Covid-19 and Contact Lenses: Know the Risks Before you Wear

The current COVID-19 pandemic has brought many patients and prospective patients to our virtual doorstep in search of information – and in need of comfort. We believe real information and actionable advice are comforts in and of themselves. So, let’s put everyone’s mind at ease about contact lens wear and coronavirus, and leave you with simple things you can do to stay safe.

What we know about Covid-19 and contacts

As of April 2020, there are no published, peer-reviewed scientific studies examining a potential increased risk of Covid-19 transmission and infection in contact lens wearers. What we do know is that the 2019 novel coronavirus (2019-nCoV), like other viruses, can be transmitted through the body’s mucous membranes like the eyes, nose and mouth. There are three principle routes by which a healthy individual can conceptually contract the virus from an infected individual:

• An infected person can cough, sneeze, or breathe such that droplets or microdroplets come in contact with the mucous membranes (nose, mouth, eyes) of an individual nearby. This is why healthcare providers at Covid-19 testing sites wear both a face mask and either goggles or a face shield to protect their eyes.
• Droplets and fluids containing the virus can be transferred directly from an infected individual to a healthy individual, as when two people are playing basketball and one guards the other. The virus is then introduced into the body when the healthy individual touches their nose, mouth, or eyes with their hand or arm, to which the virus had been passed. From there, the coronavirus can find its way to the lungs and wreak havoc, particularly in vulnerable individuals. Note that virus alone on skin, without transfer to the nose, mouth, or eyes, is not thought to cause Covid-19 infection.
• Droplets and fluids containing the virus are passed from an infected individual to a healthy individual via an inanimate object, such as a tricycle or toy passed between two neighborhood children in your yard or on a play date; a basketball, football, or baseball being passed around; a grocery cart handle; or a gas pump handle. When the healthy individual then touches a mucous membrane surface (nose, mouth, eyes), the individual becomes infected with Covid-19.

Note that in routes #2 and #3 above, the final step involves the healthy person touching their face and infecting themselves with the virus. This is why health authorities from the beginning have emphasized the importance of regular handwashing and minimizing any touching of the face.

Handwashing and avoiding face touching

Knowing this, there are two very good ways to prevent the virus from entering your airways: 1) handwashing and 2) not touching your face, which can prove “easier said than done.” The American Journal of Infection Control discovered in a 2015 study that people touch their faces, on average, 20-plus times per hour; nearly half the time, they touched the eyes, mouth and nose. Over the course of a day, we’re playing Russian roulette with viruses hundreds of times!

Have you ever tried not to touch your face? It’s challenging, but the habit can be unlearned. Many of us rub tired eyes (a terrible habit for many reasons), scratch our nose, bite our fingernails, or touch our faces for any number of other subconscious reasons.

During a worldwide pandemic as we are all striving to unlearn the habit of unconscious face touching, how does it help to have planned, twice-daily, conscious face touching – in the form of contact lens insertion and removal – on our schedule? Also, how much more frequently do we touch or rub our eyes when wearing contact lenses? Who has ever had a lens fold, rotate, or roll around in their eye? Who has had to adjust their contact lens in their eye during the day? When the need arises for contact lens adjustments, how often is soap, a faucet, a sink, and a newly washed towel or clean paper towel in close proximity? Even in the minority of cases when all of this is available, like if you work from home, how often do contact lens wearers take the time, each and every time, for proper hand washing before adjusting their contacts?

The data on this question are grim. According to a report published in 2015 by the Centers for Disease Control and Prevention (CDC), “almost all of the 41 million estimated contact lens wearers in the United States may be engaging in at least one behavior known to increase their risk of eye infections.”

One source, the American Optometric Association (AOA), reported, “there is substantial evidence that many contact lens wearers are not compliant with hand washing procedures, up to 50 percent in some reports, and this increases the risk of microbial contamination of contact lenses.” A 2015 consumer survey showed that 1/3 of Americans report handling contact lenses without washing their hands, and even 28% of medical students in an international study did not wash their hands prior to handling their contact lenses.

Even among contact lens wearers who wash their hands, how many are using proper technique? Surveys show that 94-96% of Americans think they wash their hands properly [sources: QSR Magazine, 2009 https://www.qsrmagazine.com/news/are-americans-washing-their-hands and Harris Interactive, 2010], but a USDA study published in May 2018 showed that we are doing so just 3% of the time. [source: https://www.usda.gov/media/press-releases/2018/06/28/study-shows-most-people-are-spreading-dangerous-bacteria-around]  Unless you’re an A+ hand washing student, wearing contacts during a viral pandemic may not be ideal.

When should contact wearers wash up?

Probably more often than most are accustomed to. If you wear contact lenses, you will need to wash your hands both before and after inserting or removing contacts, at the very least. And odds are you’ll need to step up your scrubbing technique, too.

