Tears are more important than we might think, they play a crucial role in supporting the health of our eyes. When we blink, for example, tears spread across the front surface of the eye; called the cornea. This lubricates and nourishes the eye, washing away foreign matter and helping to prevent infections. They also keep the surface of the eye smooth for clear vision.

Dry eye, however, is a condition in which the quality or quantity of tears is inadequate to maintain the right amount of lubrication and, as a result, good corneal health.

If you regularly struggle with dry eye, wearing contact lenses might seem like the last thing on your mind. However, with the right care advice, you can still go about your daily business wearing contacts safely and comfortably. First, though, here are a few quick facts on what can cause dry eye:

●      Dry eye is more common in older adults and women

●      Certain medical conditions and medications can cause this condition

●      Exposure to wind, smoke, and dry environments can increase the evaporation of tears

●      Working on a computer for long periods without blinking is a common cause of dry eye

Common dry eye symptoms

Dry eye can cause several symptoms including:

  • A stinging or burning sensation
  • A feeling of grit in the eye
  • Stringy mucus near the eyes
  • Redness
  • Light sensitivity
  • Watery eyes
  • Blurred vision
  • Difficulty with night driving

Each of these symptoms might deter you from wearing contact lenses; the last thing you’d want is to feel like something else is in your eye. However, not all contact lenses are the same, so it’s worth noting that even if one type does not work for you, others can be tried before giving up on contact lens use.

Lenses, such as easyvision daily umere and Dailies Total1, made from newer materials called silicone hydrogels allow more oxygen to pass through to the cornea and reduce dehydration during lens wear.1 These advanced materials allow many people with dry eye to continue using contact lenses without symptoms.1 

Can contact lenses induce dry eyes?

Despite the introduction of advanced lens materials, some contact lens users still experience dryness and discomfort, especially at the end of the day.

In fact, dry eyes due to contact lens usage are one of the most common reasons for discontinuing lens wear permanently.2

Contacts can cause dry eye because the presence of the lens on the cornea limits oxygen flow into the eye — it’s oxygen that’s necessary to develop natural tears. The lens material also limits tear exchange between the outer and inner layers.2

However, modern silicone hydrogel materials with high oxygen transmissibility have eliminated this problem to a significant degree.  

Contact lens aftercare with dry eyes

There are several things you can do to make contact lens use with dry eyes more comfortable. These are also good aftercare tips to follow when wearing contact lenses generally.

  • Practice good hand hygiene to avoid transferring germs from the fingers to the lens 
  • Never sleep with your contacts in (unless you use extended wear lenses or ortho-k contact lenses)
  • Use new contact lens solution every day to ensure proper disinfection
  • Always change to a fresh pair of lenses as directed. Extending the use beyond the recommended time can lead to a build-up of debris on the lens surface
  • Consider going lens-free for a few hours every day. The eyes need to breathe - oxygen and nutrients help make tears
  • Talk to your optician about switching to a different contact lens cleaning and storage solution. Sometimes, preservative-free or hydrogen peroxide solutions can significantly improve comfort1
  • Include omega-3 fatty acids (flaxseed oil and fish oil) in your diet, they are believed to be beneficial for dry eyes1

What contact lenses should I wear for dry eyes and astigmatism?

Toric lenses for astigmatism made with silicone hydrogel material and replaced on a daily disposable schedule are likely to work best for people with dry eyes. These breathable contacts are designed to retain water and keep the eyes lubricated throughout the day.

Several brands offer toric lenses for dry eyes, including:

You should discuss with your optometrist which ones may be suitable for you.

Daily versus monthly contact lenses for dry eyes

The use of daily disposables can, according to clinical research, reduce dryness in the eyes and improve comfort with fewer uncomfortable hours of wear.3 This is due to the fact that these lenses are only used once and, as such, have a low risk for collecting dirt or debris. Users of monthly contact lenses, on the other hand, clean and store the lenses overnight for up to 30 days. This increases the likelihood of dirt and protein deposits on the lens surface, which can cause dryness and discomfort.

