Glaucoma is a group of conditions that damage the optic nerve, which transmits visual information from the eye to the brain. This damage is often associated with abnormally high pressure inside the eye, known as intraocular pressure (IOP). Since glaucoma can cause progressive and irreversible vision loss, proper management is necessary. People who rely on contacts for vision correction can generally continue wearing them, but this depends on the disease’s severity, the treatment plan, and clearance from an eye care professional. Wearing contact lenses with glaucoma requires careful attention to medical protocols and hygiene practices to protect the ocular surface.
How Glaucoma Affects Standard Contact Lens Wear
Glaucoma and its treatments can introduce physical complications that make standard contact lens use challenging. Ocular surface disease, including decreased tear production and tear break-up time, is common in glaucoma patients. This dryness can cause discomfort and intolerance when wearing contact lenses, especially soft hydrogel types.
The integrity of the cornea, the clear front surface of the eye, can also become compromised in advanced glaucoma or due to chronic medication use. Since a contact lens rests directly on this sensitive tissue, any pre-existing compromise increases the risk of complications like corneal abrasions or infections. The lens itself can also interfere with accurate measurement of intraocular pressure, a routine part of monitoring the condition’s progression. Eye care providers may prefer rigid gas-permeable (RGP) lenses over soft lenses, as the RGP material allows more oxygen to reach the cornea.
Managing Contact Lenses Around Glaucoma Medications
The most common treatment for glaucoma involves prescription eye drops designed to lower intraocular pressure. A significant issue is that many medicated drops contain preservatives, such as benzalkonium chloride (BAK). Soft contact lenses have a strong affinity for these preservatives, meaning the lens material can absorb and concentrate the BAK.
The concentrated preservative is then slowly released onto the eye, which can lead to irritation, inflammation, and toxicity to the corneal surface. To prevent this chemical interaction, patients must remove their contact lenses before applying medicated eye drops. After instilling the drops, a specific waiting period, typically at least 15 minutes, is required before reinserting the lenses, allowing the medication to be absorbed and excess preservative to dissipate.
Following surgical procedures for glaucoma, such as laser treatments or trabeculectomy, contact lens wear is usually prohibited temporarily or permanently. The healing process requires a sterile environment and an intact ocular surface. Contact lenses could interfere with the success of the procedure, potentially reducing the effectiveness of a filtering bleb. An eye surgeon must provide specific clearance before resuming contact lens use after recovery.
Strict Hygiene and Safety Protocols for Wearers
Maintaining rigorous hygiene standards is necessary for a person with glaucoma who wears contact lenses, as their eyes are vulnerable to complications. Glaucoma patients, particularly those using eye drops, have a heightened risk of infection, which could worsen the underlying condition. This necessitates strict adherence to a cleaning routine using only fresh, recommended contact lens solution every time the lenses are stored.
Wearers should never clean their lenses with tap water and must avoid sleeping in them unless specifically approved for an extended-wear schedule. Because glaucoma can cause gradual changes in vision requiring prescription adjustments, regular communication with both the ophthalmologist and the optometrist is necessary. This collaborative approach ensures the lens prescription and material are continually re-evaluated against the progression of the glaucoma and the health of the ocular surface.
Specialized Contact Lenses in Glaucoma Monitoring
Beyond standard vision correction, new contact lens technologies are being developed for both the monitoring and treatment of glaucoma. Specialized smart contact lenses are equipped with miniature sensors that continuously track fluctuations in intraocular pressure over a 24-hour cycle. Since eye pressure naturally varies throughout the day, this continuous data provides doctors with a more complete picture of disease progression than a single office measurement.
One device, the Triggerfish lens, is a soft silicone lens that records changes in corneal curvature, which correlates with IOP fluctuations, and wirelessly transmits the information. Other research focuses on creating lenses that actively treat the condition by providing controlled drug delivery. These therapeutic lenses store anti-glaucoma medication within a hydrogel layer and release it slowly onto the eye, potentially offering a more consistent and effective way to lower pressure.