Question
QUESTION: Dr. Axelrod,
I was wondering, I have been a big fan of opti-free replenish and have been using it for as long as I have had contacts which has been years. Well, I have noticed that my eyes have been getting a bit red. I remembered that when I took out that particular bottle of solution out, I took it out of the cabinet and it MAY have been exposed to the sunlight for a little bit. Will that affect the contents of the solution, and therefore have a pretty good chance of causing the red eyes?
My doctor's office told me that I can switch to Clear Care solution, and use saline to rinse while soaking it in clear care. However, I told them that I also have a lot of opti-free replenish at home, and they suggest that I use replenish as normal, and then just use clear care once a week to disinfect and makes the lenses cleaner and healthier so long as I use pure saline to rinse out all the clear care. I was also told that after the clear care has neutralized, it becomes saline. So it would be safe to clean it out with saline, and then continue on with the opti-free as normal right?
Would that really make the lenses better and cleaner and better for your eyes? I mean, isn't opti-free equally effective as clear care? Do you have any idea why they would advise to use once a week, or is that a new notion? Thank you.
Kristy
ANSWER: hi Kristy,
I'm a big fan of rubbing lenses to keep them clean. None of the NoRub systems keep lenses as clean as a simple daily rub. Also the no rub systems limit lens life to 30 days unless you rub. (I think all but don't quote me) Both the solutions you speak of are FDA approved as effective and sufficient as disinfecting agents. But rubbing with ClearCare would be tricky since you'd be handling the hydrogen peroxide solution which I don't recommend. Though clearcare is good, it does have a cleaning agent built in, which itself can be irritating to the ocular surface and therefor it does not turn into pure saline like it's predecessor AOSept did. With the AOSept system, you would first rub to clean the lens with a dedicated daily cleaner like Miraflow. They are stopping the AOSept and Miraflow production and trying to compete with the other no rub products with ClearCare as a no rub system. You could still rub with any daily cleaner, rinse off with plenty of saline then run it through the ClearCare system. But that's a lot of trouble. It sounds like your going through a lot of trouble when you are really trying to solve the red eye problem but don't know why you have the red eye problem.
Here's what I suggest.
Stop the contacts for a few days and make sure your eyes can be fine without bothering them with contacts.
Then use a new bottle of optifree and new fresh contacts and see what happens.
Then if you have a problem, switch to a different multipurpose solution like Aquify or Complete or Renu. Probably you'll find one that is ok providing you just aren't contact lens intolerant or poorly fit.
Using the Clearcare once a week as a magic bullet won't make a big difference.
About your question about sunlight:I don't know, you could call Alcon and see if they can tell you. Yes you could do the rinse with saline or even rinse with optifree after clearcare but clearcare is meant to allow the lenses to be inserted right out of the neutralized solution. Rinsing with saline may help if your sensitive to clearcare: but if you are sensitive to it just don't use it at all. And don't use a solution if you're sensitive to it even if you try to rinse it off with saline.
Hope that helps,
Mitch Axelrod, OD
---------- FOLLOW-UP ----------
QUESTION: Hi Dr. Axelrod, thank you for getting back to me. So as long as we use saline to rub off the clear care, we can go ahead and use opti-free? If we use saline to clean off the lenses, we can change solutions right? Would that still be considered "mixing solutions." I was told to never mix any solutions, but if unpreserved saline is used to clean off the lenses before using another kind of solution, then that would be no problem then?
However, is clear care THAT much better than opti-free replenish? What is your personal choice?
Thank you.
ANSWER: So as long as we use saline to rub off the clear care, we can go ahead and use opti-free?
You can use optifree to rinse off residual NEUTRALIZED Clearcare, you don't have to use saline but yes you can. But why rinse off the neutralized clear care, you can put it in your eye. If you are rinsing off clearcare because you are sensitive to the neutralized Clearcare, don't use Clearcare.
If we use saline to clean off the lenses, we can change solutions right?
Yes, but again what are you trying to achieve by using multiple solutions? Remember, the contacts are 'wet sponges' and as such you cannot rinse all the previous solution out. That is why you cannot attempt to rinse off UNneutralized Clearcare as it is inside the lens.
Try to find a single system/solution. You can develop a sensitivity or allergy to any solution at any time. Do not think that once you are OK with optifree you are forever OK with optifree. You may need to try a different multipurpose solution. Remember to rub your lenses upon removal to keep them clean.
Do not store your lenses in saline nor clearcare. Read the instructions and if anything I said counters the instructions,go with the instructions.
Regards,
Mitch Axelod, OD
---------- FOLLOW-UP ----------
QUESTION: Oh I see I see. Well then I have one more thing to clarify from your recent answer and that is simply this. I think I need to make an example. For example, clear care is being used to soak for 6 hours. After the 6 hours or more, it's put into the eyes. At the end of the day, the contacts are taken out and rinsed with saline. Then it is rubbed and soaked overnight with opti-free for the rest of the week. The clear care is only to be used once a week. Is that a dangerous system? Is that still considered "mixing solutions" if Clear care, unpreserved saline or regular saline, and opti-free are used just for once a week? Will that get rid of red eyes? Okay I'm done after this post, I promise. Thank you.
Answer
You can go to all that trouble and still have red eyes. Again, you need to find out why the eyes are red and all you are doing is introducing more product and variables to muddle the picture. Back off the contacts, make sure the eyes are OK, then introduce one variable at a time with a new pair of contacts.
Best of luck,
Mitch Axelrod, OD
