When a contact lens shifts out of sight, the fear that it has slipped entirely behind the eye is common. However, the anatomy of the eye makes it impossible for a contact lens to travel to the back of the eye socket. Understanding the physical boundaries and knowing the correct steps for locating and safely removing a displaced lens are important actions to take. This guide offers clarity and practical instructions to manage a lens that has moved from its intended position.
The Physical Limits of Contact Lens Travel
The worry that a contact lens could migrate fully behind the eyeball is rooted in a misunderstanding of the eye’s physical structure. A thin, moist membrane called the conjunctiva covers the entire white part of the eye, known as the sclera. This membrane folds back on itself to line the inner surface of both the upper and lower eyelids.
This continuous, folded layer creates a natural, sealed pocket, often described as a cul-de-sac, that physically prevents any foreign object from passing beyond the front of the eye. A lens can certainly become dislodged and slide from the cornea into this pocket formed beneath the eyelid. However, this anatomical barrier guarantees that the lens cannot slip into the orbital tissue behind the eye.
Symptoms of a Misplaced or Fragmented Lens
If a lens is misplaced, it will likely cause a distinct sensation. The most common sign is a foreign body sensation, often described as feeling like grit or sand persistently in the eye. This discomfort occurs because the lens is folded or lodged beneath the eyelid, where it scrapes against the delicate surface tissues with every blink.
A displaced lens can also cause immediate and localized redness, as well as excessive tearing as the eye attempts to flush out the irritant. If the lens has torn, even a small, jagged fragment can cause a sharp pain or persistent scratching sensation, which may increase the risk of a corneal abrasion. Visually, you can check for the lens by looking into a mirror and moving your eye in different directions; many lenses have a slight tint that makes the edge visible against the white of the eye.
Step-by-Step Guide to Self-Removal
When you suspect a lens is stuck, the first step is to thoroughly wash your hands with soap and water to prevent introducing bacteria to your eye. Next, rehydrate the eye and the lens, as dryness often causes the lens to adhere tightly to the eye’s surface or fold over. Apply several drops of contact lens-safe rewetting drops or sterile saline solution to the affected eye and blink gently a few times.
Moving your gaze in the direction opposite to where the lens is stuck helps shift the lens from the conjunctival pocket toward the center of the eye where it can be pinched out.
Locating and Removing the Lens
- To coax a lens out from under the upper eyelid, look downward while gently massaging the closed upper lid toward the center of your eye with a clean finger.
- If the lens is lodged under the lower lid, look upward as you gently manipulate the lower lid.
For a fragmented lens, the approach is similar, focusing on flushing the eye with saline to move the piece to an accessible area, such as the corner of the eye.
Rigid Gas Permeable (RGP) Lenses
If the lens is a rigid gas permeable (RGP) type, avoid massaging the eyelid, as the harder material could scratch the cornea. Instead, use a clean fingertip to gently press on the eye just beside the edge of the lens to break the suction. Alternatively, use a small suction cup device designed for RGP removal.
When to Consult an Eye Care Professional
If you are unable to locate or remove the lens after multiple, gentle attempts, or if the discomfort persists, stop trying to avoid damaging the eye surface. You should immediately contact an eye care professional if you experience severe, sharp, or worsening pain, especially if it does not subside shortly after the lens is removed. These signs may indicate a corneal abrasion or developing infection that requires immediate medical attention.
Other red flags requiring professional attention include:
- Persistent redness that lasts more than a few hours.
- Any discharge from the eye.
- A sudden, noticeable change in your vision.