Disclaimer: This article provides general information about water and contact lenses. It is not a substitute for personalised medical advice. If you have any concerns about your eyes or vision, please seek an urgent assessment from your eye care professional. If you are an eye care professional, please feel free to guide your patients to this article to augment the advice you provide.

Many of us enjoy the freedom contact lenses offer. However, it’s vital to understand that water and contact lenses simply don’t mix^1,2,3,4. Exposing your lenses to any type of water – tap, shower, pool^2,4, or hot tub¹ – can introduce harmful microorganisms to your eyes. This can lead to serious eye infections, potentially causing pain and even vision loss³.

This piece aims to shed light on why keeping water and contact lenses separate is so important for your eye health. We’ll look at the specific dangers, how to protect your eyes, and what to do if you suspect a problem.

Understanding these risks helps you continue to enjoy clear vision safely. Remember, your eyes are precious, and taking good care of your contact lenses, especially concerning water exposure, is a key part of protecting them^1,2. This post is to ensure you have the facts about water and contact lenses, as well as the dangers the combination poses.

The Hidden Dangers: Acanthamoeba and Pseudomonas

When we talk about the risks of water and contact lenses, two particular troublemakers often come up: Acanthamoeba and Pseudomonas.

Acanthamoeba

Acanthamoeba is a tiny, amoeba (a single-celled protozoan parasite) found in many water sources, including tap water^1,4, seawater, hot tubs¹, swimming pools^1,2,4, lakes³, and even distilled water¹. If this organism gets trapped between your contact lens and your eye, the conditions are perfect for it to cause a severe infection called Acanthamoeba keratitis^1,4.

This condition is notoriously difficult to treat³ and can be incredibly painful^4,5, sometimes leading to long-term vision problems⁵ or, in rare cases, the need for a corneal transplant^3,5.

Pseudomonas

Pseudomonas aeruginosa is a bacterium that thrives in water⁶. Water sources include tap water⁷, bath water⁶ and home-made contact lens solutions⁶. It’s a common cause of microbial keratitis⁶, an infection of the cornea, especially among those who wear contact lenses. Pseudomonas infections can progress very quickly⁸, causing significant pain⁸, redness, and discharge⁸. In some cases, this may lead to sight loss⁶.

The challenge with these organisms is their resilience and how easily they can contaminate lenses if water and contact lenses come into contact. Even a quick rinse of your lens case under the tap can introduce these dangerous pathogens⁶. So be aware!

A Holiday to Forget

I remember a patient that came in to see me upon returning from her holiday in Crete. She had been wearing her daily disposable lenses in the pool at her hotel. She presented to me with a significantly red and painful eye. Prompt referral to an ophthalmologist resulted in a diagnosis of acanthamoeba keratitis (infection of her cornea).

She was remorseful that she didn’t listen to her previous optometrist’s advice about the dangers of water and contact lenses. That holiday will be remembered now as the one that caused her lifelong vision issues. My last appointment with her showed her vision being very poor and she is still experiencing significant discomfort from the eye, several years on.

Water and Contact Lenses: Understanding the Risks and Statistics

The connection between water and contact lenses and eye infections is well-documented. Acanthamoeba keratitis, while relatively rare overall^1,2, is significantly more common in contact lens wearers¹. Studies have shown that contact lens users have a much higher risk of developing microbial keratitis compared to those who don’t wear lenses^3,5.

In the UK, research from Moorfields Eye Hospital highlighted that showering while wearing contact lenses dramatically increases the risk of Acanthamoeba keratitis⁹. One study suggested that people who showered daily in their lenses were up to seven times¹⁰ more likely to develop the infection.

The issue isn’t just about swimming; any contact between water and contact lenses can be problematic. This includes washing your face, using hot tubs¹, or even handling lenses with wet hands. The statistics paint a clear picture: proper lens hygiene, which crucially involves avoiding all water contact, is paramount.

