Yes, contact lenses can absolutely lead to a scratch on the surface of the eye, an injury medically known as a corneal abrasion. The cornea is the clear, dome-shaped surface at the very front of the eye, which plays a major role in focusing light. While contact lenses are a safe and effective vision correction tool, improper handling, extended wear, or external factors can cause this painful surface injury when the outermost layer of the cornea is scraped away. Although minor abrasions typically heal quickly, recognizing the signs and responding appropriately is important to prevent complications.
Recognizing the Signs of Injury
A corneal abrasion often causes immediate and significant discomfort because the cornea is densely packed with nerve endings. The most common symptom is sudden, sharp eye pain, often accompanied by a gritty or foreign body sensation, making it feel like sand or grit is perpetually trapped in the eye.
The injured eye will typically begin to water excessively (tearing) and may become noticeably red. Additionally, many people experience photophobia, a heightened sensitivity to light that makes bright environments painful or difficult to tolerate. If the scratch is located centrally, it may also cause temporary blurred or hazy vision until the corneal surface regenerates.
How Contact Lenses Cause Scrapes
Contact lenses can cause corneal abrasions through several mechanisms. One of the most frequent causes is debris becoming trapped between the lens and the corneal surface. Small particles like dust, dirt, makeup residue, or even a loose eyelash can rub against the cornea with every blink, quickly causing a scrape.
Improper handling during insertion or removal is another common route for injury. Accidentally touching the cornea with a fingernail, especially if the nails are long, is a direct cause of abrasion. Furthermore, if a lens folds or crimps unexpectedly while being placed on the eye, its edge can drag across the corneal epithelium, causing a scratch.
The condition of the lens itself can also be a factor; a lens that is chipped, torn, or has rough edges will constantly irritate and abrade the cornea with normal blinking. Over-wearing contact lenses, particularly sleeping in them when not approved for overnight use, can lead to severe eye dryness. This dryness causes the lens to adhere tightly to the cornea, and the simple act of removing the lens can peel away the surface cells, resulting in an abrasion.
What to Do Immediately After an Injury
If you suspect a corneal abrasion, the immediate and most important step is to carefully remove the contact lens from the eye. You must resist the urge to rub the eye, as this will only worsen the scratch and potentially embed any remaining debris deeper into the cornea. Aggressively flushing the eye is also not recommended, though a gentle rinse with sterile saline or clean water to dislodge a loose particle is acceptable.
It is important to seek prompt medical attention from an eye care professional, especially if the pain is severe, vision changes occur, or if the injury was caused by a dirty or organic object. During an examination, the doctor uses specialized eye drops with a fluorescent dye to highlight the extent of the scratch. Treatment typically involves prescribing antibiotic drops or ointment to prevent infection, since the abrasion creates an opening in the eye’s natural protective barrier. Minor abrasions often heal rapidly, usually within 24 to 72 hours, because the corneal cells regenerate quickly. For comfort and to aid healing, the doctor may also use lubricating drops or sometimes place a temporary bandage contact lens over the area.
Preventing Future Incidents
The best way to avoid corneal abrasions is by maintaining proper lens care and wearing schedules. Always wash your hands thoroughly with soap and water and dry them with a lint-free towel before touching your contact lenses or eyes. This hygiene step minimizes the transfer of dirt, oil, and bacteria that can get trapped under the lens.
It is essential to follow the prescribed wear schedule and never sleep in lenses unless they are specifically approved by your eye doctor for overnight wear. Over-wearing lenses reduces oxygen flow and increases dryness, which raises the risk of lens adherence and subsequent abrasion. Before insertion, inspect your lens for any tears, chips, or rough edges, and immediately discard any damaged lens. Finally, attend regular eye exams to confirm your lenses have the correct fit and prescription, as an ill-fitting lens can also increase friction against the cornea.