Contact lens discomfort (CLD) is a common experience for many wearers, often described as a persistent feeling of dryness, grittiness, or irritation that can shorten the comfortable wearing time of lenses. Contact lenses offer a convenient alternative to glasses, but their placement directly on the eye’s surface makes them highly susceptible to factors that affect comfort. Understanding the specific source of the irritation is the first step toward finding relief. This article breaks down the most frequent sources of contact lens irritation, from simple fixes related to user behavior to serious medical concerns requiring professional attention.
Physical Issues with the Lens Itself
A primary cause of discomfort stems from the physical relationship between the lens and the eye. An improper fit is a frequent offender. A lens that is too tight restricts the flow of tears and oxygen to the cornea, potentially leading to swelling. Conversely, a lens that is too loose moves excessively with each blink, causing a constant rubbing sensation against the lid or cornea.
The lens material itself can also be a source of irritation, especially if a wearer develops a sensitivity to components like silicone hydrogel. Even when the fit is correct, a lens with a small tear, chip, or rough edge can cause a persistent, sharp discomfort that feels like a foreign object. Microscopic foreign debris, such as dust, pollen, or makeup residue, can become trapped beneath the lens surface, leading to a gritty feeling that intensifies with blinking. Inspecting the lens for damage or trapped particles before insertion can often resolve these physical discomforts.
Hygiene and Wear Schedule Mistakes
User habits are a major factor in contact lens discomfort, often creating an environment where microorganisms and irritating deposits can thrive. One significant error is “topping off” old solution in the lens case rather than completely emptying and refilling it with fresh multipurpose solution. Reusing old liquid drastically reduces the disinfectant’s effectiveness, allowing microbes to survive and contaminate the lenses.
The lens case itself is a common reservoir for bacteria and fungi, where poor cleaning allows the formation of a sticky layer called biofilm. This biofilm can be transferred to the lens and subsequently to the eye, increasing the risk of infection. To prevent this, the case should be emptied, rubbed with fresh solution, rinsed, and allowed to air-dry face down after each use. The case should also be replaced entirely every one to three months.
Furthermore, wearing lenses longer than the prescribed duration or sleeping in lenses not approved for extended wear significantly reduces the oxygen supply to the cornea. This oxygen deprivation can inflame the cornea, making it more vulnerable to infection.
Physiological and Environmental Causes
Discomfort may also originate from the eye’s underlying biology or the external surroundings, independent of the lens condition or care routine. Dry Eye Syndrome is the most common reason for contact lens discomfort, affecting up to half of all users. The presence of the lens disrupts the natural tear film, increasing the rate at which tears evaporate. Lens material, particularly the high water content in some soft lenses, can absorb moisture from the eye itself, leading to increased dryness, burning, and a persistent gritty sensation.
Allergic reactions are another physiological cause, which may be seasonal due to airborne allergens like pollen, or a reaction to preservatives found in certain contact lens solutions. The external environment plays a large role, as conditions like low humidity, air conditioning, and high air flow accelerate tear evaporation. Exposure to irritants such as smoke or dust further exacerbates the problem, leading to dryness and redness. The cumulative effect of these factors can destabilize the tear film, causing even a perfectly fitted lens to feel uncomfortable.
When Discomfort Signals a Serious Problem
While most contact lens discomfort is minor, certain symptoms are warning signs that require immediate professional attention. Any sudden, sharp, or escalating pain should prompt the immediate removal of the lenses. This is particularly true if the pain is accompanied by severe, persistent redness that does not subside shortly after the lens is taken out.
Other serious indicators include an unusual sensitivity to light (photophobia), excessive tearing or discharge, or if the eye feels swollen. If vision becomes noticeably blurred and does not clear upon blinking, it suggests a potentially serious infection or corneal complication. In the presence of these symptoms, remove the contact lenses immediately and contact an eye care professional without delay. Do not attempt to self-treat or reinsert the lenses, as ignoring these signs could lead to serious complications such as corneal ulcers or permanent vision loss.