Contact lenses can cause or worsen feelings of dryness, a common issue known as contact lens-related dry eye (CLDE). This discomfort often happens because the lens interferes with the delicate, natural tear film that covers the eye’s surface. The presence of the lens can also reduce the amount of oxygen reaching the cornea, which can lead to irritation and dryness over time. Finding the right lens involves considering the material, design, and replacement schedule to maintain comfort and eye health.
Understanding Lens Materials
The material a contact lens is made from plays a significant role in how well it supports a dry eye. Lenses fall into two main categories: traditional hydrogel and modern silicone hydrogel (SiHy). Hydrogel lenses rely on their water content to transmit oxygen to the cornea, but this method is inefficient and limits breathability.
Silicone hydrogel materials are superior for dry eye sufferers because they allow significantly more oxygen to pass through the lens to the eye. SiHy lenses achieve high oxygen transmission because the silicone component, not the water, is the primary vehicle for oxygen transmission. This allows the cornea to remain healthier and less irritated, reducing the risk of oxygen deprivation that can contribute to discomfort.
Key Lens Design Features
Beyond the base material, specific design features influence how a lens interacts with the tear film and retains moisture. It may seem logical that lenses with a high water content would be best for dry eyes, but this is often not the case—a concept known as the “water content paradox.” Lenses with a high percentage of water can act like a sponge, drawing moisture away from the eye’s natural tears as the water in the lens evaporates.
For many people with dry eyes, lenses with a medium-to-lower water content, typically less than 50%, are often more comfortable. These lenses are less prone to dehydration and less likely to absorb moisture from the ocular surface. Many modern lenses also incorporate moisture-retaining technologies, such as embedded wetting agents or lubricants that release slowly throughout the day. These agents mimic elements of the natural tear film, helping the lens surface stay smooth and hydrated, promoting sustained comfort.
The Impact of Replacement Frequency
The frequency with which lenses are replaced directly affects comfort for those prone to dryness. Daily disposable lenses are widely regarded as the best option for managing dry eye symptoms. Since a fresh, sterile lens is used every day, there is minimal time for proteins, lipids, and other deposits from the tear film to build up on the lens surface.
This daily fresh lens approach prevents the accumulation of irritating debris, which is a major contributor to reduced comfort and exacerbated dryness. In contrast, bi-weekly or monthly lenses require diligent care to resist deposit buildup over a longer period. For reusable lenses, a highly effective cleaning solution is necessary to break down and remove these deposits, which otherwise reduce the lens’s ability to remain hydrated and breathable.
Supportive Care and Professional Guidance
Choosing the right lens is only one part of managing dry eye related to contact lens wear; supportive care is also important. Rewetting drops, specifically formulated for use with soft contact lenses, can provide temporary relief from dryness experienced during the day. Opting for preservative-free drops is often advisable, as the preservatives found in some multi-dose bottles can cause sensitivity or irritation in already dry or sensitive eyes.
For reusable lenses, the choice of cleaning and disinfection solutions can significantly affect comfort. Hydrogen peroxide-based solutions are highly effective at deep cleaning and removing protein deposits without the use of chemical preservatives. These systems require a special case to neutralize the hydrogen peroxide over several hours, transforming it into a gentle saline solution before the lenses can be worn.
If discomfort or dryness is severe or persistent, it is important to seek professional guidance from an eye care specialist. A comprehensive examination can help diagnose any underlying causes, such as meibomian gland dysfunction, ensuring that the treatment plan addresses the root of the problem rather than just the symptoms.