Waking up to find a contact lens seemingly vanished from the surface of your eye is a common and unsettling experience that causes immediate anxiety. Many wearers immediately fear the lens has slipped into a place where it cannot be retrieved. Rest assured, this happens frequently, and there are safe, straightforward steps to locate and remove the dislodged lens without causing harm to your eye. The immediate goal is to stay calm and understand that the lens is not truly “gone.”
Where Did the Contact Lens Go?
The anatomy of the eye makes it physically impossible for a contact lens to slip away into the back of your head. The front surface of the eye is covered by a thin, clear membrane known as the conjunctiva. This protective tissue folds back on itself from the white of the eye to line the inside surface of the eyelids, creating a continuous barrier.
This anatomical structure ensures there is no open pathway for any foreign object, including a contact lens, to travel behind the eyeball. If you cannot see the lens on the cornea, it has most likely moved to a hidden location. The lens is typically folded or tucked up under the upper eyelid, which offers a deeper pocket for the lens to hide in compared to the lower lid.
Falling asleep with lenses in often causes the lens to dry out and stick to the eye surface, or conversely, causing it to move and adhere to the conjunctiva under the lid. The sensation of a missing lens is usually just the lens being displaced to a location where it is not visible or easily felt. It is still within the confined space of the eye’s front surface and will not become permanently lost.
Immediate Steps to Find and Remove the Lens
The first action is to thoroughly wash your hands with soap and water to avoid introducing any bacteria or debris into your eye. Once your hands are clean and dry, the next step is to rehydrate the eye and the lens, which has likely dried out overnight and become stuck. Apply several drops of sterile saline solution or contact lens rewetting drops, but avoid using tap water or non-approved solutions.
After lubricating the eye, close your eyelid and gently massage the area over the eyelid in the direction you want the lens to move. If the lens is under the upper lid, massaging gently in a downward motion can help coax the lens to slide back down onto the center of the eye. You should also try moving your eye slowly in all directions—up, down, and side to side—while keeping the eyelid closed.
If the lens is still not visible after gentle massage, use a mirror in a well-lit area to inspect the whole eye surface. Look down while gently lifting and pulling your upper eyelid away from the eyeball to check the area beneath it. For a lens stuck under the lower eyelid, look up while pulling the lower lid down.
Repeat the application of lubricating drops and the gentle blinking or massaging process as needed. It can sometimes take up to ten minutes for a dried lens to become rehydrated and movable.
Recognizing Symptoms of Potential Damage
While removing the displaced lens is the immediate concern, sleeping in contacts significantly increases the risk of eye complications. The lack of sufficient oxygen reaching the cornea while you sleep, combined with a dried lens, can lead to two primary issues: corneal abrasion and microbial keratitis. A corneal abrasion is essentially a scratch on the clear front surface of the eye, which can occur if the dry lens adheres to the cornea and is forcefully removed.
Symptoms of an abrasion or irritation can include persistent eye pain or discomfort, a noticeable feeling that something is still lodged in the eye, and excessive tearing. More concerning are signs of infection, known as microbial keratitis, which is a serious inflammation of the cornea.
This condition presents with distinct symptoms like severe, worsening pain, persistent redness, a noticeable discharge from the eye, and increased sensitivity to light, or photophobia.
If you successfully remove the lens but the eye remains red, irritated, or painful for more than an hour, or if you develop any of the more severe symptoms, immediately seek professional medical attention. Do not insert a new contact lens into the irritated eye, as this can worsen an abrasion or accelerate a developing infection. Early diagnosis and treatment are important to prevent complications like a corneal ulcer, which is an open sore on the eye’s surface that can potentially threaten vision.