Contact Lenses for Dry Eyes

Since contact lenses can limit oxygen flow to the eyes, they can exacerbate dry eyes in some people. While people with dry eyes had more limited options in the past, new technology means they have more options in contact lenses today.

What Kind of Contacts Work for Dry Eyes?

Overall, soft contact lenses work better for dry eyes than hard lenses, simply because soft lenses allow more oxygen to reach the eye.

Currently, most popular contact lens brands integrate two features that were not present in earlier versions of soft contact lenses:

• Sufficient moisture delivery: This helps the maintenance of a quality tear film.
• Adequate oxygen delivery to the cornea: This helps to preserve corneal health and avoid conditions such as keratitis (corneal inflammation), or infections. Ample oxygen is needed to cleanse the cornea.

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What Is Dry Eye Syndrome & What Causes It?

Dry eye is a condition where a person’s tears do not fully lubricate and protect the eye from debris or dry conditions.

The following are potentially contributing factors:

• A decline in health
• Aging
• Inflammation of the eye
• Dehydrating effects of medication 
• Exposure to a dry environment
• Nutritional or liquid intake deficiency

Sometimes, dry eyes may emerge as a result of wearing contact lenses.

The Importance of Treating Dry Eye Syndrome

Identifying the underlying cause of dry eye is key to treating the condition and avoiding potential dry eye problems from contact lenses. Treatment of dry eye (ocular surface disease) may take months.

Experts agree that treating dry eye syndrome before a contact lens fitting is necessary since contact lenses need a moist surface for improved adherence.

It’s generally recommended to avoid contact lenses while experiencing symptoms of dry eye. Wear glasses until symptoms clear.

What to Consider in Lens Choice for Dry Eyes

Lens Type

When you reach a point where you can reasonably consider contact lenses, your choices will vary based on the severity of your dry eye condition.

• Moderate to severe dry eye: For more serious (moderate to severe) dry eye, a scleral (hard) contact lens will promote lubrication.  Scleral lenses provide a space over the cornea for collection of tear film.
  These lenses have been shown to improve dry eye symptoms. 
• Mild to moderate dry eye: For a less serious dry eye condition, a soft contact lens is generally a good choice. Soft contact lenses for dry eyes are made from a material that keeps the eye moist and allows oxygen to reach the cornea (usually silicone hydrogel).

Moisture Content

While it seems counterintuitive, contact lenses with high water content are actually worse for dry eyes. These lenses actually reduce the moisture level in the eyes. 

Instead, people with dry eye syndrome generally benefit from contact lenses with a lower moisture level.

Daily Disposable Lenses

These lenses generally work best for people with dry eyes. Since the lenses are thrown away every day, there is less likelihood of them becoming contaminated with irritants that can worsen dry eye or lead to infection.

Overall, dailies are preferred for people with dry eye because they eliminate common causes of contact lens discomfort (CLD):

• Introduction of microorganisms from imperfect cleaning processes
• Irritation from residue or cleaners 
• Irritation from particles, which may include proteins from tear film, remaining on the lens after cleaning

CLD is the main reason people stop wearing contact lenses, and the primary reason for CLD is contact lens-associated dry eye disease (CLADE).

One study found that, of all study participants, 10 to 50 percent stopped wearing contact lenses due to CLD within 3 years, with 25 percent identifying moderate to severe discomfort. The most common symptom was dry eye.

In that three-year study, those who wore daily disposable lenses were more likely to have no CLD compared with subjects using reusable lenses over biweekly, monthly, or six-month periods.

A second study similarly found that wearers who chose a daily disposable contact lens were less likely to discontinue contact lenses than those who wore contacts on a longer schedule, such as a weekly or six-month schedule.

