Dry Eyes and Contact Lens Usage

Have you ever wondered why your eyes feel dry and uncomfortable after wearing contact lenses for an extended period?

Contact lenses, while convenient, can sometimes lead to aggravated dry eye symptoms. This issue stems mainly from reduced tear production due to extended wear, disrupting the eye’s natural lubrication and leading to discomfort, particularly in low-humidity environments.

I’m Juliet Menakaya, owner and principal optometrist of Junic Eye Care. At our Canberra optometry practice, I’ve consulted with many contact lens wearers who run into problems because they are also suffering from dry eye syndrome a.k.a. “dry eye disease”.

It’s a complex issue where a little professional advice can go a long way.

For example, I’ve had patients purchase contact lenses directly from the internet without having a proper contact lens fitting, unaware that they have underlying signs of dry eyes which ought to be managed first. I have also seen patients who don’t adhere to the recommended wearing or cleaning regime thus making their eyes more prone to dryness.

So in this blog post, I hope I can illustrate how contact lens wear can be made more comfortable for dry eye syndrome sufferers.

How Contact Lenses Affect Eye Moisture

There are two general types of dry eye condition. Most people will experience some combination of these issues, with evaporative dry eye being a more prevalent problem.

Aqueous Tear-Deficient Dry Eye:

• This condition occurs when the lacrimal glands do not produce enough of the aqueous (watery) layer of the tear film.
• Those with this condition may find contact lenses uncomfortable due to insufficient lubrication. The lack of adequate tear volume can lead to increased friction between the lens and the cornea, causing irritation.

Evaporative Dry Eye:

• This type is caused by rapid evaporation of tears from the eye’s surface, often due to meibomian gland dysfunction, which affects the lipid (oily) layer of the tear film.
• Contact lenses can exacerbate this condition by absorbing the tear film’s moisture, leading to increased tear evaporation and dryness.

Choosing the Right Contact Lenses for Dry Eyes

Choosing the right kind of contact lenses for dry eyes is essential to ensure comfort and maintain eye health. Here’s a summary of various types of lenses and how they can be beneficial for those with dry eye symptoms:

Silicone Hydrogel Lenses

• These lenses are made from a material that allows a significant amount of oxygen to pass through to the cornea.
• They help maintain corneal health and reduce the risk of hypoxia-related complications. Their high oxygen permeability can also reduce tear film evaporation, making them a good choice for those with evaporative dry eye.

Low Water Content Lenses

• These lenses have a lower percentage of water in their composition compared to other soft lenses.
• They are less likely to dehydrate in dry environments, which can be beneficial for people whose tear film evaporates quickly.

Daily Disposable Lenses

• These are single-use lenses that are discarded after one day of wear.
• The daily replacement schedule minimizes the chance of lens-surface build-up, which can irritate dry eyes. They also reduce the need for potentially irritating cleaning solutions.

Scleral Lenses

• Scleral lenses are large-diameter rigid gas permeable lenses that vault over the entire corneal surface and rest on the sclera (the white part of the eye).
• They create a tear-filled vault over the cornea, which helps keep it moist and can be particularly beneficial for severe dry eye cases.

Orthokeratology (Ortho-K) Lenses

• These are specially designed rigid gas permeable lenses worn overnight to temporarily reshape the cornea.
• Ortho-K lenses can be a great option for dry eye sufferers as they are worn during sleep, eliminating the need for daytime contact lenses and thus reducing the potential for dry eye symptoms during waking hours.

When choosing contact lenses for dry eyes, it’s important to consider individual factors like the severity of dry eye symptoms, lifestyle, and personal comfort preferences.

Regular consultations with an optometrist are essential to determine the most suitable type of lenses and ensure proper fit and care.

Contact Lens Fitting and Regular Checkups

The importance of proper contact lens fitting cannot be overstated, especially for individuals who experience dry eye symptoms. Here’s why accurate fitting and regular eye exams are crucial:

• Eyes Can Change: Regular eye checks are necessary to monitor eye health and ensure that the contact lens prescription is up to date. Your eye’s shape and condition can change over time, which requires adjustments in the lens prescription.
• Eyes Are Unique: Each person’s eyes have a different shape, size, cornea, and eyeball lens. A prescription that is tailored to these individual differences ensures that contact lenses correct vision effectively without causing discomfort or harm.
• Monitoring Eye Health: Regular exams help detect any changes in eye health that might affect contact lens use, such as changes in tear production or the development of conditions like dry eye disease.
• Managing Irritation: Lenses that do not fit properly can rub against the eye’s surface, leading to increased irritation and discomfort, especially in individuals already suffering from dry eyes.
• Management of Tear Film: A poor fit can disrupt the natural distribution of the tear film. This disruption is crucial in the context of dry eyes, as it can exacerbate the symptoms by causing uneven tear distribution and increased evaporation.
• Monitoring Oxygen Permeability: Ill-fitting lenses, especially those that are too tight, can restrict the amount of oxygen reaching the cornea. For dry eye sufferers, this can further irritate and dry out the eyes.
• Minimizing Risk of Eye Infections: Poorly fitted lenses can lead to an increased risk of eye infections and corneal damage, as they may trap debris and bacteria against the eye, creating an environment conducive to infections.

