Red eyes, blurry vision and stuff like that

There’s something about contact lenses that makes getting dry eye symptoms – momentary blurry/ filmy vision, ‘blink to clear’, ‘lens awareness’, gritty eyes, ‘makes you want to rub your eyes’, dry eyes,  tired eyes – more likely.  Dry feeling eyes is one of the main causes for people reducing or ceasing contact lens wear.

It can happen in two ways.  Contact lens wear can ‘amplify’ any underlying dry eye – that is, make things more noticeable to people who already knew they have dry eye, and sometimes give symptoms to people that had low-grade, non-symptomatic dry eye.  Contact lens wear can also, it seems, give reversible dry eye symptoms to people who have no detectable dry eye signs before contact lens wear.

There are environmental things that can push a non-symptomatic contact lens wearer to being symptomatic -

• Type of work – screen based work is generally done at a higher level of gaze than paper based work, leaving more of the eye exposed to the environment.
• Type of work – spending longer periods staring at the same place is more likely to give dry eye symptoms than if your work involves more visual variety.
• Type of work – people blink less the more they are concentrating on a task.
• Type of work – people are more likely to report dry eye symptoms if they are doing ‘boring’/repetitive tasks than if they are doing creative work.
• Environment – hot air, strong air flows, low humidity environments all increase tear evaporation of the eye, making dry eye symptoms more likely.  Where I live, there’s always a surge of contact lens dry eye at the beginning of winter once the heaters get turned on.
• Medications and medical conditions can affect dry eye symptoms.

So, without doing anything to your contact lenses, you may be able (or maybe not) to reduce dry eye symptoms.

There are a number of things that can be done to help contact lens wearers through dry eye symptoms – ask at your next eye exam if any of these might help:

• Lens design – if a contact lens fits too tightly, it may be comfortable to start with but get worse as the day goes on.
• Lens material – material softness, and wettability vary from one lens to another.
• Lens hydration characteristics – most soft contact lenses are about 60% water, and they can lose water content during the day, leading to changes lens fit, and thus lens awareness on the eye. Some lens materials ‘hold their water’ better than others.
  • Rehydrating the lens part-way through the day by adding lubricant eye-drops, or
  • Rehydrating the lens part-way through the day by taking them out, popping them in their case with solution for a few minutes, can often give lenses a new lease on life for the second half of the day.
• Lens depositing – some lens materials collect more deposits during the day, and during their lifespan than others.
  • Also being more careful with recommended disposal cycles, or
  • Moving to daily disposable contact lenses, can make a big difference to people who are problem depositors.
• Contact lens solution choice – an interesting study found some combinations of contact lens solutions and contact lens materials led to more dry patches on the eye than others.
• Don’t minimise your contact lens cleaning routine – do all the steps, keep your lenses as clean as possible.
• Wearing times  - try not to push your eyes to their limit.  Keep an up-to-date pair of specs, so that you don’t have to keep wearing your contacts if your eyes are feeling dry.
• Disposal periods – Many of the dry eye contact lens wearers I see are people who push their contact lens disposal periods out too far.  It’s just not good for the eyes to keep wearing each pair of lenses until your eyes complain.  It may not seem like economic sense, but the ideal in disposable contact lenses is to start a fresh lens before the previous one is giving you problems.
• Daily disposables are a good option for some dry eye contact lens wearers, for two reasons.  Firstly, each day is a fresh lens.  Secondly, because the lens is only used once, some brands of daily disposables actually contain a lubricating agent that gradually disperses out of the lens during the day.
• Help out your eyes tear production by keeping your eyelids in good order.  A warm compress on the lids at the end of the day, and/or a lid hygiene program like LidCare, can help support the functioning of the glands in the eyelid that produce components in your tears.
• Lubricant eye-drops can be helpful to keep the lens hydrated, and to restore a clear, clean layer of tears over the front surface of the contact lens.  Lubricant drops always work best preventatively – that is, learn your eye’s patterns, and then use drops to prevent the symptoms.  Once your getting dry eye symptoms, drops can be helpful, but the opportunity for them to do their best work has been missed.  The preservatives in some drops are not recommended for use during contact lens wear.

Everyone’s eyes are different – what works for your friend may not be what’s needed for you.

Dry eye symptoms in contact lens wear can come from a lot of different sources. And there are lots of possible fixes, so be sure to talk about it at your next eye exam if dry eye symptoms are a problem for you.