The Best Contact Lens Brands for Dry Eyes

Various brands make contacts that are designed to work well for people with dry eyes. Here are some of the top options broken down by lens material:

Soft Contact Lenses: Silicone Hydrogel

Most people with dry eyes choose a daily disposable lens. Each of these brands uses a silicone hydrogel lens:

• Alcon Dailies Total1 
• Acuvue Oasys 1-Day With HydraLuxe Technology 
• Bausch & Lomb INFUSE One-Day  

Soft Contact Lenses: PC (Phosphorylcholine) Technology

CooperVision offers the Proclear line of contact lenses that are designed specifically for dry eye comfort. There is a Proclear lens for each vision type. 

The unique PC (phosphorylcholine) Technology attracts moisture to the lens surface to keep the lens hydrated in a manner designed to minimize the dry eye condition. 

Hard Contact Lenses (Scleral Lenses)

While soft contact lenses are the most popular and affordable lenses, scleral lenses may help people with dry eye syndrome. A number of studies have shown that a scleral contact lens can actually improve dry eye.

A scleral contact lens is a hard lens with a silicone component. Since it rests on the scleral instead of the cornea, there is a fluid-filled gap between the contact lens and the cornea, so it hydrates the eye. 

There are common brands for scleral contact lenses:

• Ampleye Art Optical
• X-Cel Specialty Contacts
• Zenlens

Scleral lenses can be very expensive. If you have severe dry eye syndrome, talk to your eye doctor about whether scleral lenses are right for you.

Solutions & Care Products for Dry Eyes

If you have dry eyes, keep a few things in mind when choosing products:

• Be careful with multipurpose solutions. Sometimes, the solution you use could be causing or worsening dry eye symptoms, and this may be more likely with some multipurpose solutions.
  With saline solutions and contact cleaning solutions, preservatives are most likely to produce “adverse ocular events.” Keeping this aggravation effect in mind, it’s generally advised to first change the solution, not the lens, if dry eye symptoms appear to be worsening.
• Try products for sensitive eyes. Many brands make saline solutions that are designed specifically for dry or sensitive eyes. It’s worth it to try these options.
• Consider a hydrogen peroxide-based solution. Hydrogen peroxide cleaning solutions, such as Clear Care Plus with Hydraglyde Cleaning & Disinfecting Solutions, are free from preservatives and more thoroughly disinfect lenses. Make sure to rinse the lenses well before putting them back in your eyes.
• Try rewetting drops. These drops are safe to use with contact lenses. Choose artificial tears or rewetting drops that are free from preservatives. Options with preservatives could further exacerbate your dry eye symptoms. 

Tips for Contact Lens Wear With Dry Eyes

The presence of microorganisms and friction from unremoved proteins can exacerbate any dry eye condition and result in discomfort. Because of this, it’s even more important to employ good hygiene practices if you have dry eyes.

Follow these care tips:

• Wash your hands thoroughly before you touch your contacts. This will help to avoid transferring any bacteria or other irritants to your lenses.
• Use fresh solution each time you store your contacts. Never attempt to reuse solution. This does not promote a sterile environment.
• Never sleep in your contacts. When you sleep in contacts, your eyes don’t receive adequate oxygen, resulting in more dryness.
• Give your eyes a break from contacts. Alternate between wearing glasses and contacts to give your eyes a chance to rest from contact use.
• Do not wear your contacts for longer than specified. If you have daily disposable lenses, throw them out every night. Do not attempt to extend your wear schedule at all.

Lifestyle Changes to Aid Dry Eye Syndrome

Certain lifestyle modifications can help to improve dry eye symptoms. Try these:

• Drink more water. This promotes overall hydration, which can reduce dry eye.
• Add omega-3s to your diet. Consuming more omega-3 fatty acids, like those found in walnuts and salmon, may lessen symptoms of dry eye. You can also benefit from omega-3 supplements.
• Limit screen time. When we use screens, we are less likely to blink, which can worsen dry eye symptoms. Whether you’re using a computer, smartphone, or tablet, or watching TV, reduce screen time when dry eye symptoms crop up.
• Quit smoking. Smoking is likely to increase your overall risk for dry eye symptoms. 
• Protect your eyes. Wear sunglasses to protect your sun from UV rays, and choose protective eyewear that can keep dust and other irritants out of your eyes.