Proper contact lens fitting is a detailed process that requires the expertise of a trained optometrist or ophthalmologist. It involves not only determining the correct prescription but also choosing the right type of lens material, size, and curvature to suit the individual’s eyes and lifestyle.

For those with dry eye symptoms, the importance of a precise fit is even greater to ensure comfort, minimize irritation, and promote overall eye health. Regular follow-ups and open communication with your eye care professional are key to maintaining the best possible vision and comfort while using contact lenses.

Managing Dry Eyes While Wearing Contact Lenses

Managing dry eyes while wearing contact lenses involves a combination of appropriate eye care products, lifestyle adjustments and diligent hygiene practices.

Here are some tips for contact lens wearers on how to effectively manage dry eyes:

Use of Lubricating Eye Drops Compatible with Contact Lenses

• Specialized Formulas: Opt for lubricating eye drops specifically formulated for use with contact lenses. These drops help maintain moisture and alleviate dry eye symptoms without affecting the lens material.
• Regular Application: Regularly using these drops can provide ongoing relief and comfort, especially during prolonged lens wear or in dry environments.

Lifestyle Adjustments and Dietary Supplements for Eye Health

• Screen Time Management: Reduce eye strain by taking regular breaks during prolonged screen use, following the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds).
• Environmental Considerations: Use a humidifier in dry indoor environments and wear sunglasses outdoors to protect against wind and sun, which can exacerbate dry eyes.
• Dietary Supplements: Omega-3 fatty acids, found in fish oil and flaxseed oil, can support eye health by improving tear quality and reducing dry eye symptoms.

Proper Cleaning, Storing, and Replacing Contact Lenses

• Regular Cleaning: Clean lenses thoroughly as per your optometrist’s instructions to remove deposits and microbes.
• Proper Storage: Always store lenses in fresh, sterile solution in a clean lens case.
• Timely Replacement: Adhere to the replacement schedule for your lenses to minimize the risk of irritation and infection, which can worsen dry eye symptoms.

Hygienic Practices in Preventing Dry Eye Irritation

• Hand Hygiene: Always wash and dry your hands thoroughly before handling contact lenses.
• Avoid Touching or Rubbing Eyes: This can transfer bacteria to the eyes and lenses, increasing the risk of infection and irritation.

Signs Indicating a Need for an Urgent Professional Assessment

• Persistent Discomfort or Pain: Any ongoing discomfort or pain while wearing lenses should be evaluated.
• Redness or Swelling: These can indicate an infection or an allergic reaction.
• Blurred Vision or Light Sensitivity: Sudden changes in vision or increased sensitivity to light require immediate professional attention.
• Excessive Tearing or Unusual Eye Discharge: These symptoms can signal an underlying problem that needs to be addressed by an eye care professional.

By incorporating these practices into your daily routine, you can effectively manage dry eyes while enjoying the benefits of wearing contact lenses.

Regular check-ups with an eye care professional are crucial to ensure that your contact lens use is not adversely affecting your eye health.

Conclusion

As an optometrist, I understand the challenges of managing dry eyes for contact lens wearers. And in my experience, choosing the right lenses is one of the most important decisions to make.

Silicone hydrogel lenses, for instance, offer excellent oxygen permeability, while daily disposables minimize irritants. For severe dry eyes, scleral lenses can be a game-changer, and Orthokeratology (Ortho-K) lenses are great for overnight use.

In addition, I always stress the importance of regular eye exams to ensure lenses fit correctly, as poorly fitted lenses can aggravate dry eye symptoms and increase infection risks.

If you are a contact lens wearer who experiences persistent discomfort, redness, or vision changes, I encourage you to seek immediate professional advice. My goal is to help contact lens users in Canberra to achieve a comfort and clear vision despite their dry eyes.

To visit our optometry practice, click the “Book Online” button at the top of the page or call (02) 6152 8585 today.

You’ll find our clinic conveniently located in the Molonglo Health Hub, just a short 10 minute drive from central Canberra, with plenty of free parking when you get here.