Contact Lens Storage Case Hygiene Compliance Is Low

female hand holding contact lenses box in bathroom
female hand holding contact lenses box in bathroom
Periodic reminders and improved patient-practitioner communication can prevent contact lens misuse, a study suggests.

Compliance with contact lens case hygiene is often poor despite a high awareness of risk among contact lens wearers, according to research published in Optometry and Vision Science. 

Researchers determined levels of compliance and risk perception by conducting a study of 299 contact lens wearers (median age, 24 years, 76.9% women). They administered nonvalidated surveys to all participants, asking them to assess their compliance with contact lens case hygiene and replacement procedures, determine information provided to them by their eye care provider, and rate their perception of risks associated with noncompliance on a scale from 1 to 5 (1= no risk, 5= maximum risk). A majority of the cohort reported using monthly replacement lenses and multipurpose solutions. A total of 68.9% of the cohort reported contact lens experience of 5 years or more. 

Overall, the researchers found that hygiene-related compliance behaviors were poor. Among the study sample, 19.1% of participants reported never cleaning their cases, 68.6% reported exposing their cases to tap water, and 26.4% said they did not replace their cases every 6 months. 

Despite the poor levels of compliance, two-thirds of participants reported that their eye care practitioner provided them with specific instructions for case management. Overall 68.6% and 57.2% of the cohort associated failure to clean their case and frequently replace it with a high risk of ocular surface disease, respectively (based on risk scores of 4 or 5).

The team noted that higher education levels and more years of contact lens wearing experience were associated with risk perception, particularly with regard to handwashing (P =.02 and P <.001, respectively). They did not note any statistically significant differences between participants receiving care instructions orally or in writing. 

“Strategies need to be explored through reinforced and periodic reminders and improved patient-practitioner communication to translate risk awareness to better compliant practices, increase contact lens safety, and prevent serious ocular complications such as microbial keratitis,” according to the researchers.

Study limitations include the potential for volunteer bias and reliance on self reporting. 


Cardona G, Alonso S, Yela S. Compliance versus risk awareness with contact lens storage case hygiene and replacement. Optom Vis Sci. 2022;99(5):449-454. doi:10.1097/OPX.0000000000001881