Impact of Contact Lenses and Dry Eyes
This article focuses exclusively on providing information about dry eyes. For a comprehensive understanding of the topic, please refer to the full article available here.
Contact lenses are a popular vision correction option that offers convenience and freedom from wearing traditional eyeglasses. However, the use of contact lenses can have various impacts on the ocular surface. This blog post explores the potential effects of contact lenses on the eyes and discusses important considerations for contact lens wearers.
Contact Lens-Induced Dry Eye:
Contact lens-induced dry eye is a common issue experienced by contact lens wearers. To address this problem, wetting agents containing hyaluronic acid can be incorporated into lens care solutions. These agents help alleviate dryness and improve comfort. It is also advisable for patients with contact lens discomfort and dry eye to avoid using lens care products that contain polyhexamethylene biguanide. However, more research is needed to establish evidence-based recommendations for safe and effective contact lens care.
Potential Complications During the Pandemic:
With the emergence of the COVID-19 pandemic, concerns about ocular complications for contact lens wearers have arisen. While the presence of the novel coronavirus in ocular tissues is possible, the risk of infection appears to be very low. Studies estimate that approximately 11% of COVID-19 patients may experience ocular manifestations, such as conjunctivitis or dry eye/foreign body sensation. Additionally, "long COVID" has been associated with corneal epithelial nerve loss and increased immune cell density in the cornea, which may have implications for contact lens wear in the long term.
Mask-Associated Dry Eye and Chalazion:
Wearing face masks and shields has become essential during the pandemic. However, prolonged mask use can lead to ocular complications, including an increased risk of developing a chalazion and the onset of mask-associated dry eye. Poorly fitted masks can create an air current across the cornea, resulting in faster tear film evaporation, dry spots on the ocular surface, eye irritation, and discomfort. Contact lens wearers with mask-associated dry eye may experience worsened dry eye symptoms due to their already lower-quality tear film. Eye care practitioners should educate patients on proper mask fit to minimize the impact on ocular comfort while wearing contact lenses.
Contact Lens Wear with Systemic Diseases and Medications:
Contact lens wear can present challenges for individuals with systemic diseases or those using systemic medications. Conditions like diabetes mellitus and thyroid disease can complicate successful contact lens wear due to their ocular surface manifestations.
- People aged 65 years of age with diabetes have a prevalence of dry eye of 15%–33%.
- Dry eye has been reported in up to 85% of patients with and is the most frequent cause of ocular discomfort in this population.
Patients with diabetes require careful consideration, including disease control, glycemic levels, presence of retinopathy, and overall health. Systemic medications, such as antidepressants, antihistamines, and beta-blockers, can cause or exacerbate dry eye and make contact lens wear challenging. It is crucial to optimize the underlying systemic disease and manage the ocular surface for successful contact lens wear in these individuals.
Impact of Age and Years of Contact Lens Wear:
The age of contact lens wearers and the duration of lens wear can affect the ocular surface. Children and teenagers often report significant improvements in vision, appearance, and overall satisfaction with contact lens wear. However, dry eye disease becomes more prevalent in patients over 50 years of age. Age-related changes, such as meibomian gland atrophy and reduced corneal epithelial immune cells, may impact the success of contact lens wear.
It has also been suggested that contact lens wear accelerates age-related changes in the meibomian glands
Contact Lens Wear After Refractive Surgery:
Patients who have undergone procedures like PRK, LASIK, or small incision lenticule extraction (SMILE) may opt for contact lens wear to correct residual errors or change eye colour. However, these surgeries can cause ocular dryness symptoms and affect tear film stability. It is advisable to defer contact lens wear until after the eye has recovered from surgery and topical medical therapy has been completed. Regular follow-up visits are necessary to monitor potential complications and ensure successful contact lens wear.
Management Approaches for Contact Lens Discomfort:
Contact lens discomfort can be addressed through various management strategies. These include modifying lens choice, wear mode, and care; addressing modifiable risk factors; treating underlying diseases; improving the ocular environment; and modifying the general environment. Topical artificial tears, oral essential fatty acids, punctal occlusion, and topical medications may provide relief. However, further research is needed to establish their specific efficacy in the context of contact lens wear.
Contact lens wearers should also consider their occupation and potential impacts on the ocular surface. For individuals who use digital devices extensively, reduced blink frequency and amplitude can lead to eye strain, dryness, and irritation. Blinking plays a crucial role in maintaining tear film stability during contact lens wear, making adequate blinking essential for comfort. Proper refractive correction for digital device use is also important to alleviate digital eye strain.
Contact Lens Wear and Exposure to Cosmetics:
The use of cosmetics, including eye makeup and creams, can affect contact lens comfort and contribute to dryness. Certain ingredients in cosmetics, such as preservatives, may have toxic effects on ocular tissues. Cosmetic enhancements like eyelash extensions and tattooing can also pose risks to ocular health. Contact lens wearers should be aware of these potential adverse effects and choose compatible products.
Contact lenses offer vision correction convenience, but their use can impact the ocular surface. Contact lens wearers should be aware of potential complications, consider systemic diseases and medications, and adopt appropriate management strategies. Regular visits to eye care practitioners and adherence to good hygiene practices are crucial for maintaining ocular health while wearing contact lenses.