Contact Lenses for Dry Eyes FAQs 

Can I get contacts if I have dry eyes?

Most often, yes. Your eye doctor can help you determine the source of your dry eyes, so you can address the underlying issue. In some cases, choosing a different type of lens may allow you to wear contact lenses despite your dry eyes.

Do contacts make dry eyes worse?

In some cases, yes. You need adequate moisture in your eyes to comfortably wear contacts. If your contacts are making your dry eye symptoms worsen, talk to your doctor about switching to a different lens type.

What type of lenses work best for dry eyes?

Most often, soft contact lenses are a good choice for people with dry eyes. For severe cases of dry eyes, scleral contact lenses may be recommended.

References

1. Is There a Preferred Brand of Contact Lenses for Those That Suffer from Dry Eye? (March 2014). American Association of Ophthalmologists.

2. Contact Lens Wearer Demographics and Risk Behaviors for Contact Lens-Related Eye Infections — United States, 2014. (August 2015). U.S. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR).

3. Risk Factors for Microbial Keratitis With Contemporary Contact Lenses: A Case-Control Study. (October 2008). Ophthalmology.

4. Therapeutic Uses of Scleral Contact Lenses for Ocular Surface Disease: Patient Selection and Special Considerations. (July 2018). Clinical Optometry.

5. New Ways to Keep Dry Eye Patients Comfortable in Contact Lenses. (December 2020). Optometry Times Journal.

6. PC Technology. Cooper Vision.

7. Disinfectants and Preservatives. (October 2021). Swedish Chemicals Agency.

8. Surface Active Agents and Surfactants Analysis. (Accessed February 2002). Intertek.

9. Contact Lenses: When a Solution Is the Problem. (August 2012). American Academy of Ophthalmology.

10. Common Ophthalmic Preservatives in Soft Contact Lens Care Products: Benefits, Complications, and a Comparison to Non-Preserved Solutions. (September 2021). Clinical Optometry.

11. Contact Lens Care Systems & Solutions. (August 2021). U. S. Centers for Disease Control and Prevention.

12. Saline Solution. (March 2022). Bausch + Lomb.

13. The Pros and Cons of Preservatives. (April 2015). Review of Ophthalmology.

14. Dry Eye Rewetting Drops Versus Artificial Tears. (August 2008). Optometric Management.

15. Scleral Lenses: An Overlooked Fix for Dry Eye. (April 2013). Review of Contact Lenses.

16. Frequency of Ocular Examinations. American Academy of Ophthalmology.

17. Update on Scleral Lenses. (November 2018). American Academy of Ophthalmology.

18. Contact lens wear and dry eyes: challenges and solutions.  (February 2017). Clinical Optometry (Auckland).

19. A 3-Year Prospective Study of the Clinical Performance of Daily Disposable Contact Lenses Compared With Frequent Replacement and Conventional Daily Wear Contact Lenses. (October 1996). CLAO Journal.

20. A Comparison of Conventional and Disposable Extended Wear Contact Lenses. (July 1993). CLAO Journal.

21. The Influence of Overnight Orthokeratology on Ocular Surface and Meibomian Gland Dysfunction in Teenagers With Myopia. (January 2019). Journal of Ophthalmology

22. Contact Lens-Associated Dry Eye Disease: Recent Advances Worldwide and in Japan. (November 2018). Investigative Ophthalmology & Visual Science.

23. Dry Eye: Rewetting Drops vs. Artificial Tears. (August 2008). Optometric Management.

24. A Review of the Compatibility of Topical Artificial Tears and Rewetting Drops with Contact Lenses. (October 2020). Contact Lens & Anterior Eye.

25. The Benefits of Fish Oil for Dry Eye. (October 2020). American Academy of Ophthalmology.

26. Smoking and the Risk of Dry Eye: A Meta-Analysis. (October 2016). International Journal of Ophthalmology.