Contact lenses occasionally move from the cornea, creating an uncomfortable sensation that often makes people worry the lens has disappeared completely. Many people fear the lens has slipped to the back of the eye, but this is anatomically impossible. A thin membrane called the conjunctiva lines the inside of the eyelids and folds back to cover the white part of the eyeball, forming a barrier that prevents anything from traveling behind the eye. A lost lens is almost always simply folded, dried, or tucked into a crevice under the eyelid.
Recognizing the Signs of a Lost Lens
The initial indication that a contact lens is still present is often a change in physical sensation rather than a visible sighting. The most common sign is a foreign body sensation, described as a persistent grittiness or the feeling of having sand in the eye. This discomfort occurs because the misplaced or folded lens is constantly rubbing against the sensitive inner surface of the eyelid.
The eye typically reacts to this irritation with increased tear production, resulting in watering. If the lens is folded or significantly shifted off-center, it can cause sudden blurring or distortion of vision. Persistent irritation may also lead to localized redness. These symptoms indicate that the lens has not fallen out and requires attention.
Step-by-Step Visual Confirmation
Once a misplaced lens is suspected, wash hands thoroughly with soap and water to prevent introducing bacteria. Inspection requires a well-lit area and a mirror to aid the visual search. The lens often retains a slight tint, which can make the edges visible against the white sclera or the iris.
Begin the search by gently pulling the lower eyelid down while looking upward, which exposes the lower conjunctival sac where a dislodged lens often settles. Next, look far to the left, right, up, and down, allowing the eye’s movement to encourage a tucked lens to shift back into view. If the lens is not immediately visible, attention must shift to the upper eyelid, which is a common hiding spot.
To check the upper lid, look down toward your feet and gently place a clean finger or cotton swab on the middle of the upper eyelid. While maintaining a downward gaze, gently fold the eyelid up and back over the swab or finger to inspect the inner surface for the lens. A dried or folded lens often adheres to this surface, or it may be lodged in the superior fornix, the upper pocket formed by the conjunctiva.
Immediate Actions and When to Consult a Doctor
If a lens is located and appears stuck or dry, the safest immediate action is to rehydrate the lens and the eye surface. Apply several drops of saline solution or contact lens rewetting drops to the eye, then close the eyelid and gently massage the area. This moisture helps restore the lens’s flexibility and makes it less likely to scratch the cornea upon removal.
If the lens is visible, use the pad of a clean finger to gently slide it toward the white part of the eye, where it can be pinched out safely. Resist the urge to rub the eye vigorously, as this can cause the lens to scratch the corneal surface or break into pieces. If the lens is not found, but the irritation quickly subsides after flushing the eye, the lens likely fell out unnoticed.
If the lens cannot be removed after several attempts, or if symptoms do not resolve after confirmed removal, consult a doctor. Severe, persistent pain, blurred vision, or the presence of a yellow or green discharge indicate a potential issue. These symptoms could point to a corneal abrasion or the onset of an infection, requiring prompt assessment by an eye care professional.