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Medical Author:

Frank J. Weinstock, MD, FACS

Frank J. Weinstock, MD, FACS

Dr. Weinstock is a board-certified ophthalmologist. He practices general ophthalmology in Canton, Ohio, with a special interest in contact lenses. He holds faculty positions of Professor of Ophthalmology at the Northeastern Ohio Colleges of Medicine and Affiliate Clinical Professor in the Charles E. Schmidt College of Biomedical Science at Florida Atlantic University.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Problems resulting from contact lens wear range from the inability to remove the lenses (usually after first being fit) to blindness from infections. Proper fitting, instruction, and care and maintenance can prevent most problems.

• When being fit with contact lenses, the fitter should provide the patient with information as to what to do in case of a problem (call the office, go to the emergency room, etc.).
• After being fit, inability to remove lenses occasionally occurs. Call your fitter for instructions as to how to proceed.

The most common reasons for contact-lens wearers to seek care is irritation of the eyes, redness, or blurred vision. These can be caused by the lenses wearing out or warping, a change in the eyes requiring new lenses, poor fitting of the lenses, poor care of the lenses, or sensitivity to solutions. These relatively minor inconveniences must be evaluated because they may signal the onset of corneal ulcers and deeper infection.

• With the glut of contact-lens solutions available, it is important to use only the solution recommended by the fitter. Some solutions may be incompatible with certain lenses or may contain components, such as Thimerosal (20% of people are allergic to this substance), which are not compatible with the eyes of certain people.
• One major concern, from the wearer's viewpoint, is the danger when a contact lens slips off the eye. The lens sits on the surface of the eye but cannot travel "back to the brain" because the clear covering of the eye goes under the eyelid and keeps the lens from going further back. If the lens cannot be repositioned on the cornea, it is under the eyelid and can be easily slid or moved to its correct position on the cornea (sometimes requiring the help of the fitter). It will do no harm if it is under the eyelid for a number of hours.
• Redness of the eyes associated with pain, blurred vision, and light sensitivity is more serious and may signal a potentially blinding condition, such as a corneal ulcer due to an infection.
• Abrasions (scratches) on the surface of the cornea (corneal abrasions) usually result from insufficient oxygen reaching the surface of the eye, although they may also result from dirt or other foreign bodies getting under the lens. It may be due to either over-wear of the contact lenses or lenses that are not tolerated by the eye. These disturbances of the cornea not only may be very painful but also may predispose the eye to a serious, blinding infection.
• Occasionally, someone inadvertently soaks his or her lenses in cleaning solution or soap solution, resulting in redness of the eye with a great deal of pain. This is extremely uncomfortable but usually causes no permanent damage. Drops and irrigation of the eye may be necessary to relieve the pain.
• Makeup may get under a lens and cause irritation or a greasy film on the lens, making it difficult to see clearly. Sometimes polishing in the office will be necessary to remove this film.

It is important to keep in mind that any of these eye complaints may occur and have nothing to do with the contact lenses and may be signs of other unrelated eye conditions such as infections, cataracts, or glaucoma. It may be necessary to see your eye-care professional for the correct diagnosis and treatment.

Any change in the condition of the eyes of contact-lens wearers must be evaluated for the cause and possible treatment. Whether or not these eye complaints are due to the contact lenses, they still must be diagnosed and treated. When in doubt, call your fitter for information as to how to proceed; remember that opticians do not treat eye diseases.

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