Contact lenses

Over-wear of contact lenses and allergies can both cause these symptoms, but in these cases, the symptoms are usually in both eyes. Taking a break from your lenses is often enough to alleviate some symptoms. In the case of a new red and sore eye, or one which doesn’t get better after a break from contact lenses, it is important to discuss these symptoms with a professional. Please call your local optometrist, or our Moorfields Direct line. 

You should come to A&E if your eye is red and/or painful, or if you have sudden, dramatic and persistent reduction in vision.

In an emergency, for example if your eye suddenly becomes red, painful or your vision suddenly becomes worse:

• You should attend your local ophthalmic casualty service or GP
• The A&E department at Moorfields will see casualties and, if necessary, will arrange an appropriate referral

It is important to let the staff know if you are wearing an extended wear lens (e.g. regular overnight wear) or a bandage (therapeutic) contact lens.

• First, you will be assessed by an experienced ophthalmic-trained nurse at the reception
• The nurse will determine who needs urgent attention. Please note, only patients with an ocular emergency will be seen by the medical staff in A&E
• Please note that A&E does not provide contact lenses or contact lens solutions

Statutory NHS patient charges or exemptions arrangements apply and these charges are updated annually on 1 April each year. The current prices are available from the contact lens clinic.

• The payment is for one standard replacement contact lens (or where appropriate, six months supply of daily or monthly disposable lenses)
• If lenses are to be posted, there is a charge for all patients.

The same charges apply for replacement lenses or if a lens breaks outside the three-month manufacturer’s warranty period (this does not affect your statutory rights).

Please note that lenses will not be ordered until payment or proof of exemption has been seen.

• Patients who have proof of a qualifying benefit (our cashiers department can advise)
• Patients requiring a lens as a "bandage" or “prosthesis”
• Children under 16, or 16 to 19 years and in full-time education
• Patients not in receipt of an eligible benefit can apply to the NHS Business Services Authority for a contribution to the cost of their lenses using an HC1 form, which can be obtained directly from the authority (0300 3301 343) or from Moorfields’ cashiers office on the ground floor at the City Road hospital
• Patients who need their contact lenses to be changed for clinical reasons within a specific time of payment

Someone who is exempt from standard charges, but repeatedly breaks or loses lenses will be charged for replacements (this does not affect your statutory rights).

To avoid the problems of contact lens loss, we advise that you keep a spare.

Costs can be obtained from the clinic and are reviewed annually. Please note that there is no exemption from payment for spares.

No – your GP can prescribe eye medication, but is prohibited from prescribing contact lens solutions.

We must receive a referral letter, either from your GP, an ophthalmologist at Moorfields or another hospital.

Yes, if you can tolerate your lenses, we would like to assess the effect of the lenses on your eyes.

Please advise our appointment clerks in advance if you know that you cannot keep an appointment so that an alternative date can be arranged (020 7566 2475).

Patients will be discharged if they fail to attend two consecutive contact lens clinic appointments or if they are not seen for more than 15 months.

• If you are not a current patient, you will not be able to obtain contact lenses or contact lens solutions from the hospital, nor can you be seen in the clinic unless you are re-referred by your doctor
• If you are discharged from the hospital and continue to wear contact lenses, it is essential that you are under the care of a contact lens practitioner

Contact lenses are provided at Moorfields only when there is a medical need. Usually this is when vision cannot be improved with spectacles but can be improved with contact lenses. The contact lens clinical staff at Moorfields will assess eligibility. Examples of eligibility include some disorders of the cornea, high prescriptions (over +10.00DS/-15.00DS) and "bandage" lenses.

You will be assessed in the contact lens clinic to ensure that you are suitable and eligible for lenses. The lens type will be selected according to your medical need. The lenses are often specially made, so you will usually require a separate appointment to have the lenses issued and to receive instruction on lens care and lens handling.

Please use one of the following methods to contact the contact lens orders department:

• Email: moorfields.contactlenses@nhs.net
• Phone: 020 7566 2100
• Write to us at Contact Lens Orders, Moorfields Eye Hospital NHS Trust, 162 City Road, London EC1V 2PD, UK
• Visit us at clinic 4, contact lens reception (Monday to Friday, 9am– 4.45pm)

This depends on the complexity of the lens and the individual manufacturer, but typically:

• Rigid gas permeable (corneal) lenses take two to six weeks
• Scleral contact lenses take six to eight weeks
• Cosmetic soft contact lenses take two to six weeks.

