What are the best eye drops for relieving pain when closing eyes after wearing contact lenses?

Eye Drops for Contact Lens-Related Pain

For pain when closing eyes after wearing contact lenses, start with preservative-free artificial tears (such as polyethylene glycol/propylene glycol formulations) used 4-6 times daily, and discontinue contact lens wear until symptoms resolve. 1

Immediate Management Algorithm

First-Line Treatment: Preservative-Free Artificial Tears

• Use preservative-free formulations exclusively when applying drops more than 4 times daily, as preserved tears can cause additional ocular surface toxicity with frequent use 1
• Apply 1-2 drops in affected eye(s) as needed throughout the day 2
• Polyethylene glycol/propylene glycol-based tears (like Systane) demonstrate superior tear film breakup time extension compared to carboxymethylcellulose formulations, maintaining effectiveness up to 20-30 minutes post-instillation 3

Contact Lens Management

• Immediately discontinue contact lens wear until pain resolves—continuing to wear lenses while symptomatic risks corneal abrasion and infection 4
• Once asymptomatic, lubricating drops can be used before lens insertion and after removal to minimize recurrence 4, 5
• Consider that your symptoms may represent contact lens discomfort syndrome, which affects 13-75% of contact lens wearers and can lead to permanent discontinuation if not addressed 5

When to Escalate Beyond Simple Lubrication

Red Flags Requiring Same-Day Evaluation

• Persistent pain despite 24-48 hours of artificial tears and lens discontinuation suggests possible corneal abrasion requiring fluorescein examination 6
• Photophobia, vision changes, or purulent discharge indicate potential infection requiring urgent ophthalmologic evaluation 6
• If corneal abrasion is confirmed, prophylactic broad-spectrum antibiotics (Polytrim drops or erythromycin ointment) should be prescribed 6

Moderate Dry Eye Treatment (If Simple Tears Insufficient)

• Consider anti-inflammatory therapy with cyclosporine 0.05% or lifitegrast 5% if symptoms persist beyond 2 weeks despite adequate lubrication 1
• Emulsion-based lubricants may provide additional benefit for tear film instability 1
• Treat concurrent meibomian gland dysfunction with warm compresses if present 1

Common Pitfalls to Avoid

Preserved artificial tears with chronic use: Benzalkonium chloride and thimerosal-containing drops cause epithelial toxicity when used more than 4 times daily 1, 4

Continuing contact lens wear while symptomatic: This risks progression from simple irritation to corneal abrasion or infectious keratitis 4, 5

Using topical NSAIDs for pain control: These delay corneal healing and should be avoided 6

Assuming all artificial tears are equivalent: While most have comparable efficacy, polyethylene glycol/propylene glycol formulations demonstrate superior tear film stabilization in head-to-head trials 3

Adjunctive Measures

• Apply viscous gel or ointment formulations at bedtime for overnight protection 1
• Use moisture chamber eyewear or glasses with side shields to reduce tear evaporation 1
• Ensure adequate hydration and consider omega-3 supplementation for underlying dry eye 1

Evidence Quality Note

While low-certainty evidence suggests lubricating drops improve contact lens discomfort compared to no treatment, the effect compared to saline alone remains uncertain 5. However, the safety profile and low cost make preservative-free artificial tears the appropriate first-line intervention in real-world clinical practice 5, 7.