When does a contact lens wearer need to see a doctor for red and irritated eyes?

Doctor's Answers 2

Contact lens is a great non-surgical way to see the world without glasses. It gives many the freedom to participate in an active lifestyle and the quality of vision is much better compared to glasses in users with high levels of short-sightedness.

However, it is important to remember that contact lens does “stress” the eye in several ways. One of which is to reduce the transfer of oxygen to the window of the eye or cornea. This oxygen deprivation has been associated with complications relating to severe eye infections as well as turning the cornea cloudy. Some of these complications may leave the eye permanently scarred and the patient blinded.

Another common outcome of contact overuse is that the surface of the eye becomes “intolerant” to contact lens resulting in a form of allergic reaction against either the contact lens material or its associated solutions. Allergic conjunctivitis may present with eye redness, tearing, itch or a foreign body sensation sometimes described as though there are fine grains of sand trapped under the upper eyelid.

Fortunately, most cases of contact lens overuse resolve with medications and a period of rest away from the contact lens. Patients may regain their tolerance after several weeks or months.

As a general rule, I advise patients to give contact lens a break of at least 2 days out of a week and not to persist wearing them beyond 6-8 hours per day. Definitely, avoid showering, swimming and sleeping with the contact lens on.

Most patients should be able to keep themselves out of trouble by moderating the use of contact lens and maintaining a high level of hygiene with contact lens use.

Should your symptoms of redness and irritation persist, first stop the use of contact lens then see your optometrist/ophthalmologist for an eye exam to determine the exact problem with your eyes. Hopefully, all you need will be a couple of weeks of anti-inflammtory eyedrops and rest from your contact lens.

Hope you will have many more years of happy contact lens use with the above advice.

Photo of Dr E-Shawn Goh
Dr E-Shawn Goh

Ophthalmologist

This is common query so it must be a frequent occurrence for contact lens users!

Red and irritated eyes are a common but non-specific symptoms that especially if they occur in contact lens users may be a cause for concern. The causes are manifold from benign causes like dry eyes, a minor scratch of the cornea, to contact lens overwear or even early signs of a microbial infection.

If there are obvious red-flags like decreased vision, significant pain out of expectation, or if there is a visible spot or lesion on the cornea, then you should seek immediate medical attention from your Ophthalmologist.

If the symptoms are limited to that of mild red eyes that do not cause significant pain, and vision is not affected with no visible lesion on the cornea, then a prudent approach would be the use of your own preservative-free lubricant eye drops, stopping use of your contact lenses and observing for deterioration of your symptoms. If the symptoms fail to resolve within 24 hours, or even worsen after usage of your lubricant eye-drops, you are advised to seek immediate medical attention from your Ophthalmologist.

If in doubt, even a short-consult with your Ophthalmologist can help to guide your prudent use of contact lenses in order to minimise the incidence of complications. You can even ask whether refractive laser surgery would be suitable for you if you are increasingly contact lens intolerant.

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Can I do TransPRK if I have dry eyes due to Meibomian Gland Dysfunction?

Yes you are right that meibomian gland disease (MGD) is a major cause of dry eyes. If you do have a combination of MGD and dry eyes, there are many ways to treat them! However, since you mentioned that your eyes are neither dry nor painful without contact lens use, I suspect you may have another condition known as Giant Papillary Conjunctivitis (GPC). It is very common for chronic contact lens over-wearers to develop GPC. It is your body’s response or ‘rejection’ to the chronic use of contact lenses, which is regarded as a ‘foreign’ material to your eye.

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