A 2013 study by researchers at Michigan State found that about 95 percent of people observed did not properly wash their hands. That is, they failed to wash long enough with the correct technique to kill germs, banish bacteria and vanquish viruses. Some failed to use soap; others didn’t wash at all.

It’s imperative to know when to wash hands. You accumulate germs from everything you touch throughout your day – germs that can infect you when you touch your face, or infect others when you shake hands. Frequent handwashing will help you limit your exposure to, and transfer of, microbes that can spread diseases like Covid-19.

Wash BEFORE and AFTER:

• Inserting or removing contact lenses
• Touching or rubbing your eyes, nose or mouth
• Food preparation
• Eating a meal
• Wound care
• Caring for a sick person
• Using the restroom or changing diapers
• Touching surfaces in public spaces (handrails, cart handles, doorknobs)

Also wash AFTER:

• Coughing, sneezing and blowing your nose
• Petting or feeding pets
• Handling household waste
• Hands become visibly dirty

Is there a proper handwashing technique to follow?

Washing your hands isn’t difficult. It’s not even time-consuming – you just need 20 seconds to kill most germs. The World Health Organization (WHO) recommends following this handwashing technique:

1. Wet both hands with warm water. You don’t have to use hot water for a good clean. In fact, scalding water could cause burns! Just keep the temperature comfortable.
2. Apply enough soap to adequately clean both hands (front and back) and wrists.
3. Rub palms together.
4. Then, clean the back of each hand with the opposite palm, interlacing your fingers.
5. Again, rub palms together, interlacing your fingers to get the dirt and germs that hide out between fingers.
6. Interlock the fingers of both hands, so that you can rub the back of your fingers against the palm of the opposite hand. It’ll feel a little bit like shaking your own hand as if to say, “Congrats on that stellar technique, clean freak!”
7. Grip your thumb with the opposite hand and use a rotational movement to clean the thumb. Think of it as a motorcycle throttle movement.
8. Scrub the tips of your fingers in a circular motion on the palm of the opposite hand. This helps clean dirt from under the fingernails. Repeat on both hands.
9. Don’t forget the wrists! Rub your wrists with your hands.
10. Rinse your hands thoroughly with clean water and use your elbow to turn off the tap.

The whole process should take at least 20 seconds, about the time it takes to sing “Twinkle, Twinkle, Little Star.” In this classic handwashing video, the subject illustrates the importance of washing all surfaces of the hands and wrists by working to coat a pair of gloves with paint.

 

Finally, remember to dry your hands hygienically with a clean, single-use towel. If you’re leaving a restroom, use the towel or your elbow to open the exit door.

A word about hand sanitizer …

Sometimes soap, water and a sink aren’t readily available. If this is the case, try to get a hold of hand sanitizer that contains at least 60 percent alcohol. To clean hands, apply a liberal amount of sanitizer to the palm of your hand. Rub your hands together and rub the product thoroughly over all surfaces of your hands, front and back, until your hands and fingers are dry. Repeat if you can.

“If you wear contact lenses, switch to glasses for a while.”

We certainly understand the anxiety contact lens wearers are experiencing in light of the novel coronavirus outbreak. Many have made the choice to seek alternative solutions, such as LASIK, or switch to glasses, as recommended by the American Academy of Ophthalmology. No matter how careful we are, anyone can understand that minimizing face touching minimizes the risk of virus transmission.

For those who continue to choose contacts

For those who still choose to wear contacts, to minimize additional risk, be vigilant about frequent and proper handwashing every day. That means washing hands before and after every insertion or removal of contact lenses. (The same goes for you too, eyeglass wearers!) Ensure that you are always drying your hands with clean towels.

Dispose of daily use contact lenses at the end of the day – do not reuse them! If you use weekly or monthly contacts, disinfect contacts according to the instructions provided by the manufacturer or prescribing doctor.

Avoid touching your eyes, especially in dusty, wet or dirty environments. Call an eye care professional if you experience any worrisome symptoms:

• Redness or crusty eyes
• Blurring with either or both eyes
• Pain or discomfort

 What if I experience flu-like symptoms?

The symptoms of Covid-19 are similar to many other contagious diseases, such as the flu: fever, cough, fatigue, body aches, sore throat and chest tightness. Some experience only mild symptoms, while other gradually get worse. Others may never have symptoms at all.

If you do experience cold or flu-like symptoms, discontinue contact lens use if you have not already done so. Contact your primary care physician for a telehealth evaluation.

Of course, for the best primer on Covid-19 and emerging news about the virus, we encourage you to visit the Centers for Disease Control and Prevention (CDC) at CDC.gov. Eye health questions and concerns, on the other hand, are in Brinton Vision’s wheelhouse and we will continue to assist you with vital, relevant information as we all navigate this time together.

Direct your questions about Covid-19, contact lenses, LASIK, and vision correction surgery to Brinton Vision by clicking “contact us” above or calling us at 314.375.2020.