If you’ve been wearing contact lenses for awhile, you may have experienced discomfort caused by dry eye syndrome. In today’s post, your local eye care provider Nova Vision Center shares what causes dry eyes and how to manage the condition.
What Is Dry Eye Syndrome?
Dry eye syndrome is characterized by dryness around the eyes that is sometimes accompanied by inflammation, irritation or blurred vision. Discomfort is more pronounced for contact lens wearers, since moisture prevents friction between the eyes and contact lenses.
Dry eye can be caused by damage to the tear glands or skin around the eyes, certain autoimmune conditions or hormone changes. It can also be caused by allergies, aging or certain medications. Wearing contact lenses for long periods can also result in dry eyes.
How to Manage Dry Eye Syndrome
Before taking any medication or other preventive measures, it’s best to see an eye doctor to determine what’s causing your dry eyes. Dry eyes are commonly treated with lubricating eye drops, which work well when inefficient tear glands or exceedingly low humidity levels are what’s causing the problem. When medication is causing dry eyes, treatment may require a change to your existing prescription.
Contact Lenses and Dry Eye Syndrome
If you have dry eyes that are caused by contact lenses, don’t worry–you may still be able to continue wearing your contacts provided you switch to a different type of lens. Here are some options:
- Soft Contact Lenses — Soft contacts are made of hydrogel, a material that contains water. While soft lenses are typically disposable, some manufacturers offer extended-wear lenses that can be reused for up to 30 days.
- Silicone-Based Hydrogel Contact Lenses — These are similar to hydrogel lenses but retain moisture far longer than regular hydrogel contacts.
- Gas-Permeable Contact Lenses — This type of contact lens is more rigid, but allows oxygen to reach the eye. Orthokeratology lenses are made from a similar material.
Nova Vision Center is your leading optometrist and eye care provider in Fairfax County. Give us a call at (703) 578-3600. You can also fill out our contact form to schedule an appointment. We serve clients in Alexandria and Arlington, VA.
Overview
More than 30 million people in the United States wear contact lenses, according to the Centers for Disease Control and Prevention. Many people prefer contacts to eyeglasses because they’re more convenient and they correct your vision without changing your appearance. Usually, you can barely feel that you’re wearing them.
But if you develop a condition called dry eye syndrome, contact lenses can become uncomfortable. This occurs when your eyes don’t produce tears properly or make enough fluid to keep your eyes lubricated and comfortable.
According to the National Eye Institute, almost five million Americans experience dry eye syndrome. Causes can include:
- damage to the tear glands around the eyes
- damage to or disease of the skin around the eyes
- diseases, such as Sjogren’s syndrome and other autoimmune conditions
- medicines, such as antihistamines, certain antidepressants, blood pressure medications, and birth control pills
- hormone changes that can occur with menopause
- dry eye can also be associated with allergies and with aging eyes
Wearing contact lenses for long periods of time can also cause dry eye. According to a study in Optometry & Vision Science, about half of contact lens wearers develop contact lens-related dry eye.
Dry eye may cause pain, burning, or a gritty feeling, as if something is in your eye. Some people experience blurred vision. With dry eye, you may feel especially uncomfortable while wearing your contact lenses.
You don’t have to give up wearing contact lenses if you have dry eye. Treating the cause of dry eye or changing to a different type of lens can help.
Your doctor can help identify the cause of why you have dry eye before starting treatment.
Your doctor may recommend lubricating eye drops if your eyes aren’t producing enough tears. If a medication you’re taking is the cause, you may need to switch. There’s also a procedure to plug the drain system in your eyes so that more moisture stays in your eyes. This procedure may be offered in severe cases.
If the problem is with your lenses, you may have to try a different kind. Here are a few options.
Lens materials
Different types of contact lens materials are available. Soft contact lenses are made of a flexible plastic that allows oxygen to pass through to the eye. Rigid gas-permeable contact lenses are made of a harder material, but they also allow oxygen to reach the eye.
Soft lenses are made of hydrogel, which contain water. There are disposable soft lenses that can be worn for a day and then thrown out. Extended wear soft lenses can be reused for up to 30 days.
Changing your contact lenses daily prevents protein deposits, which can make your eyes feel even drier. If you experience problems with dry eye, you may want to try disposable lenses.
You may also consider switching to a silicone-based hydrogel lens. These types of lenses doesn’t allow water to evaporate as readily as others. They may reduce dry eye better than regular hydrogel contacts.
Proclear is the only brand of disposable lenses that are FDA-approved to help reduce the sensation of dry eye discomfort. It contains phosphorylcholine, which is supposed to attract water and keep your eyes feeling moist.
Lens water content
Soft contact lenses are categorized by how much water they contain.
High-water content lenses are more likely to cause dry eye than those with low-water content. They tend to send more moisture to the eye when you first put them in, but can dry out faster. You may need to try lenses with different water contents until you find the one that works for you.
