Can You Wear Contact Lenses If You Have Chronic Dry Eye?

Mild or occasional dry eyes can be annoying or uncomfortable, but chronic dry eye can cause serious problems. Treatment for chronic dry eye depends on the underlying cause. The treatment can focus on managing the underlying condition or on improving tear quality.

Chronic dry eye can even affect your daily contact lens wearing. Understanding how dry eye impacts your symptoms can help you better manage your symptoms.

How does dry eye affect contact lenses?

In order to comfortably wear contact lenses, your eyes need to have a good tear film. The tear film is made up of 3 layers:¹

• Oily (lipid) layer – This is the outermost layer of the tear film. This layer helps to keep the tears from drying out too quickly.
• Watery (aqueous) layer – The middle layer of the tear film. This is a watery layer that makes up most of what we see as tears. Its purpose is to clean, protect, and lubricate the eye.
• Mucus (mucin) layer – The inner layer of the tear film, which helps to spread the watery layer evenly over the eye surface. This layer is made up of mucin, which helps keep the eyes moist and free from particles. Without this layer, the tears could not coat the eye properly.

A large amount of water in the tear film is lost to evaporation. When a contact lens is in the eye, it changes the tear film structure. The oily layer is not continuous, and tear evaporation can increase. This makes it more likely that the eyes will become dry.¹

There are many different kinds of contact lenses. Each kind of lens fits on the eye in different ways, and each kind of lens interacts differently with the tear film.¹

What kinds are available?

If you choose to wear contact lenses, there are many different types available. Types of contact lenses can include:²

Soft contact lenses

• Made of soft, flexible plastic
• Allows oxygen to pass through to the cornea
• New styles have silicone-hydrogels, allowing even more oxygen to the eye

Rigid gas permeable (RGP) contact lenses

• More durable and less likely to have deposit buildup
• Can take longer to get used to, comfort-wise
• Less likely to rip

There are also extended-wear and disposable contact lenses. Extended-wear lenses are worn continuously for a scheduled period of time and then replaced. It is suggested that you have a day in between periods of wear, where the lenses are not worn. This is to give your eyes a rest. Disposable lenses are typically worn for a day and then replaced with a new pair. Your doctor will be able to evaluate your eyes to see if these are good options for you.²

Scleral lenses may be an option, though some doctors may not know about them. Scleral lenses go over the entire corneal surface, resting on the sclera. This is the white part of the eye. Typical contact lenses are much smaller and are not on the sclera. The way these lenses fit the eye can act as a fluid reservoir, keeping moisture in.³

What can be done to make wearing contacts easier?

If you have chronic dry eye and wear contact lenses, talk with your doctor first. They will determine the underlying cause and treat that. There are still things you can do to help make wearing contacts easier with dry eye.

Infuse, daily disposable contact lenses from Bausch + Lomb, could be an option. They are silicone hydrogel lenses that have osmoprotectants, electrolytes, and moisturizers on them. These are released during wear to help the eye maintain moisture.⁴

Other things you can do to make wearing contact lens easier include:^5,6

• Check your solution – Multipurpose solutions may be a cause of dry eye or irritation with contacts.
• Check your contact lens – Some silicone hydrogel lenses and solutions/drops are not suited for each other. Ask your doctor about switching lenses for a period of time to see if that helps
• Use eye drops or ointments

Talk with your doctor before using any drops or ointments to make sure they are safe for you.

Things to consider

You may have to try different brands of contact lenses or drops, but many people with chronic dry eye may be able to wear contact lenses. Your doctor can help you with the treatment of chronic dry eye and guide you to which contact lenses are best for you.