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Excerpt:
Contact Lenses with Glaucoma: Timing Drops, Preservatives, and ComfortEffective glaucoma treatment usually means daily eye drops to lower eye pressure. If you wear soft contact lenses for vision, you’ll need extra care when using these drops. Contact lenses can trap medication and preservatives, which may irritate your eyes. This article explains the best way to use glaucoma drops with contacts: removing lenses before dosing, waiting to reinsert them, understanding preservatives, choosing the right lenses, and keeping itchy, dry eyes at bay. We also cover tips for coordinating care between your eye doctors (ophthalmologist and optometrist).Timing and Contact Lens UseRemove contacts before drops: Always take out your lenses before applying glaucoma eye drops. This keeps the lens from soaking up too much medicine or preservatives and blocking absorption. Wait at least 15 minutes: After you put in the drop, wait at least 15 minutes before putting your lenses back in () (). This guidance comes from experts and the FDA. Most eye drops wash out of the eye quickly (often in 5 minutes or less) (), so a 15-minute wait ensures the medicine has time to work without being trapped under the lens. In fact, one study found that wearing a lens just 5 minutes after a drop had the same effect as not wearing one at all (). In practice, waiting the full 15 minutes is safest, but if needed you’ll usually still get most of the benefit even after 5 minutes. Waiting also protects your lenses. Soft contact lenses (especially older high-water hydrogel types) can absorb drop preservatives if lenses are left in, so removing them helps prevent comfort problems later () ().Do one eye at a time: If you use drops in only one eye, finish that eye completely before removing and then reapplying the lens. By following this simple routine – remove drops → dose eyes → wait 15 minutes → reinsert lenses – you get the full glaucoma treatment effect while keeping your contacts safe.Preservatives in Glaucoma DropsMany glaucoma eye drops use preservatives to keep the bottle sterile. The most common is benzalkonium chloride (BAK). In fact, roughly 70% of glaucoma medications contain BAK (). BAK is very effective as an antimicrobial, but it can irritate the eye’s surface. Studies show BAK can disrupt and damage cells on the cornea and conjunctiva (the clear front of the eye and the white part) () (). Side effects of BAK include redness, burning, a broken tear film (dry spots), and inflammation. Over time, chronic exposure to BAK can worsen dry eye and even increase ocular inflammation () ().Contact lenses make the preservative issue more complex. Soft lenses (especially high-water hydrogel lenses) can absorb BAK and other chemicals from your tears (). Once absorbed, the lens slowly releases the preservative back onto the eye. This “reservoir” effect means your eyes may get exposed to BAK for a long time, even after you’ve rinsed your eye (). That is why lens wearers must remove lenses before drops and wait; it prevents lenses from soaking up extra preservative.Preservative-free options: If you have chronic irritation or are on multiple drops, ask your doctor about preservative-free glaucoma medications. Preservative-free (PF) drops are available for many glaucoma drugs and can greatly improve comfort () (). For example, research notes that switching to PF drops can reduce the dry eye side effects of glaucoma treatment (). Some newer drops use gentler preservatives (like Purite or SofZia) that break
