Contact Lens Hygiene and Care: A San Francisco Optometrist's Guide

You are running late, your hands are not quite clean, and you pop a contact lens in anyway. Most days nothing happens. But contact lenses sit directly on the most exposed surface of your eye, and the shortcuts that feel harmless are exactly the ones that land people in our chair with a red, painful eye.

The short answer: Healthy contact lens wear comes down to a few non-negotiable habits. Wash and dry your hands before every touch, keep lenses away from water of any kind, clean and store them in fresh solution (never yesterday's, never tap water), replace your lenses and your case on schedule, and take out your lenses at the first sign of pain, redness, or light sensitivity. Do those things and contacts are safe and comfortable for decades.

This guide comes from Dr. Michelle Blas, OD at Eyes in Disguise Optometry on Union Street in San Francisco's Cow Hollow, where specialty contact lens fittings are part of the daily work. Here is how to wear your lenses without putting your eyes at risk, and the warning signs that mean it is time to call.

Wash and Dry Your Hands Every Single Time

This is the habit that prevents the most problems, and it is the one people skip most. Every time you handle a lens, you transfer whatever is on your fingers onto your eye.

• Wash with plain soap and water before you insert or remove a lens, every time, no exceptions.
• Avoid moisturizing or heavily scented soaps. The oils and fragrances leave a film on the lens that irritates your eye and blurs your vision.
• Dry your hands with a lint-free towel. Fibers from a regular hand towel stick to a wet lens and scratch your eye going in.
• Handle lenses over a clean surface, not an open drain, so a dropped lens does not disappear or pick up grit.

A good rule: same hand, same lens, same order every day. Starting with the right eye each time makes it much harder to mix up an old lens with a fresh one.

Can You Shower, Swim, or Sleep in Contacts?

Short version: no, no, and almost never. These three habits cause a large share of the serious contact lens infections we see.

Water and contacts do not mix. Tap water, shower water, pool water, hot tub water, and Bay water all carry microorganisms your lens will trap against your eye. The one that worries optometrists most is Acanthamoeba, a microbe found in water that causes a rare but devastating corneal infection. It is hard to treat and can permanently damage vision. That is why you take your lenses out before you shower, and why you never rinse or store them in water.

Swimming is the same risk with more exposure. If you swim or surf, wear prescription goggles instead, or use daily disposable lenses under tight goggles and throw them away the moment you get out. Never reuse a lens that touched pool or ocean water.

Sleeping in lenses starves your cornea of oxygen and traps bacteria against it overnight. Studies put the risk of a serious eye infection many times higher for people who sleep in lenses not approved for it. Unless your specific lenses are prescribed for overnight wear, take them out before bed, even for a nap.

How to Clean and Store Your Lenses the Right Way

If you wear anything other than daily disposables, cleaning and storage matter every night. The steps are simple, and each one exists to solve a real problem.

1. Rub, then rinse. Even with "no-rub" solutions, rubbing the lens gently in your palm with a few drops of solution removes far more debris and bacteria than rinsing alone.
2. Use fresh solution every time. Fill the case with new multipurpose solution at every storage. The disinfecting only works when the solution is fresh.
3. Never top off. Adding new solution on top of old solution dilutes the disinfectant and lets bacteria build a resistant film. Empty the case and refill it completely.
4. Never use water or saliva. Not to rinse, not to store, not "just this once" when you run out of solution. If you are out of solution, wear glasses until you can buy more.
5. Keep the bottle tip clean. Do not let it touch your fingers, the lens, or the case, and keep the cap on between uses.

Match your solution to your lenses. Some eyes and some lens materials do better with hydrogen peroxide systems than with multipurpose solution. If your eyes feel dry or stingy by afternoon, ask us about switching, because the solution is often the culprit.

Your Contact Lens Case Needs Care Too

The case is the part almost everyone forgets, and a dirty case re-contaminates a perfectly clean lens. Treat it as part of the routine.

• Empty and rinse it with fresh solution (not water) each morning after you put your lenses in.
• Wipe it and let it air dry face down on a clean tissue. A closed, damp case is where bacteria and biofilm grow.
• Replace the case every three months, and sooner if you see any film or cracks. Cases are cheap. A corneal infection is not.

Follow Your Replacement Schedule, Not Your Optimism

Daily, two-week, and monthly lenses are engineered to be discarded on a schedule. Stretching that schedule is one of the most common habits behind irritation and infection.

• Daily disposables go in the trash at the end of the day, every day. Never sleep in them, never save them for tomorrow.
• Two-week and monthly lenses are counted from the day you open them, not the days you happen to wear them. Mark the date on your calendar or phone.
• An old lens gets deposits of protein and lipid that no cleaning fully removes. Those deposits blur vision and invite bacteria, even if the lens still feels okay.

If cost is why you stretch your lenses, tell us. There is almost always a lens or a supply plan that fits your budget without asking your eyes to carry the risk.

Makeup, Hairspray, and Contacts: Order of Operations

Lenses and cosmetics coexist fine when you get the sequence right.

