The Risk of Pink Eye for Contact Wearers

An estimated 45 million people in the U.S. wear contact lenses.¹ Contact lenses improve visual acuity and can treat visual problems due to corneal surface irregularities.

Each year, about 1 in every 500 contact lens wearers develops a serious infection that could lead to blindness.² Not following proper hygiene and contact lens care instructions is linked to an increased risk of infections and complications.

Contact lenses can increase your risk for pink eye, worsen the infection if you continue wearing contacts while your eye is infected, cause complications, and increase the risk of reinfection.

What is Pink Eye?

Conjunctivitis, commonly known as pink eye, is an infection or inflammation of the conjunctiva, which is the clear membrane covering the surface of the sclera (white part of the eye) and inner eyelids. The conjunctiva is transparent, but it can become red and irritated when inflamed or infected.

Common symptoms associated with pink eye include redness, itchiness, and discharge. You may also feel like something is in your eye, have a burning sensation, and have swelling around your eye.

Viruses, bacteria, and allergens are common causes of pink eye, as are exposures to chemicals. Contact lens wearers are at a higher risk of contracting an infection because they place a foreign body on the surface of their eyes.

Viral and bacterial infections that cause pink eye are contagious. The infection can spread to your other eye and other people.  

How Contact Lenses Increase the Risk of Pink Eye

According to the Centers for Disease Control and Prevention, approximately 99% of contact users surveyed report not following at least one of the recommended contact lens hygiene behaviors and therefore increasing their risk of infection.¹ Between 40% and 90% of contact lens wearers do not properly care for their lenses.³

Over 90% of contact lens wearers use soft contact lenses. These lenses absorb water and the viruses and chemicals found in water. They are also a suitable medium for microbial growth, increasing your risk of infection.

Since contact lenses touch the skin, the eye surface, tears, air, contact cases, and other potential sources of contamination, it is not surprising that one-third of contact lens wearers have experienced a red, painful eye that requires emergency treatment. Wearing contact lenses and trauma are the top two causes of eye infections.⁴

Types of Pink Eyes

Viral, bacterial, and allergic conjunctivitis are the most common forms contact lens wearers are likely to encounter.

Viral

Viral conjunctivitis typically starts in one eye and quickly spreads to the other. Having a respiratory infection or wearing contact lenses while swimming or bathing can increase your risk of viral conjunctivitis.

Viruses can be easily transmitted from person to person, either through respiratory droplets or touching contaminated surfaces, such as a contact lens case.

Bacterial

About 80% to 95% of all conjunctivitis associated with wearing contact lenses is bacterial. When contact lenses or cases are not properly disinfected, bacteria can contaminate contact lenses and contact cases and cause conjunctivitis.⁴

Bacterial eye infections can threaten vision. Prompt diagnosis and treatment by a licensed eye doctor is essential.

Allergic

Contact lenses can trap allergens against the eye’s surface, causing intense itching, tearing, and swelling. While allergic conjunctivitis is not contagious, prompt treatment is important because the symptoms make it difficult to continue wearing contact lenses. Talk to your doctor before using over-the-counter eye drops to treat allergies to ensure they are safe to use with contact lenses.

Common Causes of Pink Eye in Contact Wearers

Wearing contact lenses increases your risk of pink eye and subsequent complications. Factors that increase the risk of conjunctivitis for people who wear contacts include:

• Contact lenses can become contaminated with microorganisms, especially if proper lens hygiene practices are not followed.
• Debris, proteins, and microorganisms accumulate over time on extended-wear contacts, increasing the risk of infection.
• Failing to wash hands prior to handling contacts and not disinfecting contacts and the storage case regularly increases the risk of infection.
• Wearing contacts in swimming pools, hot tubs, showers, and other bodies of water can increase the risk of infection. Exposing your contact lenses to water increases your risk of Acanthamoeba keratitis, a corneal infection that is resistant to treatment and cure.
• Contact lenses keep tears from washing the surface of the eyes.
• Allergens and environmental irritants can become trapped between the contacts and the eye surface, increasing the risk of irritation and infection.
• Falling asleep with contact lenses in place can increase irritation, dryness, and infection.

