Are disposable contacts unsafe beyond their recommended time limits?

Question

My wife is fussing at me because I've been wearing the same pair of 2 week contacts for probably 4 months now. My experience thus far is to only replace if they either tear or develop irritation. The eye doctor I got my prescription from said it can cause a rash on the underside of the lids. Then there's sites like this. I obviously don't have a rash problem. What's the truth about these?

Answer 1

While I was unable to find any information on the safety of using 2-week (or longer rated) contact lenses past their date, the contact lens manufacturer Johnson & Johnson settled a lawsuit in 2001 for labelling identical contact lenses as "dailies" as well as "2-week" versions.

Johnson & Johnson has agreed to pay as much as $860 million to settle lawsuits accusing the company of misleading consumers into prematurely throwing away disposable Acuvue contact lenses.

The suits contended that the company drove up sales of its 1-Day Acuvue soft lenses by advising consumers to use them just once, even though the product is identical to regular Acuvue lenses, which may be worn as long as two weeks.

Under the settlement, Johnson, based in New Brunswick, N.J., would pay as much as $840 million in cash and coupons to consumers, according to papers filed Monday in state court in New Jersey. The agreement also includes money for new eye exams and $20 million in fees for consumers' lawyers, whose suits were combined into a class action.

The existence of the lawsuit was also verified this time by Johnson & Johnson itself on its corporate site. It officially denied that the two forms of contact lenses are identical, but settled the lawsuit anyway:

The class action, filed in Camden, New Jersey in 1996, involves allegations that Vistakon's marketing of Acuvue® and 1-Day Acuvue® lenses created the misleading impression among consumers that the less expensive 1-Day Acuvue® lens was different from the Acuvue® lens and should not be used for the same wear schedule as the Acuvue® lens, when in fact both lenses are medically suitable for the same wear schedules. The action did not question the quality or safety of the lenses.

Johnson & Johnson and Vistakon deny these allegations. The Court has not ruled on either the merits of plaintiffs' claims or the defenses, and the settlement in no way implies or acknowledges any wrongdoing by Johnson & Johnson or Vistakon. "This was a complex case with difficult issues," said plaintiffs' counsel Peter L. Masnik. "We are pleased that the parties were able to negotiate a significant resolution that provides valuable benefits to the class members and promotes eye health by payment towards eye examinations."

Therefore, at least in the case of this specific brand (Acuvue) of contact lenses, it would be safe to wear the daily version of the lenses for up to 2 weeks, as the products were identical.

Answer 2

Yes, expired unsealed contacts may be unsafe to use beyond their recommended time limits due to contamination causing eye infection.

The conclusion of Dart et al's 2008 study was that daily disposable lenses are associated with less severe disease.

The risk of microbial Keratosis has not been reduced in users of Daily disposable (DD) and silicone hydrogel contact lens. However, vision loss is less likely to occur in DD than in reusable soft CL users.

Results of a 2014 survey support previous work which reported that young adult wearers are more prone to higher risk taking and that risk taking may be associated with noncompliance with lens care.

Wearers who are at high risk because of a high-density living environment could benefit from daily disposable lenses that require less care.

The sterility of expired and sealed soft contact lenses was investigated in a study published in The South African Optometrist regarding the safety of expired lenses. The results of that study shows some contamination in expired lens packs, but the researchers were unable to make any broad claims due to a very small sample size. Their goal was to initiate further research into the quality and utility of expired lenses than to answer the question authoritatively.

Further the authors report in the 2008 study that

Fifty-four SCLs were tested for the presence of fungal (27 samples) and bacterial (27 samples) contamination. These samples included both expired and unexpired SCLs that were either blister packed or vial packed. A small percentage of the lenses tested positive for contamination.

The conclusion for Stapleton et al's research into risk factors for contact lens related microbial keratitis (MK) in Australia found that the risk factors included overnight use, poor case hygiene, smoking, internet purchase, less than 6 months’ wear experience and higher socio-economic group. If safety is to be maximized in contact lens wear, practitioners should ensure their patients wear their lenses according to the recommended wearing schedule, are properly instructed in lens handling, lens case hygiene and replacement, and patients should be aware of the importance of good hand hygiene and the increased risk associated with overnight use.

A reduction in morbidity may be possible through recognition of appropriate risk factors, such as hygiene, specifically attention to storage case hygiene as both case cleaning and replacement reduces the risk of severe disease in daily contact lens use.