• Insert lenses first, then do your makeup. Remove your lenses before you take your makeup off at night.
• Skip waterline eyeliner. It clogs the glands that keep your eyes moist and sheds particles straight onto the lens.
• Choose fresh, non-flaking mascara, and replace eye makeup every three months to limit bacteria.
• Close your eyes for hairspray and dry shampoo, and wait for the mist to settle before you blink.

If your eyes are sensitive to makeup, our guide to the best makeup for sensitive eyes covers products and habits that are kinder to lens wearers.

Contacts and San Francisco Screens: The Dryness Problem

Plenty of local lens wearers work long days on screens, and dryness is the complaint we hear most. Contacts sit on your tear film, and screens cut your blink rate by more than half, so the film thins out and the lens starts to feel gritty by late afternoon. The city's wind and dry indoor heat do not help.

• Use the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds, and blink fully a few times.
• Keep contact-lens-safe rewetting drops at your desk. Regular eye drops are not all made for use with lenses, so check the label or ask us.
• Aim vents and heaters away from your face, and consider a small humidifier if your office runs dry.
• Give your eyes a lens-free evening when you can. Switching to glasses after work lets your corneas recover.

If dryness is a daily battle, a different lens material or a daily disposable often solves it, and it can be a sign of dry eye worth evaluating. See our contact lens fittings in San Francisco for how we match the lens to your eyes and your screen habits.

Warning Signs You Should Never Ignore

A healthy contact lens day is a day you barely think about your lenses. When something feels wrong, act on it. Take the lens out first, then decide.

Remove your lenses and call us the same day if you notice:

• Pain or a gritty, scratchy feeling that does not clear when you take the lens out
• Redness that is getting worse rather than better
• Light sensitivity, where normal light suddenly feels harsh
• Blurry vision, discharge, or watering that is new
• A lens that feels stuck, or a sensation that something is still in your eye after removal

Those symptoms can signal a corneal infection or a scratch, and a lens-related infection can move fast. Do not put the lens back in, and do not wait to "see if it settles." Eyes in Disguise offers emergency eye care with same-day appointments for exactly this.

The Bottom Line

Contact lenses are safe and comfortable when you respect a handful of rules: clean, dry hands every time; no water and no sleeping in lenses that are not made for it; fresh solution and a clean case; an honest replacement schedule; and lenses out at the first sign of trouble. None of it is complicated, and all of it protects the one pair of eyes you get.

Due for a lens check or fighting end-of-day dryness? Book a contact lens exam at Eyes in Disguise on Union Street and Dr. Blas will fit you with a lens that suits your eyes and your routine. Call (415) 474-5321 or book online today.

Frequently Asked Questions

Can you shower with contacts in?

No. Shower water carries microorganisms, including Acanthamoeba, that a lens can trap against your cornea and cause a serious infection. Take your lenses out before you shower, and keep them away from tap water entirely.

Can you swim with contact lenses?

You should not swim in your regular lenses. Pool, ocean, and lake water expose them to bacteria and parasites. If you must wear lenses in the water, use daily disposables under tight-fitting goggles and throw them away as soon as you get out, or wear prescription swim goggles instead.

Is it bad to sleep in contact lenses?

Yes, unless your lenses are specifically prescribed for overnight wear. Sleeping in lenses starves the cornea of oxygen and traps bacteria against it, which raises your risk of a serious eye infection many times over. Take them out before bed, even for a nap.

How often should I replace my contact lens case?

Replace your case at least every three months, and sooner if you see any film, cloudiness, or cracks. Rinse it with fresh solution each morning and let it air dry face down between uses.

Can I use water or saliva if I run out of contact solution?

Never. Water and saliva both carry microbes that cause corneal infections. If you are out of solution, wear your glasses until you can buy more. Only fresh contact lens solution disinfects your lenses.

Why do my contacts feel dry by the end of the day?

Long screen time cuts your blink rate and thins your tear film, and dry indoor air makes it worse. Use the 20-20-20 rule, keep contact-lens-safe rewetting drops handy, and give your eyes a lens-free evening. Persistent dryness may mean you need a different lens material or a dry eye evaluation.

Do I still need to clean daily disposable lenses?

No. Daily disposables are worn once and thrown away at the end of the day, so there is no cleaning or storage. Never sleep in them and never save a used one for the next day.

When should I see an eye doctor about my contacts?

Remove your lenses and see an optometrist the same day if you have eye pain, worsening redness, light sensitivity, new blurry vision, or discharge. Otherwise, keep your regular contact lens exams so your prescription and lens fit stay current and your eyes stay healthy.

---

About the author: Dr. Michelle Blas, OD, is an optometrist at Eyes in Disguise Optometry in San Francisco's Cow Hollow neighborhood. A graduate of the SUNY College of Optometry and a member of the American Optometric Association, she specializes in primary and emergency eye care, dry eye treatment, diabetic eye disease, glaucoma management, and specialty contact lens fittings.

Eyes in Disguise Optometry, 2133 Union Street, San Francisco, CA 94123. (415) 474-5321.