For the roughly 11% of all contact lens wearers that wear hard or rigid gas permeable (RGP) contact lenses, finding the right cleaning and storage solution is a lot more complicated than just grabbing something off the shelf at the drug store. Most readily available contact lens cleaning solutions are meant to clean soft, disposable contact lenses and won't clean and disinfect RGP lenses thoroughly enough to be safe.  Because RGP and scleral contact lenses are replaced much less frequently than soft lenses (yearly to every few years, depending on the patient), keeping the contact lens surface clean of debris and protected against infections, chips and scratches is essential to both comfort and clear vision!



The biggest risk with contact lens wear, whether you wear soft or RGP lenses, is corneal infection. Unfortunately it's possible to be blinded by contact lens wear, so proper hygiene and care is essential. For patients wearing RGP or scleral lenses, the risk of infection is extremely low with only 2 cases per 10,000 patients reported. Compare that to soft contact lens wearers who have an incidence of 25.4 cases per 10,000 patients for those who wear monthly disposable overnight wear soft contact lenses!  Even though the risks of infection are much lower when you wear daytime wear RGP lenses than overnight wear soft contact lenses, because patients wear these lenses for much longer, up to a few years at a time, the repeat exposure to bacteria can cause significant risk.

So which solutions are the best to use? Here are the top options on the market:

Multipurpose Systems:  All-in-one solution systems (sometimes abbreviated MPS solutions) are super convenient because in just one bottle you can clean, disinfect, store, and condition your contact lens overnight. Many RGP contact lens solutions will mention "conditioning" -- that means improving the wettability of the contact lens so that it stays better hydrated on your eye to maintain great comfort and clear vision.

Boston Simplus: This cleaner and storage solution has protein deposit removal that is comparable to more abrasive cleaners on the market with the pro of being an all-in-one solution. For best results, the manufacturer recommends storing the contact lens in the solution overnight, then rubbing and rinsing the lens in the morning before putting on the eye.  No night time rub required.
Preservatives: clorhexidine gluconate and PAPB

Unique pH:  This solution is an all-in-one cleaner and storage solution that works to hydrate or condition the contact lens by adjusting to the natural pH of the tears on the surface of your eye. As your tear film pH decreases (becomes more acidic), the solution becomes thinner to help maintain comfort and visual performance.
Preservatives: polyquaternium-1 and EDTA



The Cons: These solutions are extremely popular due to convenience, but if you get a lot of deposits or build up on your contact lenses, these are typically not the best option. The cleaners in these contact lens solutions are necessarily very mild since they must be gently enough to come in contact directly with the eye.  If you have significant protein build-up, adding a daily cleaner (below) is likely necessary.


2. Hydrogen Peroxide Based Cleaners
These solutions use hydrogen peroxide as one or two-step cleansing options to both disinfect lenses, clean the surface of debris and build-up, and store overnight.  They both require 6 hours of cleaning time to fully disinfect the lenses.

ClearCare: This peroxide based cleaner is an all-in one option that cleans lenses overnight (6 hours). The hydrogen peroxide solution is converted to saline via an enzymatic reaction in the special case design. This solution can be used for both RGP and soft contact lenses.  To properly disinfect RGP lenses, the manufacturer recommends putting 2-4 drops of ClearCare directly on the contact lens and then rub the lens with your finger tips. Place the contact lens in the appropriate right and left sides of the case basket, and then rinse the lenses with ClearCare directly for 5 seconds. Only after this manual rub and rinse can you fill the case with solution, close the lid, and let the contact lenses clean overnight.
Preservative Free

Oxycept UltraCare: This 2-step peroxide based system uses an enzyme tablet to neutralize the hydrogen peroxide solution. The tablets contain cyanocobalamin (vitamin B12) to create a pink hue so you can visibly tell that neutralization is happening. The lenses must soak in solution 6 hours or overnight. Once weekly, an UltraZyme Enzymatic tablet can be added at the same time as the peroxide neutralizing tablet for an extra strength clean.

The Cons: These solutions must be allowed a full 6 hours or overnight to convert, otherwise they will cause significant discomfort and toxic corneal burn if hydrogen peroxide directly contacts the cornea. If you have had this happen to you, the pain can be severe but luckily the damage is superficial and won't cause any permanent harm to the cornea.

While these solutions have strong disinfecting properties, once the hydrogen peroxide has been converted, there is no preservative coverage to prevent contamination if you leave the lenses sitting in the storage container for days at a time. Manufacturers advise not to leave a lens stored for more than 7 days.  If you have back up lenses, it is always safest to store them dry and then clean them again before their next use.


3. Daily Lens Cleaners:
These are extra-strength cleaners that are either surfactant (soap) based to remove build up and debris or abrasive cleaners to remove more stubborn deposits.  This category of cleaner will come with a red cap to warn users not to get the solution directly in contact with the eye.  After using a daily cleaner, a separate solution will be necessary to rinse and then store the contact lenses.

Boston Advance Cleaner: This abrasive daily cleaner uses silica gel to physically scrub off proteins and deposits.  To use, place 2-4 drops of cleaner on the contact lens and then rub between your fingers for 20 seconds. Thoroughly rinse off the cleaner, and then store the contact lens overnight with Boston Advance Conditioning Solution. 
     

