A common concern for contact lens wearers is the feeling that a lens has become “lost” behind the eye. A lens cannot actually slip to the back of the eyeball due to the conjunctiva, a natural anatomical barrier that lines the inner surface of the eyelids and covers the white part of the eye. While the lens is not truly lost, it can dislodge from the cornea and get stuck under the upper or lower eyelid, creating an uncomfortable sensation. Recognizing the signs of a dislodged lens and understanding the proper steps for safe removal can prevent panic and protect eye health.
Initial Signs That Suggest a Stuck Lens
The initial feeling of a dislodged contact lens is often a foreign body sensation. This differs from simple dryness or dust irritation by presenting a distinct grittiness or scratchiness that does not resolve with blinking. The eye may immediately produce excessive tears as it attempts to flush out the irritant. A stuck lens, particularly a soft lens that has folded, may cause a notable blurring or distortion of vision. Objective signs include unusual redness over the white part of the eye or a heightened sensitivity to bright light (photophobia), which occur because the misplaced lens is irritating the cornea or the conjunctiva.
Locating the Missing Contact Lens
Once symptoms suggest a lens is stuck, the next step is to visually confirm its location, which requires clean hands and good lighting. Thoroughly wash your hands with soap and dry them on a lint-free towel to avoid introducing contaminants to the eye. Use a well-lit mirror to carefully examine the entire visible surface of the eye, moving your gaze slowly in all directions.
The lens may be folded over and tucked into the fornix, the pocket where the conjunctiva meets the eyelid. To check the upper lid, look down toward your feet while gently lifting the upper lid outward. To inspect the lower lid, look up toward the ceiling and gently pull the lower lid down with a clean finger. A dislodged lens may appear as a slight, translucent shadow or a small, bunched-up piece of material, often near the edges of the visible eye.
Step-by-Step Safe Removal
Before attempting manual removal, lubricate the eye, especially if the lens feels dry and adhered to the surface. Apply several drops of a sterile saline solution or contact lens-approved rewetting drops to add moisture and restore the lens’s flexibility. After applying the drops, close your eye and gently massage the eyelid to help the lens float freely or shift toward the center of the cornea.
If the lens is stuck high up under the upper eyelid, look down while gently massaging the top of the closed lid in a downward motion toward the center of the eye. This encourages the lens to slide down to a more accessible position. Once the lens is visible and moves freely, use the pad of a clean index finger and thumb to gently pinch the lens off the surface of the eye. Use only the soft pad of the finger, avoiding fingernails which can scratch the cornea, and never use instruments like tweezers. If the lens is centered but appears dried out and stiff, continued application of lubricating drops and gentle blinking can often rehydrate the lens enough for a normal removal pinch; do not force the lens, as this increases the risk of damaging the corneal epithelium.
Warning Signs Requiring Immediate Medical Attention
If the contact lens cannot be found or safely removed after several gentle attempts, or if your symptoms worsen, seek professional help. Immediate medical attention is necessary if you experience severe, sharp pain that persists even after the lens is confirmed to be removed. Persistent redness, inflammation, or any noticeable discharge from the eye are indicators of a possible complication. A lingering sensation that something is still scratching the eye, even though the lens is gone, may signal a corneal abrasion, which requires prompt evaluation by an eye care professional. Any sudden decrease in vision or heightened sensitivity to light that does not quickly resolve also warrants an immediate consultation, as these signs could indicate a serious corneal infection leading to permanent vision damage.