In December 2019, as the COVID-19 pandemic had not yet erupted, a group of forward-thinking leaders in contact lens practice was already working to address issues that are now even more critical than ever to discuss—the safety of reusing contact lenses for fitting. In this issue, our authors provide a technical report that represents consensus among the leading organizations in the profession of optometry: the American Academy of Optometry and the American Optometric Association. This is an important alliance that I hope will continue to grow with time.
Optometry and Vision Science puts a high priority on bringing evidence-based clinical practice guidance to our community, and this joint consensus recommendation is an excellent example of the convergence of expert-guided review of evidence and distillation of that evidence into practical clinical guidelines.
This collaborative effort involved individuals who are active in the leadership of the American Academy of Optometry's Cornea, Contact Lens, and Refractive Technology Section, as well as members of the American Academy of Optometry's Contact Lens and Cornea Section. The workgroup includes three diplomates in the Cornea, Contact Lens, and Refractive Technology Section, which is a testament to the knowledge, expertise, and commitment to advancing the art and practice of the profession that is part of the ethos of achieving diplomate status within the academy.
During the COVID-19 pandemic, the journal has received numerous expert opinions on the SARS-CoV-2 virus, ocular susceptibility, and its implications for contact lens use and disinfection. None of these submissions survived peer review. What was lacking in each case was a foundation on defensible science. What the authors of this technical report have created is a well-developed, science-based, defensible set of practical guidelines that provide a rational basis for changing clinical practice that should survive the test of time.
To be clear, these guidelines were developed and reviewed before the onset of COVID-19, and although others developed responses in reaction to the pandemic, these guidelines are not specific to this event. They address all common clinical pathogens and stress fundamental health and hygiene practices that are the basis for good clinical practice guidelines.
The guidelines come down to the following ideas and fundamental guidelines1:
- 1. The ideal approach for trial contact lenses is to use the lens a single time, after which the lens is dispensed to the same individual or discarded. Where reuse is necessary, moist heat management is preferred over chemical management whenever applicable per the 2018 ISO Standards.
- 2. Contact lens practitioners should take every precaution to limit multipatient contact lens transmission of disease by educating themselves and their staff on best practices for disease control. This includes the techniques of hand washing, gloving, disinfection of instruments, contact lenses, storage cases, and management of in-office contact lens solutions.
- 3. If an option is based on patient's individual needs, empirical fitting without the use of a trial lens is suggested.
- 4. When disinfection of diagnostic lenses is required, the authors offer a quick reference guide useful for the contact lens practice.
1. Sindt C, Bennett E, Szczotka-Flynn L, et al. Technical Report: Guidelines for Handling of Multipatient Contact Lenses in the Clinical Setting. Optom Vis Sci 2020;97:544–8.