Contact lens wearers — beware when using Clear Care

In December 2010 and again in May 2012, Check-Up warned consumers who wear contact lenses about Clear Care, a lens cleaning product from Ciba Vision (a Novartis company) that contains hydrogen peroxide. The product must only be used to soak contact lenses within a special lens case that deactivates the hydrogen peroxide prior to placing the lenses back in the eyes. Unfortunately, the product has repeatedly been used by mistake without the special lens case, causing severe pain and, all too often, an eye injury. Many patients wind up in the hospital emergency room. There are also less expensive generic versions available.

One of the most recent cases was reported to us by a woman whose college-age daughter was spending the night at a friend's home. The student realized she'd forgotten her contact lens solution so her friend located a roommate's solution and the contact lenses were soaked in it for the night. It was Clear Care. The next morning, her daughter put her right contact lens in her eye and immediately started to scream out in pain. She removed the contact and, after no relief with flushing the eye with water, she went to a hospital ER. Her eye was flushed with no abatement of symptoms. Staining the eye with a special dye showed corneal damage had occurred.  The hospital gave her some antibiotic eye drops and referred her to an eye doctor whom she visited the next day. The eye doctor prescribed an even stronger medication and advised her to return for a follow-up.

This young woman joins hundreds of others who've sent us reports after they experienced severe pain and/or eye injuries when using Clear Care. There are many more who've complained about the product on the Internet. Unknown is how many actual cases there are that have not been reported. Based on my research on this topic I believe that there are likely hundreds of thousands of people who have experienced burning by getting this product or the generic directly in their eyes. Ask any group of 100 or so people and 3 or 4 will be contact lens wearers who will tell you they've done this. I have conducted this experiment multiple times in pharmacy school classrooms or during talks to health professionals. Several people in my office have done this (including pharmacists and nurses), as has my own daughter.  Given the number of lens wearers, it could even be millions who've had this happen over the years. It's beyond being careless.

The product is poorly designed and sets people up for making errors. It is not supposed to be used to wet or soak lenses in the usual manner that other lens cleaning products are used. Clear Care has a special lens case with a built-in neutralizer—a ring of platinum that reacts with hydrogen peroxide—that causes the hydrogen peroxide to turn into water. The entire process takes about 6 hours. After this, the lenses can be placed in the eyes. The product label includes several statements to use only the lens case provided, and to not rinse lenses with Clear Care prior to insertion. But for many, the statements have not been noticed given their impaired vision without their lenses in place. For others, the statement may not be a clear warning. Some may think, "Why use the special lens case when I have my own case." Also, those who do not routinely rinse their lenses with saline prior to insertion may simply ignore this statement, thinking it doesn't apply to them.

I can't think of any other ongoing issue like this where a pharmaceutical company for which FDA has not required product redesign. Last April Health Canada came out with a warning to consumers but our FDA has been publicly silent on the matter despite numerous contacts I've made, urging that the problem be addressed. In the past we encouraged the maker of Clear Care to redesign the product container in a way that prevents misuse. It should also have a different shape and/or color than typical cleaning or saline solutions and much stronger and more vivid warnings that are clearly labeled as a warning about eye burns. The company did make a few very minor labeling changes but that seems to have had no effect at all in reducing the flow of reports we get. It's strange that FDA hasn't addressed this yet, especially when this issue has received national media attention. I've been told they are looking into the matter but I've been told that for over two years now!

When purchasing your lens care products, READ the package with your contacts in or glasses on to make sure you have the correct product. If you use Clear Care, read the instructions carefully, use the special case provided for soaking your lenses, and make sure the lenses have been soaking for at least 6 hours before placing them in your eyes. Talk to your pharmacist if you have any questions about contact lens care products.

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