Globally, the incidence of Pseudomonas keratitis is also a concern for lens wearers, often linked to improper disinfection routines or, again, exposure of water and contact lenses¹⁰. These infections don’t just cause discomfort; they can have lasting effects on vision if not managed promptly and correctly.

Important Advice to Remember

Many patients that attend my appointments are horrified about the dangers that combining water and contact lenses pose. This risk is a staple discussion I have with every contact lens wearer. Many also state they were unaware of the danger – which has been shown in studies to be the case^1,3.

Whether this is due to eye care professionals are not always discussing this risk at every contact lens appointment (they should be!¹) or if it is something patients either fail to remember or neglect to take seriously is difficult to pinpoint – however, this is one of my main motivations for this post.

Responsibility falls on both the prescriber and the patient to look after their eyes. Therefore, to simplify:

EYE CARE PROFESSIONALS: PLEASE DISCUSS THE RISK OF WATER AND CONTACT LENSES AT EVERY APPOINTMENT

and

PATIENTS: PLEASE TAKE WHAT YOUR EYE CARE PROFESSIONAL ADVISES YOU SERIOUSLY

Do’s and Don’ts: Safe Contact Lens Habits Around Water

Practising safe contact lens wear is your best defence against water-borne infections. The golden rule is to keep water and contact lenses entirely separate. Here’s a straightforward guide that is backed my numerous eye care organisations across the world^11,12:

Dos:

• Wash and dry your hands thoroughly with soap and a lint-free towel before handling your lenses. This is a critical first step.
  
• Only use sterile contact lens solutions recommended by your optometrist or contact lens optician to clean, disinfect, and store your lenses. Never use water.
  
• Clean your contact lens case regularly with fresh solution, wipe it with a clean tissue, and let it air dry upside down with the caps off. Replace your case at least every month.
  
• Remove your contact lenses before showering, swimming, or using a hot tub. This simple action greatly reduces your risk.
  
• Always follow your optometrist or contact lens optician’s advice on lens wear schedules and replacement frequency.

Don’ts:

• Never rinse your lenses or lens case with tap water, bottled water, or any non-sterile liquid. This is a major risk for contamination.
  
• Don’t swim, shower, or use a hot tub while wearing your contact lenses. The risk of infection from water and contact lenses in these environments is high.
  
• Avoid topping up old solution in your lens case; always discard the used solution and refill with fresh.
  
• Don’t wear your lenses for longer than recommended or sleep in them unless specifically advised by your optometrist or contact lens optician for lenses designed for overnight wear.
  
• Never share your contact lenses with anyone else.

Adhering to these guidelines significantly minimises the chances of harmful microorganisms reaching your eyes.

Swimming with Vision Needs

So, what are your options if you need vision correction while swimming but know that water and contact lenses are a no-go? Thankfully, there are safer alternatives.

Prescription swimming goggles are an excellent choice¹. These can be custom-made to your exact glasses prescription, providing clear underwater vision without the infection risks associated with contact lenses in water. They create a seal around your eyes, keeping pool water out. Many opticians offer this service.

Refractive Surgery (e.g. LASIK). Whilst this may be drastic for just the occasional swim, if you are a suitable candidate and wish for a more permanent solution to avoid glasses or contacts altogether then refractive surgery may be an option. However, this is a significant decision with its own set of considerations and isn’t primarily for swimming. If this is something you may wish to consider, speak to your optometrist or book an appointment with a refractive surgeon (such as with EuroEyes Laser Eye Clinic London)

Glasses. For casual splashing or beach visits where you might get water in your eyes, simply removing your contact lenses and wearing your regular prescription glasses is the safest bet.

If you absolutely must wear vision correction in a situation with high water exposure where glasses and goggles aren’t feasible, daily disposable lenses, worn for the briefest possible time and discarded immediately after any water contact, might be considered a lesser risk by some, but only with extreme caution and ideally after discussion with your eye care professional. Even then, the risk from water and contact lenses is not eliminated. If this applies to you, please do not rely on this paragraph alone and discuss your needs with your eye care professional.