Lobob ESC: This surfactant based cleaner is self-preserved and contains no abrasive particles that could change the shape or design of the RGP lens over time. After a digital rub, it must be rinsed off thoroughly like Boston Advance Cleaner above.

MiraFlow Extra Strength Cleaner: This daily cleaner is compatible with both RGP and soft contact lenses, and is popular among eye doctors for its' ability to remove stubborn lipid-based deposits like makeup and lotions.  It's formula contains isopropyl alcohol so not only is it an excellent deposit-buster, but it has strong antimicrobial effects as well.

The Cons: Daily lens cleaners require that extra step of needing a second solution to rinse and store the lenses. Because of the chemical properties of salines or multi-purpose solutions, rinsing the lenses with these options requires a steady stream of solution and a thorough rinse to both sides of the lens. Historically, many RGP wearers were taught to rinse off daily cleaners with tap water, but studies have shown this could increase the risk of blinding microbial infections from Acanthamoeba. Many daily cleaners still mention rinsing with water on their instruction labels, however. As the FDA considers making changes to these instructions, it's safest to avoid using tap water with contact lenses all together, and if you do rinse daily cleaner off your RGP lenses with water, make sure you then immediately use a multipurpose disinfecting solution to clean your lenses and help reduce the risk of contamination and infection.

Also of note is that RGP lenses with Tangible Hydra-PEG coatings should NOT be cleaned with abrasive daily cleaners like Boston Advance due to the risk of damaging the surface coating.

4. Storage, Disinfecting, and Conditioning Solutions
These solutions are designed for overnight storage. They improve RGP lens wettability by hydrating the surface of the lens and improving it's ability to adhere to your tear film for best vision stability and on-eye comfort. They also have disinfectant abilities to prevent contamination of the lenses while being stored overnight or over several days.

Boston Original Conditioning Solution: For conditioning and disinfecting, soak lenses for at least 4 hours. This is a tried and true formula is getting harder to find and has been largely replaced in favor of the Boston Advance Conditioning Solution below.
Preservatives: chlorhexidine gluconate and EDTA

Boston Advance Conditioning Solution: This conditioning solution is made for disinfecting, storage, and improved wettability. It's designed to partner as the 2nd step after using the Boston Advance Daily Lens Cleaner.
Preservatives: chlorhexidine gluconate, polyaminopropyl biguanide, edetate disodium



Always check with your doctor about the most appropriate cleaning and storage solutions for your eyes. It's possible for patients to have allergic reactions to specific preservatives, and that's why I've listed them here for quick reference.  Taking the extra time to properly clean (with a rub!), rinse, and condition your lenses overnight can not only prevent potentially blinding infections, but can greatly improve your entire contact lens experience by keeping your RGP and scleral lenses comfortable and clear all day long.

This post contains affiliate links to the products listed 

Do you get a lot of build-up on your contact lenses by the end of the day?  See if these symptoms sound familiar:

• your lenses feel very uncomfortable as you blink
• your vision gradually reduces as you go through your day
• when you take your lenses out at night you see debris or film on the surface of the lens

1) Check your disposal time
If you know you are prone to overwearing your lenses, build-up is a big red flag that your lenses are past their expiration date.  Check with your doctor or you can look things up online to reaffirm how often you should be throwing away your lenses.  Many of my patients that get depositing in Acuvue lenses find that their issues completely resolve once they begin throwing the lenses away every 2 weeks like the lenses are approved for.

Miraflow is hard to find, so I often recommend the Walgreens version below.  Both via

2) Change your Cleaning Process
There is a reason that so many contact lens solutions are available on the market -- different people need different options to get the best results from their contact lenses.  There are a number of great cleaning options out there, so here is how to best maximize your results.

• Add a specific daily cleanser to your regimen

• Products like Miraflow Extra Strength Daily Cleanser or even the generic Walgreens version are specific cleansers safe to use with soft contact lenses and Synergeyes hybrid contact lenses for removal of deposits.  They are alcohol based, so it is always best to rinse the lenses with a cleanser afterwards.  Just apply a drop to your contact lens in the palm of your hand, and gently rub in a circular motion for 15 or so seconds.   Then you can rinse off with your regular multi-purpose contact lens solution or sterile saline

Change to Clearcare for overnight cleaning

Anyone who reads this blog has picked up on the fact that I am enamored with Clearcare.  This solution solves so many of patients problems due to the strong overnight cleans you receive with a peroxide based solution.  Just remember to let the lenses sit overnight and never put the solution directly into your eye.  This solution works perfectly with soft contact lenses of all shapes and sizes, and if you are a known depositor I still use it with my Synergeyes patients (though for many patients in Synergeyes Duette the preferred solutions are Aquify or Biotrue).  All other types of Synergeyes lenses (Clearkone, etc) should use Clearcare for best results. 

3) If you are still having issues, it is time to see your doctor
 Sometimes there is a medical condition causing you to get more build-up on your lenses, and without treatment, you may not have complete resolution.  Allergies or the more aggressive GPC (giant papillary conjunctivitis) where your eye basically rejects contact lens wear can cause depositing as a side effect. Treating the eye with anti-histamines or stronger steroid eye drops can help decrease the inflammation to your eye and make lens wear possible again.

4) Change to Daily Disposables
While dailies aren't available in every prescription, sometimes it is easiest to just change to a lens that you throw away every day instead of trying several cleansing products nightly to combat lens build-up.  Check with your doctor to see if daily lenses are available for you.