Dry eye disease (DED) affects between 5% and 50% of people worldwide, making it a common and often challenging condition to manage1 . Contact lenses can worsen dry eye symptoms by disrupting the tear film and causing irritation, but advances in lens technology have improved comfort for many wearers2 . Choosing the right contact lenses and proper care can help reduce dryness and maintain eye health3 .
Understanding Dry Eye Causes
Dry eye disease results from insufficient tear production or poor tear quality, leading to irritation and discomfort1 . Several factors contribute to dry eyes, including aging, environmental conditions, and medical issues. Contact lens wear is a significant risk factor because lenses can interfere with the natural tear film that lubricates the eye4 .
Common causes of dry eyes include:
- Reduced tear production due to gland dysfunction or systemic conditions5
- Increased tear evaporation from environmental factors or eyelid problems5
- Inflammation of the ocular surface or eyelids blocking oil glands5
- Contact lens wear disrupting tear film stability and causing mechanical irritation4 2
A comprehensive eye exam can help diagnose the underlying cause of dry eyes. Tests may include measuring tear volume with the Schirmer test, assessing tear quality with special dyes, and evaluating tear osmolarity to detect changes in tear composition5 .
💡 Did You Know? Contact lens wear contributes to dry eye by disrupting tear film, causing mechanical irritation, and reducing corneal sensation4 2.
Choosing the Right Contacts for Dry Eyes
Selecting contact lenses that support eye hydration and oxygen flow is crucial for people with dry eyes. Different lens materials and designs offer varying benefits for managing dryness.
Oxygen Transmission
Oxygen permeability is vital for corneal health. Contact lenses that allow more oxygen to reach the eye reduce irritation and dryness. Silicone hydrogel lenses are superior to traditional hydrogel lenses in oxygen transmission, helping eyes “breathe” better and feel less dry2 6.
Low Water Content
Contrary to intuition, lenses with lower water content may be better for dry eyes. High water content lenses can absorb more moisture from the eye, worsening dryness. Lower water content lenses require less moisture to stay hydrated, reducing the risk of dry eye symptoms7 .
Silicone
Silicone hydrogel lenses combine low water content with high oxygen permeability. This material is suitable for most dry eye patients, offering improved comfort and eye health7 . Examples include popular brands like Acuvue Oasys and Bausch + Lomb ULTRA8 .
Other Considerations
Daily disposable lenses are often recommended for dry eyes because they reduce protein buildup and debris that can irritate the eye. Wearing a fresh pair each day minimizes dryness and discomfort9 10. Scleral lenses, a type of large-diameter rigid gas-permeable lens, are custom-made to vault over the cornea and maintain a fluid reservoir that hydrates the eye surface, making them effective for severe dry eye cases11 1213.
| Lens Type | Key Feature | Suitable For |
|---|---|---|
| Silicone Hydrogel | High oxygen permeability, low water | Most dry eye patients7 |
| Hydrogel | Higher water content | Mild dryness only7 |
| Daily Disposable | Single-use, less protein buildup | Mild to moderate dry eyes9 10 |
| Scleral Lenses | Fluid reservoir, protects cornea | Severe dry eye disease11 13 |
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How Contacts Contribute to Dry Eyes
Contact lenses can worsen dry eye symptoms through several mechanisms:
Soaking Up Tears
Some contact lenses absorb moisture from the tear film to stay hydrated, which can leave the eyes feeling dry if tear production is insufficient3 14. This moisture loss reduces lubrication and increases discomfort.
Causing Irritation
Lenses can cause mechanical irritation by rubbing against the eyelids or ocular surface, especially if the fit is poor. Deposits of proteins and debris on lenses also reduce tear effectiveness and contribute to dryness and irritation4 3.
Decreasing Corneal Sensation
Contact lenses may reduce corneal sensitivity, impairing the eye’s natural reflex to produce tears. This decreased sensation can worsen dry eye symptoms over time4 .
Managing Dry Eye Symptoms with Contacts
Proper care and lifestyle adjustments can help reduce dry eye symptoms associated with contact lens wear.
Wear Contacts Less Often
Limiting daily wear time can give eyes a break and reduce dryness. Some people find relief by wearing contacts only part of the day or switching to glasses for extended periods3 14.
Check Your Solution
Contact lens solutions containing preservatives can irritate eyes and worsen dryness. Switching to preservative-free or hydrogen peroxide-based solutions may improve comfort15 163.
Replace Contacts Regularly
Wearing lenses beyond their recommended schedule increases dryness and irritation risk. Adhering to replacement guidelines and changing storage cases every three months helps maintain lens hygiene15 3.
Consider Daily Lenses
Daily disposable lenses reduce protein buildup and debris accumulation, lowering irritation and dryness. They are often recommended for dry eye sufferers9 10.
Change the Storage Solution Daily
Using fresh solution each day prevents contamination and reduces the risk of irritation from deposits or microbes15 .
Use Rewetting Drops
Lubricating eye drops formulated for contact lens wearers can relieve dryness during lens use. It is important to consult an eye care provider to select compatible drops3 .
Take Blinking Breaks
Frequent blinking helps maintain tear film stability. Taking breaks from screen time and consciously blinking can reduce dry eye symptoms14 .
“If you have dry eyes, make an appointment with your optometrist before trying solutions on your own.”
— Alexandra Williamson, OD, Cleveland Clinic14
When to Consult a Healthcare Provider
Persistent dry eye symptoms, especially when wearing contact lenses, warrant professional evaluation. An eye care provider can diagnose underlying causes, recommend appropriate lenses, and suggest treatments such as prescription eye drops or specialized lenses like scleral lenses5 314.
Seek medical advice if you experience:
- Ongoing eye irritation, redness, or burning14
- Blurred vision or sensitivity to light14
- Symptoms that worsen despite using lubricating drops or changing lenses5
- Difficulty wearing contacts comfortably for usual durations3
Early intervention can prevent complications and improve comfort and vision quality.
Key Takeaways
- Dry eye disease affects a large portion of contact lens wearers and can cause discomfort and discontinuation of lens use1 4.
- Silicone hydrogel lenses with low water content and high oxygen permeability are often best for dry eye patients2 7.
- Daily disposable lenses reduce protein buildup and irritation, making them a good choice for managing dryness9 10.
- Scleral lenses provide a fluid reservoir and protect the ocular surface, benefiting severe dry eye cases11 13.
- Proper lens care, including using preservative-free solutions, adhering to replacement schedules, and using rewetting drops, helps reduce dry eye symptoms15 163.
