From the Guidelines
Contact lenses should be used with caution, prioritizing daily disposable lenses and strict hygiene protocols to minimize the risk of complications, as overnight wear and improper care can lead to serious eye infections and other issues 1.
Key Considerations for Contact Lens Use
When considering contact lens use, it's essential to weigh the benefits against the potential risks. The most critical factor in minimizing complications is proper hygiene and care.
- Handwashing before handling lenses is crucial, as is using appropriate cleaning solutions and adhering to recommended replacement schedules.
- Daily disposable lenses are the safest option, as they reduce the risk of infectious or inflammatory complications compared to reusable lenses 1.
- Rigid gas-permeable lenses are associated with the lowest rate of microbial keratitis, but overnight wear of any lens type increases the risk of corneal infection 1.
Lens Types and Wear Schedules
Modern contact lenses come in various types, including:
- Soft lenses (hydrogel or silicone hydrogel)
- Rigid gas-permeable lenses
- Specialty lenses (toric or multifocal designs) Wear schedules range from daily disposables to extended wear options, but daily wear of a rigid gas-permeable lens is associated with the lowest rate of microbial keratitis 1.
Risks and Complications
Contact lens wear can lead to serious complications, including:
- Corneal infections (microbial keratitis)
- Sterile inflammatory peripheral corneal infiltrative events (CIEs)
- Acanthamoeba and fungal keratitis
- Environmental risk factors, such as exposure to tap water or contaminated lens cases, can increase the risk of complications 1.
Patient Education and Care
Proper patient education and care are vital in minimizing the risks associated with contact lens wear.
- Patients should be trained and supervised in contact lens insertion and removal.
- Contact lens cleaning and disinfection should be carefully explained, and patients should be instructed to use only sterile products specifically designed for contact lens care 1.
- Regular follow-up appointments with an eye doctor are essential to monitor the health of the eyes and address any potential issues promptly.
From the Research
Evolution of Contact Lenses
- Contact lenses have become a ubiquitous and versatile ocular technology, with a wide range of applications in vision correction and treatment of various ocular conditions 2, 3.
- The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for medical applications, including high refractive error, irregular astigmatism, and ocular surface disease 2.
Medical Use of Contact Lenses
- Contact lenses are used to treat various complex ocular conditions, including disfiguring disease, and ocular surface disease, and have been shown to improve epithelial healing and reduce pain in persistent epithelial defects 2.
- Modern scleral lens practice has achieved great success for both visual rehabilitation and therapeutic applications, including those requiring retention of a tear reservoir or protection from an adverse environment 2.
- Contact lenses are also used in the management of dry eye disease (DED) and associated ocular surface disorders, providing surface hydration, protection from environmental insults, and as a modality for constant drug delivery to the ocular surface 4.
Contact Lens Safety and Dry Eye
- Contact lenses are a safe and effective method for correction of refractive error, but lens materials and wear and care regimens can impact the risks of contact lens-related corneal inflammatory events and microbial keratitis 3.
- Contact lens wear is a relevant risk factor for dry eye, and the coexistence of dry eye poses a serious challenge in patients wearing contact lenses 5, 6.
- Studies have shown that the incidence of dry eye is higher in contact lens wearers than in normal people, and contact lens-associated dry eye (CLADE) has become an important public health problem 6.