Contact lenses are medical devices requiring a healthy eye surface and a motivated user for successful wear. A thorough examination by an eye care professional is necessary to determine candidacy, as various physical, health, and behavioral factors can make lens use inappropriate. The cornea, the clear front surface of the eye, must maintain its natural environment and receive adequate oxygen to tolerate a lens resting upon it. When the ocular surface is compromised or the wearer cannot maintain the required care regimen, contact lenses pose a significant risk of discomfort, inflammation, or infection.
Chronic Ocular Conditions That Prevent Contact Lens Use
Severe and refractory dry eye syndrome is one of the most common physical barriers to comfortable contact lens wear. The lens sits directly on the tear film, effectively dividing it into two layers, which increases tear evaporation and instability. When the eye does not produce enough high-quality tears, the lens can adhere to the cornea. This leads to irritation, fluctuating vision, and potential damage to the delicate surface layers of the eye.
Advanced corneal irregularities can make proper lens fitting impossible, particularly in conditions like severe keratoconus. This progressive disorder causes the cornea to thin and bulge outward into a cone shape, creating a highly irregular surface. Standard lenses cannot safely correct or rest upon this surface. While specialized lenses, such as rigid gas permeable (RGP) or scleral lenses, can often vault over the irregular shape and create a new smooth refractive surface, the most severe cases may not be compatible with any type of lens.
Chronic inflammatory conditions of the eyelids and conjunctiva also pose a long-term problem for lens wear. Severe blepharitis, an inflammation of the eyelid margins, causes excessive oil and debris buildup that readily transfers to the contact lens. This contamination increases the risk of eye infection and can trigger conditions like giant papillary conjunctivitis (GPC). These chronic states require complete resolution before a person can safely consider resuming contact lens use.
Systemic Health and Lifestyle Considerations
A person’s overall health and daily habits can be just as influential as the state of their eyes in determining contact lens compatibility. Systemic diseases, such as uncontrolled diabetes, compromise corneal sensation and healing, making a person more susceptible to serious corneal infections, like microbial keratitis. Autoimmune disorders, including Sjögren’s syndrome or rheumatoid arthritis, often severely reduce tear production. This leads to profound dry eye that permanently rules out lens wear.
The workplace environment is another practical factor that can disqualify a potential lens wearer. People who work in environments with high levels of airborne debris, like construction sites or mills, face a constant risk of foreign material becoming trapped beneath the lens. This trapped debris can scratch the cornea and introduce infectious agents. Lens use in these occupational settings is often unsafe.
Crucially, an inability to adhere to a strict hygiene regimen or to properly handle the lenses is a major contraindication. Contact lenses require meticulous daily cleaning, disinfection, and storage. Failure to follow these steps significantly increases the risk of severe eye infections. Individuals with dexterity issues or cognitive impairment often cannot maintain the necessary level of cleanliness. Furthermore, forgetfulness regarding replacement schedules can lead to overwearing and serious corneal complications.
Temporary Situations Requiring Discontinuation
Contact lens wear is temporarily suspended until a reversible condition resolves. Any active eye infection, such as bacterial or viral conjunctivitis, requires immediate discontinuation of lenses. This prevents worsening the infection and contaminating the lenses or storage case. Lens use can only resume after the infection has fully cleared, often confirmed by an eye doctor.
Recent eye surgery necessitates a healing period during which the eyes are vulnerable. Following procedures like LASIK, photorefractive keratectomy (PRK), or cataract surgery, the cornea and surrounding tissues need time to stabilize. A lens cannot be safely introduced until stabilization occurs. This recovery period is determined by the surgeon and is essential to avoid complications.
Certain prescription medications can also temporarily affect the ocular surface, making lenses intolerable. Some topical eye drops or high doses of oral steroids can significantly decrease tear production or alter the cornea’s integrity. Once the medication regimen is complete or adjusted, and the tear film returns to its healthy state, lens wear can often be successfully resumed.