The general answer to whether you can wear contact lenses during surgery is no, especially if the procedure involves general anesthesia or deep sedation. This rule is a standard safety protocol enforced in operating rooms across the globe. The requirement for removal is a necessary precaution to prevent serious eye damage and ensure the medical team can properly monitor the patient throughout the procedure. While you are unconscious, the body’s natural protective mechanisms are temporarily halted, creating a high-risk environment for the delicate tissues of the eye.
Reasons for Contact Lens Removal
One of the most significant risks is the cessation of the body’s natural eye lubrication under general anesthesia. Without the unconscious reflex to blink, the eyes stop producing tears and moisture, leading to rapid and extreme drying of the cornea. This desiccation can cause the contact lens material to dry out and adhere firmly to the corneal surface.
The operating room environment often involves the use of electrosurgical tools, such as electrocautery devices, which generate heat and electrical current. There is a risk that the plastic lens could interact with this energy, potentially leading to localized heat transfer or arcing. Removing the lens eliminates this potential hazard entirely and prevents a potential corneal burn.
Contacts can also interfere with the medical team’s ability to monitor the patient’s neurological status. Anesthesia providers frequently observe the size and reaction of the pupils to light as a way to gauge the depth of anesthesia and overall brain function. A contact lens, particularly a colored or rigid one, can obscure this view or distort the assessment, compromising patient safety and monitoring capabilities.
Preparing Vision Correction Alternatives
Patients who rely on contact lenses must plan ahead by bringing an alternative form of vision correction to the hospital. Physicians universally recommend that glasses be brought and worn to the pre-operative area and used immediately in the post-anesthesia care unit. Glasses pose no risk of adhering to the cornea or interfering with surgical equipment.
The pre-procedure protocol requires that you bring your contact lens case and solution with you to the facility. You will typically be instructed to remove your lenses in the pre-operative holding area, just before being moved to the operating room. This ensures the shortest possible time without vision correction before the procedure begins.
In some limited cases, such as minor procedures performed under local anesthetic without any sedation, a patient might be permitted to keep their lenses in. However, this is always at the discretion of the surgical and anesthesia team, and removal is often requested as a fail-safe measure. Having a clear plan for your glasses and lens storage prevents confusion and delays on the day of surgery.
Immediate and Delayed Complications
If a contact lens is left in during a procedure, the resulting corneal desiccation can lead to an immediate and painful condition known as corneal abrasion. When the lens adheres to the dried cornea, any attempt to remove it can tear off the delicate outer layer of cells. This abrasion is like a painful scratch on the eye’s surface, causing foreign body sensation and light sensitivity.
A more serious delayed complication stems from the lack of oxygen, or hypoxia, reaching the cornea during the prolonged period of non-blinking. The cornea receives its oxygen primarily from the air, and a lens acts as a barrier, especially when the eye is closed for hours. This oxygen deprivation increases the likelihood of a microbial infection, or keratitis, particularly if bacteria become trapped beneath the lens.
Infection can progress quickly, leading to the formation of a corneal ulcer, which is an open sore on the eye’s surface. Corneal ulcers can cause permanent scarring and vision loss if not treated aggressively. The combined effect of drying, prolonged wear, and a compromised corneal surface makes wearing contacts during surgery a substantial risk to long-term eye health.