It's been almost two years since a Check Up blog warned about how the popular contact lens cleaning product CLEAR CARE can cause severe eye burning and even eye damage if it's not used properly. Later, I called attention to the problem and requested action by FDA and the manufacturer, Ciba Vision Corp., a Novartis company.
People who wear contact lenses have told us they assumed Clear Care was just another multipurpose solution for rinsing and soaking lenses. They say they selected the product from among other lens soaking solutions stored side-by-side at the pharmacy. Or they've mistaken a friend's bottle of Clear Care and poured the solution in their flat contact lens holder for an overnight soak. But Clear Care is not just another soaking solution. It's for cleaning and disinfecting lens and it contains 3 percent hydrogen peroxide, which should never get into the eyes by using it as a contact lens rinse or soak.
The Institute for Safe Medication Practices (ISMP) is aware of hundreds of incidents where contact lens wearers have used the product improperly. The Food and Drug Administration and the manufacturer are also aware, since we brought it to their attention two years ago in case they somehow didn't know about it. People commonly miss label statements and other product signals to soak lenses only in the special contact lens holder packaged with the product. The holder has a platinum disc which causes its cleaning action and neutralizes it. If lens wearers fail to take that step and just use the solution itself as a soak, they will undoubtedly suffer eye burning and excruciating pain. Some have also suffered chemical injuries to the eye, including tissue injuries.
Figure 1… Old (left) and new Clear Care label.
The latest report came last week when an angry caller left a message in our voice mail. He indicated that his wife accidentally placed Clear Care in her eyes, resulting in severe eye pain. He saw our previous blogs on the Internet and wanted us to know about his wife and that it is still happening, stating, "This is bad stuff!"
Based on the error reports, as well as conversations I've had with others about this problem, I am amazed at how prevalent the situation has been. Several of our pharmacists and nurses have accidentally done it. I mentioned it during a class I taught recently at Temple University and several hands went up when I asked about it. My own daughter suffered terrible eye pain after confusing it with a soaking solution and a Consumer Reports blogger wrote about it happening to his daughter too. In fact, you can ask almost any group of lens wearers and chances are you'll hear some horror stories about how painful it was to get Clear Care in the eyes. Some patients wind up taking a trip to the ER.
As a result of our interaction with FDA and the company, we were told last year that changes would be made to the product to address the problem. A few meager changes have in fact happened. The product label now has a stronger statement about the importance of following directions for use and some other minor changes to the carton and instructions also have been made. In the red band at the top of the label a new statement now starts notes, "Important." But you must turn the container around entirely to see what might be important and recognize what will happen if you don't follow directions exactly. Unfortunately, as you can imagine, not everyone is going to do this and all good intentions are for naught. In addition, without their contacts in place, some users can't even read the statement, anyway.
The new statement has been insufficient to prevent this ongoing problem. There's a science behind making warnings effective and this attempt is way off target. For example, the words "danger" or "warning" followed by an exclamation point are much more likely to call attention to something important. Positioning is also important. This warning belongs on the front label panel in large type – immediately following the name "Clear Care." Sorry, but somehow I get the feeling that the manufacturer doesn't want users to see the words "burning and stinging" that appear on the other side of the label.
Overall, the container looks the same as before. No changes have been made to the packaging to prevent the problem. In fact, that is really what is needed. Pharmacies should separate Clear Care from soaking solutions or put them behind the counter to assure that proper instructions are communicated orally. If this product is to remain a non-prescription item, FDA and the company must find a way to combine the special lens holder with the cap and bottle in a way that prevents anyone from pouring out the hydrogen peroxide and soaking lenses without the neutralizing platinum disc.
Once again, let this blog serve as a warning to contact lens wearers about this risk, which could affect them as well as friends or family members who might not know about Clear Care.
Have you had your own painful episode with Clear Care or any of its generic equivalent products or know of a family member who has? We'd sure like to hear about it and promise to relay the information in confidence to FDA and the manufacturer. You can report cases here.