When Things Go Wrong: Recognising Eye Infections and What To Do

Despite your best efforts at keeping water and contact lenses apart, problems can still occur. If you wear contact lenses and experience a red, painful, or light-sensitive eye, or notice your vision has become blurry or reduced, you must act quickly. These can be signs of a serious eye infection, potentially related to water and contact lenses wear.

What should you do?

Remove your contact lenses immediately. Do not wear them again until you have been seen by an eye care professional.

Keep the contact lens you were wearing. Place it in its case with some solution (or even dry if no solution is available). This lens can be sent for laboratory analysis to identify any infecting organisms, which is crucial for guiding treatment, especially if Acanthamoeba is suspected from contact between water and contact lenses.

Seek urgent assessment. Contact your optometrist straight away. Most optometry practices have emergency appointment slots for such issues. If you cannot reach your optometrist or it’s out of hours, go to your local hospital’s Accident & Emergency (A&E) department, particularly one with an eye casualty unit if available.

Inform your eye care professional about everything. Tell them you are a contact lens wearer. Crucially, mention if there has been any recent water contact with your lenses – showering, swimming, hot tubs, or even rinsing them with tap water. This information helps them consider infections like Acanthamoeba, which can be missed if they are primarily thinking of more common bacterial infections or herpes simplex keratitis. These latter conditions can appear similar to Acanthamoeba keratitis.

If you have been told you might have herpes simplex keratitis (a viral infection), it is reasonable to ask your healthcare professional, “Could it also be Acanthamoeba, especially if there’s a history of water and contact lenses exposure?” as the initial signs and symptoms can sometimes appear similar¹³.

“Could it be Acanthamoeba?”

A question to ask if you are a contact lens wearer that has just been diagnosed with herpes simplex keratitis.

Prompt action and providing full information are key to getting the right diagnosis and treatment, which can make a huge difference to your prognosis and your recovery.

Treatments and Outlook for Water-Related Eye Infections

The treatment and prognosis for eye infections linked to water and contact lenses vary greatly depending on the specific pathogen and the severity of the infection at diagnosis.

For bacterial keratitis, like that caused by Pseudomonas, intensive antibiotic eye drops are the main form of treatment. These often need to be administered very frequently, sometimes hourly, especially in the initial stages. If caught early and treated aggressively, many bacterial infections can be resolved successfully, though some may leave scarring on the cornea that can affect vision permanently.

Acanthamoeba keratitis, however, is a different beast. It is notoriously challenging to treat because the organism exists in two forms: an active trophozoite and a dormant cyst³. The cysts are highly resistant to many common disinfectants and anti-microbial agents^3,14.

Treatment often involves a combination of potent antiseptic eye drops, sometimes for many months³ or even over a year, to eradicate both forms. It can be a long and arduous process for the patient, often involving significant pain management⁵.

The prognosis for Acanthamoeba keratitis is more guarded. Early diagnosis improves the chances of a good outcome, but delays can lead to extensive corneal damage³, severe vision loss³, and, in some cases, the need for a corneal transplant³. Even with treatment, some individuals experience chronic pain or light sensitivity.

This is why preventing exposure of water and contact lenses is so incredibly important. The message is clear: diligence with contact lens hygiene and avoiding all water contact is the best way to protect your sight from these potentially devastating infections.

An Emotional Toll

Having encountered several patients that have had acanthamoeba keratitis and many with a bacterial keratitis, I have seen firsthand the devastating effects it can have on a person’s life.

The combination of both pain and treatment regimes often physically wear them down and the emotional toll of knowing that their vision may never fully recover due to an easily avoidable mistake can weigh hard.

I would like to take the time to mention the non-profit organisation Acathamoeba Keratitis (AK) Eye Foundation that put extensive efforts into raising awareness around acanthamoeba and the risks water and contact lenses pose to contact lens wearers. I strongly recommend reading their patient journeys section, where patients that have been affected by acanthamoeba keratitis share their stories. It is powerful reading.

Why do I suggest reading these stories?

If you are a practitioner that deals with contact lenses – this is why we MUST advise all of our patients of the dangers of water and contact lenses.