What contact lenses should I wear for dry sensitive eyes?

Special contact lenses are designed to work with easily irritated and dry eyes. The lens material in these contacts retains moisture, resists deposits, and draws more oxygen into the eyes to make all-day use comfortable even for people with dry and sensitive eyes. Some contact lenses for dry sensitive eyes include:

Are multifocal contact lenses healthy for dry eyes?

They can be, as long as they’re used as recommended. People with dry eyes can wear multifocal contact lenses such as Alcon Air Optix Aqua Multifocal, which are designed to retain moisture and keep out irritating deposits.

Can contact lenses cause eye discharge?

Contact lenses are safe and convenient to use, but they do carry a risk of eye infection. Unhygienic handling, leaving them in overnight, using poorly fitted contacts (scratches make it easier for germs to enter the eye), and extending the duration of use are all predisposing factors for corneal infections.4  

It’s the eye infection itself that can be associated with discharge or pus, not the contact lens. If you have any signs or symptoms of infection, including redness, watering, irritation, discharge, pain, or discomfort with wearing contacts, see your optometrist as soon as possible.

Eye drops for contact lenses and dry eyes

If you have dry eyes, prescription and over-the-counter eye drops may allow you to continue wearing contact lenses without symptoms.1

Always consult a contact lens practitioner/optometrist before you use any eye drops to make sure they are compatible with your lenses and lens solutions

Cyclosporine/Ikervis

This is a prescription eye drop that increases tear production. It’s useful in people with contact lens associated dry eyes, however it can take 3-6 months to see the benefits. The eye drops must be instilled in the eyes 15 minutes before inserting contact lenses, and cannot be used while the lenses are in the eyes.

Alrex/Lotemax

This is a combination of steroid medication and loteprednol. Many optometrists avoid using Alrex in contact lens wearers due to the risks associated with steroids.1 However, these eye drops are particularly effective for symptoms of dry eye provoked by seasonal allergies and may be suitable for short-term use.

Rewetting drops

These are designed specifically to improve comfort with contact lens wear and increase wear time. They work best when used on a schedule and can be instilled as frequently as once every 1-2 hours.1 Using the drops before an exacerbating activity, such as computer work, is more effective than waiting until the dry eye symptoms appear.1

 

Artificial tears

Available over the counter, these drops lubricate the eyes and provide short-term relief from dry eye symptoms. They can be used up to six times a day.

If you use eye drops as a solution for dry eyes with contact lenses, practise good hygiene and follow your optometrist’s instructions to use them safely. This is important to avoid any further complications. 

For more information head to our contact lens aftercare information pages. To book an appointment with one of our optometrists, you can do so here.

References:

1. American Optometric Association. (no date). Treating Dry Eye Symptoms in Contact Lens Patients. [Online]. Available at: https://www.aoa.org/Documents/optometric-staff/Articles/Treating%20Dry%20Eye%20Symptoms%20in%20Contact%20Lens%20Patients%20-%20friedman%20edits.pdf [Accessed 24 October 2019].

2. Muntz A, Subbaraman LN, Sorbara L, Jones L. Tear exchange and contact lenses: a review. J Optom. 2015;8(1):2–11. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314619/ [Accessed 24 October 2019].

3. Riley C, Young G, Chalmers R. (no date). Prevalence of ocular surface symptoms, signs, and uncomfortable hours of wear in contact lens wearers: the effect of refitting with daily-wear silicone hydrogel lenses (senofilcon a). Eye Contact Lens. 2006 Dec;32(6):281-6. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17099389 [Accessed 24 October 2019].

4. Kellogg Eye Center, University of Michigan Health System. (no date). Signs of Infection from Contact Lenses. [Online]. Available at: http://www.med.umich.edu/1libr/Ophthalmology/ContactLens/SignsofInfectionfromContactLenses.pdf [Accessed 24 October 2019].