Telehealth provides window for contact lens support during COVID-19
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While recent data have shown no increased risk for COVID-19 through contact lens wear and indicates that the use of contact lenses remains ultimately safe, researchers highlighted the need for altered management including advising patients to reduce or eliminate sleeping in contacts and using telehealth to discuss care.
“The lack of evidence from previous outbreaks of coronavirus disease, including SARS, suggests that the risk of developing COVID-19 from contact lens wear is low,” Lyndon Jones, PhD, FCAHS, FCOptom, FAAO, from the Centre for Ocular Research and Education at the University of Waterloo, Canada, wrote in this study. “It is informative to consider viral diseases that are transmitted by direct contact and which could be used as a surrogate for evaluating the risks of COVID-19 in contact lens wearers.”
Jones and colleagues reviewed recent literature that showed no evidence that contact lens wearers were more likely to contract COVID-19 than spectacle wearers. Other data indicate that the eye is rarely involved in human coronavirus infection and is not a preferred gateway of transmission, much like other studies that have shown no increased risk for epidemic keratoconjunctivitis or HIV among those who use contact lenses.
“Given that contact lens wearers must touch their eyes when applying and removing their contact lenses, it is understandable this has been raised as a potential concern for increasing their risk of exposure to the virus,” Jones and colleagues wrote. “Best practice advice for contact lens wearers includes the same instructions that should be imparted under all situations, regardless of the COVID-19 pandemic.”
This includes thorough handwashing with soap and water followed by hand drying with unused paper towels before every contact lens application and removal.
The researchers also wrote that it has been suggested that siloxane-based materials are more likely to bind COVID-19 than hydrogels; however, there have been no laboratory studies yet reporting on the ability of coronaviruses to adhere to contact lenses.
“The factors governing the binding of SARS-CoV-2 to inanimate surfaces are so far unknown, but for a variety of waterborne viruses the major driving factors were electrostatic interactions (charge driven), followed by hydrophobic interactions, with only minor impact from van der Waals interactions,” they wrote.
With varying access to local eye care during the pandemic, Jones and colleagues suggested that a key consideration for practitioners is to minimize the impact of contact lens-related adverse events on the wider health care system, which has often been overtaxed. Options include telephone contact with patients reporting contact lens problems or video consultation using a suitable application to enable rapid triage and management.
“It is imperative that eye care professionals avail themselves of the relevant options as early as possible in order to act quickly in the interests of both their patients and the wider health care system, and not begin to investigate the possibilities only after a contact lens wearer reports having some form of adverse event,” Jones and colleagues concluded. – by Talitha Bennett
Disclosures: Jones reports he is an employee of the Centre for Ocular Research & Education and either a consultant or serves on an advisory board for Alcon, CooperVision, Johnson & Johnson Vision Care, Novartis and Ophtec. Please see the full study for all other authors’ relevant financial disclosures.
Perspective
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Glenda Secor, OD, FAAO
The absence of a vaccine, the paucity of reliable testing capabilities and only heroic treatments for the COVID-19 pandemic has overwhelmed our lives. Everyone is scared. Practitioners were prepared to address urgent eye issues and are now anxious to resume routine care. Because of our prompt, efficient and effective response to the crisis, our role within the health care arena has been confirmed. Never have we been better prepared and never has educating our patients been more critical.
It is well documented that contact lenses do not give patients COVID-19, nor do they increase the risk for contracting the virus. The virus has not been found in human tears of patients who tested positive for the virus.
Due to dryness or lens awareness, contact lens patients may touch their eyes more frequently which allows their hands to become a pathway for pathogens. Hygiene including proper hand washing and compliant lens care and replacement are critical to reducing the risk for complications regardless of COVID-19 concerns.
While glasses may reduce contact lens irritation and may reduce exposure from aerosol droplets, they fog up with most masks and spectacle patients complain more about this annoyance.
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