Transmission of Human Immunodeficiency Virus in Contact Lens Care

Human immunodeficiency virus (HIV) has been isolated from ocular tissues, tears, and soft contact lenses used by patients with AIDS. However, no documented case of HIV transmission through contact with human tears or contaminated contact lenses has been reported. A 1985 US Centers for Disease Control and Prevention (CDC) advisory recommended the following disinfection methods for trial contact lenses:

Hard lenses. Use a commercially available hydrogen peroxide contact lens–disinfecting kit (the type used for soft lenses); other hydrogen peroxide preparations may cause lens discoloration. Heat disinfection (78°–80°C for 10 min), as used for soft lens care, can also be used but may damage a lens.

RGP lenses. Same as above, but heat disinfection is not recommended, because it can cause lens warpage.

Soft lenses. Same as above, although heat should be used only if the lens is approved for such a care system.

For additional information, see the healthcare-associated infections page on the CDC website (www. cdc.gov/hai/).

The most commonly used disinfection systems for contact lenses today are chemical. Published studies suggest that chemical disinfection is effective against HIV-contaminated contact lenses, but these studies have not been reviewed by the US Food and Drug Administration (FDA). As a result, although the FDA requires demonstration of virucidal activity in treatments for herpes simplex virus, there is no such requirement for HIV.

American Academy of Ophthalmology. Minimizing transmission of blood-borne pathogens and surface infectious agents in ophthalmic offices and operating rooms. Information Statement. San Francisco: AAO; 2002.

Centers for Disease Control. Recommendations for preventing possible transmission of human ​T-lymphotropic virus type III/lymphadenopathy-associated virus from tears. MMWR Morb Mortal Wkly Rep. 1985;34(34):533–534.

Slonim CB. AIDS and the contact lens practice. CLAO J. 1995;21(4):233–235.

Appendix 4.2

Federal Law and Contact Lenses

The Federal Fairness to Contact Lens Consumers Act (PL 108-164) was passed by the US Congress and became effective on February 4, 2004. This law is intended to make it easier for consumers to obtain contact lenses from providers other than the individual who fitted the lenses. Once the fitting process is complete, the patient must automatically be provided with a free copy of the prescription, regardless of whether the patient requested it. Also, the provider must verify the prescription information within a reasonable period (typically defined as 8 hours during the normal business day) to anyone designated to act on behalf of the patient (eg, an Internet contact lens seller). The Federal Trade Commission (FTC) can impose sanctions for noncompliance on both prescribers and sellers of up to $11,000 per offense. For further details of this law, see the FTC website: www.ftc.gov.