Recommendations of the Polish Ophthalmological Society for contact-lens wearers in the COVID-19 era

COVID-19 is a disease caused by the SARS-CoV-2 coronavirus. The pathogen spreads mainly through the droplet pathway. Breathing, coughing and sneezing of an infected person leads to the formation of an aerosol, inhalation of which leads to transmission of the infection. In addition, the excreted SARS-CoV-2 virus particles can cover various objects in the environment of the infected person, and the transmission of the virus particles from hands to the mucosa is an additional route of infection [1]. The study presented by N. van Doremalen indicated that the period of stability of the SARS-CoV-2 virus in the form of an aerosol is up to 3 hours, and on objects, depending on the material of which they are made of, up to 4 hours (copper), 24 hours (cardboard paper) up to 80 h (plastic) [2].
Therefore, there is a theoretical risk of transmitting the SARS-CoV-2 virus to the conjunctiva during application of contact lenses. It is worth noting, however, that there is no scientific evidence for the role of the use of contact lenses in the transmission of infection, and in the opinion of experts of the Polish Ophthalmological Society it may highly probably be regarded as marginal.
At the same time, it should be stated that glasses can be an additional mechanical protective barrier against aerosol and the decision on how to correct vision should be made on individual basis. This position assumes that patients will comply with the routine hygiene regime applicable to all contact lens users [3].

Before putting on and removing contact lenses, the patient should wash their hands using running water and a detergent (e.g. soap). Hands should be wiped dry with a disposable paper towel.
In addition, during an epidemic, before washing hands, disinfecting the outer surface of the lens container and hands with 70% ethyl alcohol or another antiviral disinfectant could be considered.
The patient should change the fluid for storage and disinfection of contact lenses every day.
People wearing contact lenses should avoid the habit of touching or rubbing the eyes.
If this does not affect the comfort of use and vision, a change to one-day contact lenses may be suggested to the patient.
If the patient observes reddening of eyes while using contact lenses, they should be removed immediately and the patient should be seen by an ophthalmologist.

The document was consulted with and accepted by the Chief Sanitary Inspectorate.
Status as of 3.05.2020.

DISCLOSURE

The authors declare no conflict of interest.

References

1. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020; 382: 1199-1207.
2. van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020; 382: 1564-1567.
3. Bui TH, Cavanagh HD, Robertson DM, et al. Patient compliance during contact lens wear: perceptions, awareness, and behavior. Eye Contact Lens 2010; 36: 334-339.