Contact Lenses for Dry Eyes
When a contact lens wearer is having problems, the complaint often is: "My contacts make my eyes feel dry." Fortunately, there are several remedies.
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.
Intuitively, you might think that if your eyes are dry you need a higher-water-content lens, but in fact the opposite may be true. The best contact lenses for dry eyes can be lower-water-content lenses. A high-water-content lens may lose much of its moisture more easily due to environmental influences.
Also, if your eyes are inherently dry and you wear high-water lenses, the lenses may draw tears away from your eyes to stay properly hydrated, thereby increasing your dryness symptoms.
If this is the case, your eye doctor may switch you to a contact lens with a lower water content.
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 for the claim: "may provide improved comfort for contact lens wearers who experience mild discomfort or symptoms relating to dryness during lens wear." They 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.
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 that require no care products at all.
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, new drops have been introduced recently and these new products may provide more convenient, longer-lasting relief of dry eye symptoms.
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 April 2013]
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