Contact Lenses Care

Q: Can contact lenses harm the eye?

A: Contact lenses are dangerous if you have a faulty lens, or do not maintain proper ocular hygiene, or don’t follow the recommended wearing and handling procedures. For instance, corneal abrasion can occur when the lens isn’t inserted properly. Corneal edema occurs if you overwear the lens. An eye infection may be caused by fingers or contact lens solutions that are contaminated. And foreign bodies can sneak under the lens and irritate the cornea.

With regard to the vast number of contact lens wearers, though, such complications have been remarkably rare.

Q: What is corneal edema?

A: It is the most common contact lens complication and the main reason you can’t wear lenses for twenty-four hours (except for extended-wear contacts). Edema means swelling, which is what happens to your cornea when you wear your lenses too long and deprive the cornea of oxygen. Even though gas-permeable lenses, soft lenses, and lenses that allow optimum tear exchange reduce the chance of edema, there is always less oxygen than normally reaches the naked eye. You’ll know when you’ve been wearing your contacts too long: your eyes will burn, turn red, be light sensitive; maybe you’ll see halos or rainbows around lights. Unless you’re too stubborn or highly motivated, the most appealing thought in the world will be that of removing your lenses, which is exactly the right thing to do. In minor cases your cornea will recuperate in a few hours (better yet—overnight). If you really overdo it, recovery may take several days and corneal abrasion may follow.

Q: What is conjunctivitis?

A: This is an infection of the conjunctiva, the mucous membrane that covers the white part of the eye and lines the underside of the eyelids. Conjunctivitis and other eye infections can afflict the contact lens wearer who doesn’t clean (and disinfect, in the case of soft lenses) his lenses according to instructions. It can also occur when wearers clean and wet the lenses with saliva, which is loaded with bacteria, viruses, and perhaps fungi. In addition to the ordinary garden-variety conjunctivitis (”pink eye“), there’s another form called “giant papillary conjunctivitis,” which is caused only by contact lens wear (the contact lenses themselves, deposits on the lenses, or any of the contact lens solutions). In treating the individual with this type of conjunctivitis I discard the contact lens and prescribe a steroid (cortisone) eye drop. Resolution of the disorder may take days or even weeks. Once the conjunctiva has healed, I order a new lens and then instruct the patient to use different solutions. For the hard contact lens wearer the correct solution is determined by trial and error. For the soft contact lens wearer I permit only the use of unpreserved saline and the heat method of disinfection. Happily, this type of conjunctivitis, when treated properly, rarely recurs. If it does reappear, cessation of contact lens use may be the only solution.

Q: What’s corneal abrasion?

A: Corneal abrasion is the term used when the surface layer of the cornea is scraped or scratched off. This can occur when you wear the contact lenses too long (overwear syndrome); with improperly fitted lenses; or by inserting, removing, or recentering the lens improperly. Sleeping with daily-wear lenses on often leads to corneal abrasion. The symptoms are decreased vision, burning pain, sensitivity to light, the sensation of having something in your eye, and copious tearing. Abrasion that follows corneal edema may not be evident until hours after the contact lenses have been removed. Healing is mercifully rapid: usually within thirty-six hours. You may take aspirin for the pain, and cold compresses may help. Consult your ophthalmologist to make sure there are no complications; he may also recommend that you wear a tight eye patch for the duration of the recuperative period to keep the eye immobile. Though most cases of corneal abrasion are minor, a severe infection can invade the damaged cells. While this is unlikely to occur, it is a possibility, so don’t treat corneal abrasions lightly.

Q: Can contact lenses cause drooping of the eyelids?

A: It’s rare, but the results of one study indicate that in a very few cases, contact lens wear can lead to a condition called blepharoptosis, resulting in eyelids that appear to droop. All the patients studied had been wearing hard lenses, some for many years. The researchers’ most likely explanation is that the condition was caused by excessive manipulation and rubbing of the eyelids, usually because of difficulties in inserting and removing the lenses. The trauma caused eyelid muscle damage. This condition can be corrected surgically.

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