Contact Lenses for Dry Eyes
Probably the most common complaint eye doctors hear from contact lens wearers is, "My contacts make my eyes feel dry." Fortunately, there are several remedies.
Dry eye syndrome is a common problem among contact lens wearers and non-wearers alike. But symptoms of dry eyes can be more pronounced if you wear contact lenses and your contacts start to dry out, too.
Thankfully, if you suffer from dry eye symptoms such as irritated, "scratchy" and red eyes when wearing contacts, today there are many lens care products and new types of lenses available, and the right combination of these products often can improve the comfort of wearing contacts.
While "contact lenses for dry eyes" is not really a particular type of lens, several contact lens manufacturers have developed lenses designed to reduce contact lens-induced dry eye (CLIDE) symptoms, which are the leading cause of people discontinuing contact lens wear.
Supplementing your contact lens wear with lubricating eye drops approved for use with contacts also can help. The contact lens cleaning and disinfecting products you use also should be evaluated, as different products may work better to keep your contacts moist and comfortable.
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Fixing the problem starts with a visit to your eye care practitioner (ECP) so he or she can evaluate the cause of your contact lens-related dry eye symptoms and determine the best way to increase your wearing comfort. Sometimes contact lens wearers avoid talking to their eye doctor about discomfort for fear that they'll be told they can't wear contacts any longer. But with today's variety of contact lenses and care products, the need to discontinue contact lens wear altogether is very unlikely.
Water Content of Contact Lenses
Soft contact lenses are made of a combination of hydrophilic ("water-loving") polymers that hold water to keep the lenses moist and comfortable. The percentage of water content in soft contacts can vary widely from about 38 to 79 percent.
Dry eye is a common cause of contact lens discomfort. Special contacts for dry eyes can help. Or you could try ortho-k, which involves wearing contacts at night; they reshape your eyes gradually so you can see during the day without any contacts at all.
If you experience dryness-related contact lens discomfort, sometimes switching to a different brand of contacts made of a lens material with a higher or lower water content will help.
Lenses with a high water content initially provide more moisture for the eye surface, but (depending on a number of factors) high-water-content lenses sometimes can dry out faster than low-water-content lenses, increasing dryness discomfort.
More important than adjusting the water content of your contact lenses is treating any underlying cause of dryness. A condition that's often responsible for dryness discomfort among contact lens wearers is something called meibomian gland dysfunction (MGD). This is inflammation of (and reduced output from) the glands in the eyelid that secrete oil onto the surface of the eye to slow evaporation of tears and keep your eyes moist and comfortable. Your eye doctor can perform a simple test to see if you have a meibomian gland problem and take the necessary steps to eliminate or control it.
Once meibomian gland dysfunction or any related dry eye condition is successfully treated, your eye doctor can better determine the most comfortable contact lenses for your needs.
Silicone Hydrogel Contact Lenses for Dry Eyes
Silicone hydrogel contact lenses are made of one of several new soft lens materials with high oxygen permeability a characteristic that's good for your cornea, which needs high levels of oxygen to stay clear and healthy to provide good vision.
Silicone hydrogel contacts generally are low-water lenses and may help reduce dry eye symptoms. If you are experiencing dryness with standard soft contact lenses, especially toward the end of the day, your eye doctor may recommend switching to silicone hydrogel lenses.
Lens Brands That Solve Dryness Problems
Many eye care practitioners have found certain contact lens brands are particularly helpful in solving lens-related dry eye problems.
Proclear soft contact lenses (CooperVision) are one popular option. Proclear lenses are made of a high-water hydrogel material and feature CooperVision's trademarked "PC Technology" whereby the lenses contain molecules found naturally in human cell membranes. These molecules attract and surround themselves with water, keeping Proclear lenses moist and comfortable, even after 12 hours of wear, according to the company.
Proclear-brand contact lenses are currently the only contacts approved by the U.S. FDA to carry this label: "May provide improved comfort for contact lens wearers who experience mild discomfort or symptoms relating to dryness during lens wear." Proclear lenses are available in a variety of designs, including a daily disposable version.
Extreme H2O (Hydrogel Vision) is another brand of soft lenses that many ECPs report is useful in solving dryness-related comfort issues. Extreme H2O lenses are made of two high-water hydrogel materials that have unique water-binding properties that allow the lenses to retain virtually all their water content through the entire wearing period, according to the company. Extreme H2O lenses are available in weekly and two-week disposable designs.