Lens size
Most contact lenses measure about 9 millimeters across. They cover just the iris, the colored part of the eye.
Scleral contact lenses typically measure 15 to 22 millimeters across. They cover part of the white area of the eye, known as the sclera. Scleral lenses are gas-permeable, meaning they let oxygen reach the eye’s surface. Some people report an improvement in symptoms with this type of lens.
Sometimes the problem is not with your contact lenses, but with the solution you’re using to clean them. Some solutions contain preservatives that can irritate your eyes and leave them dry. Others contain materials that may not be compatible with certain types of soft contact lenses and can cause a reaction.
Check with your eye doctor. If they think your lens solution may be to blame, try different brands until you find one that works for you.
There are a variety of options to help you relieve dry eye.
Switching to a different type of contact lens is a good place to start. Taking care of your lenses is another important step. Keep them clean and change them as recommended. Only wear your lenses for the amount of time your eye doctor prescribes.
Moisten your eyes with rewetting drops before putting in your contact lenses. Use the drops throughout the day so your eyes stay moist. When you’re in a very dry environment, like a heated room during winter, you may need to use drops more often. If your eyes are sensitive, try a preservative-free brand of eye drop.
You may need to temporarily stop wearing your contacts if you’re still having problems after trying different lenses and solutions. Rehydrate your eyes with preservative-free tears for a few days to let your eyes recover. Follow your doctor’s advice before trying the contacts again.
I LOVE fitting patients with contacts for sports, work and other activities. When patients tell me they have unopened boxes of contacts in their bathroom because wearing them makes their eyes feel too dry, it breaks my heart as an eye doctor.
Disheartening, for sure! An opportunity? Absolutely…because I see it as my chance to fix a problem and get the patient loving their contacts again!
To do this, we need to identify the cause of the dryness, but first let’s start with how our eyes are supposed to work…
Our eyes have a few sources of moisture. One is the lacrimal gland tucked under the bone where our eyebrows are. The lacrimal gland is the gland that produces tons of tears when we cry or get something in our eye.
Other sources of moisture include:
• A second network of glands embedded in the conjunctiva (the white surface of the eye and the undersurface of the eyelids) that produce water and mucus
• A third area of glands at the edge of the eyelids that produce an oily substance
SO WHAT CAUSES DRYNESS?
As we age, our tear production slows. If the lacrimal gland doesn’t make as many tears, you’ll have dry eye due to a lack of tear quantity. If any of the other glands slow, you’ll have dry eye due to a reduction of tear quality. We need all of our glands functioning properly to keep our eyes naturally moisturized. If any one type of gland stops functioning properly, the result is Dry Eye Syndrome. Symptoms of Dry Eye Syndrome include burning, stinging, grittiness, and an inability to tolerate contacts!
But it’s not just aging that can cause Dry Eye Syndrome. Other causes can include:
• Side effects from medications (antihistamines or blood pressure medications, for example)
• Underlying medical conditions (such as thyroid disorders, diabetes, rheumatoid arthritis, Sjogren’s syndrome, autoimmune disorders, or Parkinson’s disease)
• Environment (exposure to dust, smoke, pollutants, pollen)
• Eye surgeries
Also, looking at electronic gadgets for too long without blinking has seen a significant rise in the cause of dry eyes. It’s so common these days it actually has a name! It’s called Computer Vision Syndrome (CVS), and I’m seeing it so much more in the post-COVID world. People are working and learning from home and seeking entertainment online since we haven’t been able to leave the house. When we stare at our computer screens, we blink less. When we blink less our eyes get dry simply because they are open more. This dry eye related to Computer Vision Syndrome (CVS) can cause discomfort, blurred, or even double vision.
TAKE CARE OF YOUR DRY EYES
Taking care of dry eyes not only relieves discomfort but can help avoid infection or even scarred corneas. Treatment can range from simple, over-the-counter treatments to more complex office procedures.
For patients who make enough tears but have dry eye symptoms, I often recommend:
• Warm compresses
• Gentle eyelid massage to stimulate the oil producing glands along the edge of the eyelids
For patients who aren’t making enough tears, I often recommend:
• Artificial tears or thick moisturizing ointments
• Prescription medicines that increase tear production (Restasis or Xiidra, for example)
• An in-office procedure to block tear drainage. This procedure is completely painless and I liken it to putting a “stopper in a bathtub” to keep more of your natural tears on your own eyes
For patients who have dysfunction of their oil producing glands, I may recommend:
• Oral medication for a period of time
• Prescription topical medications to target those specific glands
For patient who have damage to their corneas from extreme dry eye, I sometime use:
• Stem cell treatments to heal and revitalize the corneal surface
Other home remedies that can help dry eye include having a humidifier in the room and drinking more water. One thing is for sure…if you have burning, stinging eyes or are unable to tolerate your contacts, find an eye doctor that can help you! dry eye is treatable and getting it treated properly can get you back in your contacts!
Wishing you good health,
Dr. Amy