Many people rely on contact lenses for clear vision, but some develop contact lens intolerance (CLI), experiencing pain, irritation, or discomfort that necessitates removing the lenses. This condition can be frustrating, especially for those who have worn contacts for years without issues.
Common Reasons for Discomfort
One frequent cause of contact lens discomfort is chronic dry eye, where the eyes do not produce enough tears or tears evaporate too quickly. Contact lenses sit directly on the tear film, disrupting its stability and exacerbating dryness, leading to irritation and a gritty sensation. Allergic conjunctivitis, an inflammatory reaction, is often triggered by environmental allergens like pollen, dust, or pet dander adhering to the lens surface. Allergies can also stem from specific components in contact lens solutions or the lens material.
Giant papillary conjunctivitis (GPC) is an inflammatory condition characterized by small bumps, called papillae, on the underside of the upper eyelid. This reaction is often caused by protein deposits on the contact lens rubbing against the eyelid. Eye infections (bacterial, viral, or fungal) can also cause significant discomfort and damage, often resulting from improper lens hygiene, such as handling lenses with unwashed hands or exposing them to water.
Overwear syndrome occurs when contact lenses are worn beyond their recommended duration, reducing oxygen supply to the cornea. This can damage the corneal surface, making the eyes red, irritated, and more susceptible to infection. Poor lens hygiene, including inadequate cleaning, reusing old solution, or not replacing the lens case regularly, increases the risk of bacterial contamination. Ill-fitting lenses can cause constant rubbing against the eye’s surface, leading to irritation and inflammation. A lens that does not conform to the eye’s unique shape can prevent adequate oxygen flow and tear exchange, contributing to discomfort.
Signs and Symptoms to Watch For
Individuals may experience persistent irritation, a feeling akin to something being in the eye, or a gritty sensation. Redness of the eyes is a common indicator, often appearing as irritation that can worsen throughout the day and persist even after lens removal. Burning or stinging sensations, along with excessive tearing or unusual eye secretions, can also signal an issue.
Vision changes might include blurred or fluctuating vision. Increased sensitivity to light (photophobia) can also develop. A reduction in comfortable wearing time, where lenses become intolerable after only a few hours, indicates developing intolerance. These symptoms can emerge gradually or suddenly.
Diagnosis and Treatment Approaches
A comprehensive eye examination by an eye care professional is the first step toward diagnosis. This examination often includes specialized tests to assess tear film quality and quantity, such as tear film breakup time or the Schirmer’s test. The professional will also examine the inner eyelids for signs of inflammation, such as papillae characteristic of GPC. If an infection is suspected, cultures of eye secretions might be taken to identify the specific pathogen.
Management strategies for contact lens intolerance vary depending on the underlying cause. Temporary cessation of lens wear, often called a “contact lens holiday,” allows the eyes to heal. Switching to different lens types, such as daily disposables or highly breathable silicone hydrogels, can reduce deposit buildup and improve oxygen flow.
Over-the-counter lubricating or rewetting drops can provide temporary relief for dryness. For inflammatory conditions or allergies, prescription eye drops containing antihistamines or steroids may be prescribed. Bacterial infections require antibiotic eye drops or oral medications.
Options Beyond Contact Lenses
Several alternatives offer effective vision correction for those who can no longer comfortably wear contact lenses. Eyeglasses provide a straightforward, non-invasive solution, eliminating direct contact with the eye. They offer visual clarity without the maintenance requirements of contact lenses.
Refractive surgeries present a long-term vision correction option. Procedures like LASIK (Laser-Assisted In Situ Keratomileusis) and PRK (Photorefractive Keratectomy) reshape the cornea using a laser to correct refractive errors such as nearsightedness, farsightedness, and astigmatism. These outpatient procedures can reduce or eliminate the need for glasses or contact lenses. Another surgical option is the implantation of collamer lenses (ICLs), thin, biocompatible lenses placed inside the eye, suitable for individuals not ideal for LASIK or PRK. Consult an eye care professional to determine the most suitable alternative based on individual eye health and lifestyle.