The hospital can supply a copy of your contact lens specifications once your contact lens fitting is complete. This is usually after you have been reviewed in the clinic, wearing the lenses for a minimum of three months after issue.

To order lenses, please call 02075662100, or email moorfields.contactlenses@nhs.net

• One month’s solutions can be supplied on prescription at each scheduled contact lens clinic appointment. The prescription is only valid at Moorfields' pharmacy. Each item incurs the standard NHS prescription charge
• Patients are able to purchase additional supplies from Moorfields’ pharmacy
• Unfortunately, solutions may not be prescribed outside appointments and will not be posted
• If you need solution urgently all of those we prescribe are available either in high street opticians, pharmacies or online.

If your eye is showing signs of infection aking a break from your lenses is often enough to alleviate some symptoms. In the case of a new red and sore eye, or one which doesn’t get better after a break from contact lenses, it is important to discuss these symptoms with a professional. Please call your local optometrist, and failing this, call our nurse advice line.

If you feel that your lens is damaged, please discontinue wearing it and contact us for a replacement.

No. You should continue to practice good lens and hand hygiene and ensure you follow the recommended cleaning and storage advice. There is no need to replace your lenses more frequently than usual.

Patients are taught how to handle and look after their contact lenses and detailed written instructions are provided. You can also view videos on how to insert, remove and care for contact lenses.  

Water borne bacteria and other bugs such as the free living protozoa Acanthamoeba can attach to contact lenses when swimming and cause infection. This is particularly a problem in public pools where there can often be traces of urine and faecal matter. The safest option is to use goggles made with your prescription. These can be obtained from your optician. Tight fitting goggles over contact lenses can be problematic in that water often seeps in.

If contact lenses cannot be avoided while swimming, we recommend air tight swimming goggles with daily disposable lenses which are removed shortly after swimming (wait a few minutes as the lenses can sometimes tighten up and be difficult to remove straight away) and disposed of. It is common for contact lens wearers who reuse lenses to have a small supply of daily disposable lenses that can be used when swimming with air tight goggles or for general use on holiday.  

Ask your optician as they will need to see if it is possible to fit you with daily disposable lenses that suit your eyes. 

For babies we often advise to insert contact lenses just before they wake up from their morning sleep i.e. whilst they are asleep. The best thing would be to contact your child's contact lens practitioner and ask them to review your insertion technique.

The only sight threatening complication of contact lens wear is microbial keratitis (or infection of the clear layer at the front of the eye where the contact lens rests, the cornea). This is because microbial keratitis (MK) has the potential to scar the surface and cause distortion of vision. In some rare cases, the cornea becomes so damaged it needs to be replaced by human tissue donated for transplant, and even more rare, the whole eye becomes infected or damaged so that it needs to be removed. This is the very worst case scenario.

The contact lenses that have the lowest risk of  MK are rigid gas permeable lenses, but these are not always practical for sport and can be difficult to wear on a part time basis and they eye needs to adapt to the feel of them. While daily disposable soft lenses do not have a lower risk of MK, the cases are less severe than in reusable contact lenses. We think this is because contact lens cases can contain more harmful bacteria than we find on the body and replacing lenses daily has less chance of those harmful bacteria.

We know that many people who wear daily disposable lenses do not always wash their hands before they wear them and sometimes wear them overnight or store them and re-use them later. All these behaviours increase the risk of infection. Wearing daily disposable lenses for your purposes seems like a sensible option, providing you follow good hygiene. This includes washing hands with soap using the proper technique (link to NHS hand hygiene technique) including the tips of fingers, which touch lenses and drying hands with a lint free clean towel. Although we drink water from the tap, it can contain harmful organisms such as Acanthamoeba, which can cause a serious eye infection and should not come into contact with contact lenses.

This is a common problem, in that eye infections with contact lenses are rare (affecting around 4 per 10,000 wearers per year with vision loss affecting only around 15% of those cases), so contact lens wearers often fall into bad habits which get reinforced with time.

The most important time to have clean hands is before you put lenses in the eyes, so maybe he could put his lenses in directly after a shower (he should not wear them in the shower as there are bugs in the water) and ideally if he had daily disposables he would just throw them out after he removed them.