections, including two ulcers, and needed antibiotic treatment. In the most severe cases, antibiotic treatment involved hourly administration for up to six months. Two individuals also needed to have a corneal transplant as the infection had perforated (punctured) their cornea.

Sleeping with contacts can cause permanent eye damage

By the end of the treatment period, all six individuals had some degree of vision loss. Three individuals also had a scarred cornea, which causes permanent eye damage. The financial and social impacts of these outcomes cannot be underestimated, particularly for younger individuals.

It must be emphasised that these six cases represent the most serious cases seen by ophthalmologists over the last two years. Also, it is not known if these individuals were more likely to develop eye infections compared with other individuals with similar habits.

How can we avoid eye infections caused by sleeping with contact lenses?

These cases demonstrate that eye infections linked to sleeping with contact lenses can affect all contact lens users regardless of their age and habits. Encouraging individuals to keep regular appointments with their eye health professional is an important step towards educating contact lens users about correct wear and care procedures. These regular check-ups can also be used to monitor and report on any issues that might arise from contact lens use.

Written by Natasha Tetlow, PhD

References: Cope JR, et al. Corneal infections associated with sleeping in contact lenses – six cases, United States, 2016-2018. MMWR Morb Mortal Wkly Rep. 2018;67:877-881. DOI: http://dx.doi.org/10.15585/mmwr/mm6732a2

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