If you are a contact lens wearer thinking “It’s rare and it won’t happen to me” then read about the many others that thought the same.

Water and Contact Lenses, Final Words

Whilst many people wear contact lenses without complications, any deviation from the advice on how to wear them safely significantly increases the risk of a complication.

Complications, although rare, can be significant. These complications can include severe eye pain, light sensitivity, scarring and sight loss. Therefore the stakes are high should you choose to ignore the advice and advocacy to keep water and contact lenses apart.

With alternative options; including glasses wear, prescription goggles and refractive surgery, there is no reason to expose your contact lenses to water.

Frequently Asked Questions about Water and Contact Lenses

References

1. Zimmerman AB, Richdale K, Mitchell GL, Kinoshita BT, Lam DY, Wagner H, Sorbara L et al. (2017). Water exposure is a common risk behaviour among soft and gas-permeable contact lens wearers. Cornea 36(8): 995-1001.
2. Radford CF, Minassian DC, and Dart JKG (2002). Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors. British Journal of Ophthalmology 86(5): 536-542.
3. Fanselow N, Sirajuddin N, Yin XT, Huang AJW, and Stuart PM (2021). Acanthamoeba keratitis, pathology, diagnosis and treatment. Pathogens 10(3): 323.
4. Wang Y, Jiang L, Zhao Y, Ju X, Wang L, Liang J, Fine RD, and Li M (2023). Biological characteristics and pathogenicity of Acanthamoeba. Frontiers in Microbiology 14: 1147077
5. Moorfields Eye Hospital (no date). Acanthamoeba Keratitis [Online.] Available at: https://www.moorfields.nhs.uk/eye-conditions/acanthamoeba-keratitis [Accessed: June 1st 2025].
6. Campolo A, Pifer R, Shannon P, and Crary M (2022). Microbial adherence to contact lenses and Pseudomonas aeruginosa as a model organism for microbial keratitis. Pathogens 11(11): 1383.
7. Bert F, Maubec E, Bruneau B, Berry P, and Lambert-Zechovsky N. Multi-resistant pseudomonas aeruginosa outbreak associated with contaminated tap water in a neurosurgery intensive care unit. Journal of Hospital Infections 39: 53–62.
8. Enzor R, Bowers EMR, Perzia B, Perera C, Palazzolo L, Mammen A, Dhaliwal DK, et al. (2021). Comparison of clinical features and treatment outcomes of Pseudomonas aeruginosa keratitis in contact lens and non–contact lens wearers. American Journal of Ophthalmology 227: 1-11.
9. Carnt N, Minassian DC, and Dart JKG (2023). Acanthamoeba keratitis risk factors for daily wear contact lens users: a case-control study. Ophthalmology 130(1): 48-55.
10. Stellwagen A, MacGregor C, Kung R, Konstantopoulos A, and Hossain P (2020). Personal hygiene risk factors for contact lens-related microbial keratitis. British Journal of Ophthalmology 5(1): e000476.
11. Boyd K (2022). How to take care of contact lenses. American Academy of Ophthalmology [Online]. Available at: https://www.aao.org/eye-health/glasses-contacts/contact-lens-care [Accessed on: June 2nd 2025].
12. The College of Optometrists (2020). How to: contact lenses. College of Optometrists [Online]. Available at: https://www.college-optometrists.org/news/2020/august/2020-08-howto_contactlenses [Accessed: June 2nd 2025].
13. Rayamajhee B, Willcox MDP, Henriquez FL, Petsoglou C, and Carnt N (2021). Acanthamoeba keratitis: an increasingly common infectious disease of the cornea. The Lancet Microbe 2(8): E345-E346.
14. Moorfields Private Eye Hospital (no date). Diagnosis and treatment. Acanthamoeba Keratitis [Online.] Available at: https://www.moorfields.nhs.uk/private/eye-conditions-and-treatments/acanthamoeba-keratitis/diagnosis-and-treatment [Accessed: June 1st 2025].