Another option is Safigel 1 Day disposable contact lenses (Safigel). These lenses are made with a patented process whereby a natural biopolymer used in several brands of artificial tears (sodium hyaluronate, or HA) is incorporated into the lens material.
When Safigel 1 Day lenses are on the eye, the wearer's body heat allows a slow release of HA from the lens material onto the front and back surface of the lenses. Each HA molecule attracts 3,000 molecules of water, keeping the lens surfaces moist and comfortable, especially for wearers with dry eyes, according to the company. Safigel 1 Day disposable lenses are available exclusively from independent eye care professionals.
Still another option that many eye doctors are recommending for contact lens wearers with dryness problems is Alcon's Dailies Total 1 daily disposable lenses. These single-use lenses feature an innovative water gradient design: the water content is approximately 33 percent at the core of the lens and increases to greater than 80 percent at the front and back surface. Because of this gradient design, Dailies Total 1 lenses provide "a silky-smooth surface for comfort that lasts until the end of the day," according to the company.
Orthokeratology and CRT
Here's a slightly different approach to contact lenses for dry eyes: Don't wear contacts while you're awake.
Orthokeratology (or ortho-k) and corneal refractive therapy (CRT) involve wearing special gas permeable contact lenses that re-shape your cornea to correct nearsightedness and allow you to see clearly during the day without glasses or contact lenses.
The lenses are worn only at night and must be worn just about every night in order to retain your cornea's new shape.
By negating your need to wear contact lenses during the day, ortho-k or CRT may eliminate contact lens-related dry eyes. This is because most people who wear contacts choose soft lenses, which must stay well-moistened to remain comfortable.
If your tear glands don't produce adequate tears to keep them hydrated, soft contacts can dry out and start absorbing moisture from the surface of your eyes, worsening dry eye discomfort. This can be especially troublesome during computer work, which causes people to blink less frequently, and this causes soft contacts to dry out more easily.
Ortho-k and CRT lenses, on the other hand, are gas permeable contacts that require less moisture to stay comfortable. Also, since your eyes are closed during sleep, there is less risk of the lenses and your eyes drying out from tear evaporation.
Cleaning and Disinfecting Products
Not all contact lens cleaning, disinfecting and storage products collectively called "contact lens solutions" work well with all contact lenses. In particular, many silicone hydrogel lenses require specific lens care products to optimize their comfort on the eye.
Your ECP probably gave you a sample of a compatible lens care product during your contact lens exam and fitting. But if you switched brands later on, you may have started trouble. And if you switched to a "store brand" contact lens solution, you may believe you bought a generic form of the product you were already using, but in reality you could be using a completely different product. [Read more about store brands.]
Talk to your eye doctor about which contact lens care products you're using, and bring the bottles to your visit.
Are You Sensitive to Preservatives?
Another issue with contact lens solutions, even if you're using the correct products, involves multipurpose solutions. While these single-solution products are very convenient, compared with the "old days" when lens cleaners, disinfectants and storage solutions were in separate bottles, multipurpose solutions contain preservatives that occasionally can cause problems.
Some contact lens wearers can develop intolerance to the preservatives in multipurpose solutions, which can manifest itself as dryness. If your eye doctor suspects you are sensitive to preservatives in multipurpose solutions, he or she may recommend switching to a preservative-free, hydrogen peroxide-based lens care system.
Another way to avoid sensitivity problems with contact lens solutions is to wear daily disposable contacts. These lenses eliminate the need for lens care products, because you simply discard them after a single use.
Sometimes contact lens-related dry eyes can be solved with occasional use eye drops known as comfort drops, rewetting drops or artificial tears.
Though these lubricating eye drops typically provide only short-term relief of contact lens dryness symptoms, some drops may be more effective and long-lasting than others, depending on the specific type of dry eyes you have. Your eye doctor can suggest the best brands for you after examining your eyes.
If using lubricating eye drops is your preferred approach, it's very important to make a product choice in consultation with your eye doctor. Many over-the-counter eye drops are not intended for use with contact lenses, and not all lens-compatible drops are compatible with all lens materials.
Your eye doctor also can tell you about other remedies for contact lens-related dry eyes, including eye vitamins and prescription eye drops for dry eye relief.
About the Author: Gary Heiting, OD, is senior editor of AllAboutVision.com. Dr. Heiting has more than 25 years of experience as an eye care provider, health educator and consultant to the eyewear industry. His special interests include contact lenses, nutrition and preventive vision care. Connect with Dr. Heiting via Google+.
[Page updated July 2014]
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