Washing hands before touching contacts, using an appropriate disinfecting solution, and keeping the storage case clean and disinfected can reduce your risk of conjunctivitis.

Prevention and Tips for Contact Lens Wearers

To prevent infectious conjunctivitis while wearing contact lenses, take the following preventative steps:^4,5,6

• Wash and dry your hands before handling your contact lenses.
• Rub and rinse your contacts as directed by your eye care professional.
• Soak your lenses in fresh disinfecting solution each night.
• Do not top off your solutions in your contact case. Refill your case with fresh solutions each night.
• Use cleaning solutions recommended by your eye care professional. Do not use water or saliva to moisturize your lenses.
• Rinse your case out and store it open to dry.
• Do not sleep with your contact lenses in your eyes unless instructed otherwise by your doctor.
• Replace lenses following the schedule provided by your eye doctor.
• Replace your contact lens storage case every three to six months.
• Remove your lenses immediately if your eyes become red or irritated or you experience any vision changes.
• Do not use cleaning solutions or drops that are beyond their expiration or discard date.

Recognizing the Symptoms and Seeking Treatment

Recognizing pink eye symptoms promptly is important, especially if you wear contact lenses. Seeking a professional evaluation and treatment at the first signs of pink eye and discontinuing contact lens use until the infection resolves can reduce your risk of serious complications.

Microbial keratitis is a serious eye infection associated with wearing contact lenses. A rapid onset and progression of pain, redness, and discharge are typical symptoms associated with this condition.

Managing Pink Eye and Contact Lenses

Developing pink eye while wearing contact lenses can be frustrating, but to protect your vision, you should stop wearing your contact lenses until at least two days after your symptoms have resolved.

Thoroughly disinfect your contact case to prevent reinfection. If you wear disposable contact lenses, use a new pair when you resume wearing contact lenses again.

When to Consult an Eye Care Professional

If you have redness, itching, or early symptoms of conjunctivitis, remove your contact lenses and contact an on-call doctor through the TelegraMD platform to receive 24-hour care. If appropriate, your online doctor can prescribe an online prescription to treat your conjunctivitis symptoms. Telehealth can be a great cost-effective alternative for treating your non-emergency medical concerns.

If you have any of the following symptoms or signs, contact an eye specialist or ophthalmologist for evaluation and treatment:

• Vision loss or vision changes
• Moderate or severe eye pain
• Changes in the surface of your cornea, a part of the eye that covers your iris and pupil
• Conjunctival scarring
• No response to treatment within a week
• A history or concern about herpes simplex or varicella-zoster conjunctivitis
• Sensitivity to light

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice. 

References

1. Cope JR, Collier SA, Nethercut H, Jones JM, Yates K, Yoder JS. Risk Behaviors for contact lens–related eye infections among adults and adolescents — United States, 2016. MMWR Morb Mortal Wkly Rep. 2017;66(32):841-5.
2. Dart JK, Radford CF, Minassian D, Verma S, Stapleton F. Risk factors for microbial keratitis with contemporary contact lenses: a case-control study. Ophthalmology. 2008 Oct;115(10):1647-54, 1654.e1-3. doi: 10.1016/j.ophtha.2008.05.003. Epub 2008 Jul 2. PMID: 18597850.
3. Bui TH, Cavanagh HD, Robertson DM. Patient compliance during contact lens wear: perceptions, awareness, and behavior.external icon Eye Contact Lens. 2010;36(6):334-9.

4. Stapleton F, Bakkar M, Carnt N, Chalmers R, Vijay AK, Marasini S, Ng A, Tan J, Wagner H, Woods C, Wolffsohn JS. CLEAR – Contact lens complications. Cont Lens Anterior Eye. 2021 Apr;44(2):330-367. doi: 10.1016/j.clae.2021.02.010. Epub 2021 Mar 25. PMID: 33775382.
5.  Kates MM, Tuli S. Complications of Contact Lenses. JAMA. 2021 May 11;325(18):1912. doi: 10.1001/jama.2020.20328. PMID: 33974017.
6. U.S. Food & Drug Administration. Contact lenses. Updated October 28, 2019. Accessed August 22, 2023. Contact Lenses | FDA