Ready to trade youreyeglasses for contact lenses? Many people excitedly make an appointment to try contact lenses, only to be told they shouldn't wear them. Several factors may not make you a good candidate, such as certain allergies, the shape of your eyes, dry eyes, and more.
Your optometrist or ophthalmologist will perform a comprehensive eye examination and conduct certain tests to determine if contact lenses will work for you.While wearing contact lenses isn't a problem for most people, there are a few conditions that may make it difficult.
This article will explain who isn't the ideal candidate for contact lenses and why, as well as what can be done.
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Dry Eye Syndrome
Dry eye syndrome is one of the most common conditions that gets in the way of successful contact lens wear. In order to feel comfortable in contact lenses, a person needs to have ample amounts of healthy tear film.
Human tears consist of water, oil, mucus, salt, natural antibiotics, vitamins, minerals, and many other ingredients. Every time you blink, you renew your tears and wipe a new layer of this complicated solution across your eye. Tears help keep contact lenses moist and lubricated.
If tear film is lacking, the contact lens becomes dry, or the surface of the lens may be exposed to the air. This may cause fluctuating, blurry vision and the eye may feel:
- Dry
- Like there is a piece of sand in your eye
- Scratchy or like it is burning
These symptoms may leave your eyes feeling very irritated after only a few hours of wearing contacts.
What Can Be Done?
Severe dry eye syndrome can be a major problem for contact lens wearers and may not be a good option. Severe dry eye syndrome can put a person at risk of corneal scarring and potential infection.
However, mild to moderate dry eye patients can usually wear contact lenses, at least part of the time. To improve dry eye problems with contact lenses, your healthcare provider may recommend:
- Fitting a special water-gradient, daily disposable lens
- Fitting a special large scleral rigid contact lens
- Increasingthe use of artificial tear contact lens re-wetting drops
- Inserting plugs into the tear drainage canal (punctal occlusion)
- A prescription medication such as Xiidra or Restasis
Blepharitis
Blepharitis is an inflammation of the eyelids. While it can affect people of any age, blepharitis tends to occur more often in people with oily skin.
Blepharitis is classified into two types:
Posterior blepharitis
Posterior blepharitis develops when oil glands in the inner eyelid allow bacteria to grow. It can be caused by meibomian gland dysfunction. Meibomian glands function to secrete a type of oil. With the force of a blink, oil is secreted into the tears and designed to prevent tear film evaporation.
When these glands are inflamed, either too much or too little oil is being secreted.This can result in evaporative dry eye. Having dry eyes can make wearing contact lenses extremely difficult.
Anterior blepharitis
Anterior blepharitis affects the outside of the eyelid where the eyelashes attach. This type of inflammation may be associated with either dandruff or bacteria. Dandruff causes the eyelids to become red and producewaxy scales on the eyelashes, whereas bacteria can cause hard crusts to form around the eyelashes.
Anterior blepharitis can actually put one at risk fordeveloping a significant eye infection while wearing contact lenses because of the amount of bacteria hanging around the eyelid. Plus, the crusty debris can spill over into the tear film and cause irritation and contact lens coating problems. Further, manipulating the eyelids while inserting and removing contact lenses can cause more debris to be spread around, increasing redness.
What Can Be Done?
It isusually best to treat blepharitis before being fit for contact lenses. Blepharitis is treated by applying warm compresses and gently cleansing the eyelid. This can be done using baby shampoo (or another gentle soap) and a washcloth. You can also cleanse the eyelid using a commercially prepared lid scrub.
Other ways to treat blepharitis include:
- Fatty acids—Dietary supplements of mega-3 fatty acids are shown to stabilize the meibomian glands and create an anti-inflammatory effect on the eye. It may take three to six months to see results.
- Topical antibiotics—Azasite, a topical form of azithromycin, has an anti-inflammatory effect in addition to being anti-infective. It is applied to the eyelid margin at bedtime. Other antibiotic ointments such as erythromycin and bacitracin may also be used.
- Oral antibiotics—For stubborn cases, oral antibiotics may be prescribed. This is particularly helpful for patients with a more severe form of blepharitis called ocular rosacea.
- Corticosteroids—When more traditional methods do not work, steroids may be used to reduce inflammation. They are prescribed for short-term inflammation control to minimize potential complications.
Severe Eye Allergies
Having severe eye allergies can create problems wearing contact lenses. The allergy cascade or reaction is often associated with triggers or antigens that make allergies flare up.
When exposed to these allergens, cells in the eyes release histamines and other chemicals in an effort to protect the eyes. It is this chemical reaction that causes blood vessels inside the eyes to swell and the eyes to become itchy, red, and watery.
Common eye allergy triggers include:
- Pollen
- Pet dander
- Dust mites
- Mold
- Cigarette smoke
- Perfume
- Exhaust
What Can Be Done?
To reduce symptoms of severe eye allergies, your optometrist or ophthalmologist may prescribe:
- Steroids
- Antihistamines
- Mast cell stabilizers
Antihistamines work wonders for those with allergies, but one detrimental side effect is that they dry out the mucus membranes, including those in the eyes. This can make it difficult to wear contact lenses successfully.
Because allergens can stick to contact lenses and activate allergies, one method to reduce eye allergies is for the wearer to be fit with daily disposable contact lenses—which are thrown out of after a day or less of wear.
What Is Giant Papillary Conjunctivitis?
Giant papillary conjunctivitis (GPC) is a condition in which the eye becomes allergic to a protein that precipitates out of the tears and onto the surface of a contact lens.
The tissue under the upper eyelid becomes lumpy and bumpy and can grab hold of your contact lenses and move them around. People with GPC often complain of irritation and mucus discharge.
GPC often develops inpeople who already wear contact lenses. This condition can usually be successfully treated.
Unusual Prescriptions
Eye care professionals have a huge variety of options to choose from to fit contacts forpatients who not only have nearsightedness or farsightedness but also astigmatism (a curvature on the eye's surface) and presbyopia (nearsightedness due to aging).However, manypeople expect that they will receive the same quality of vision that they experience with their eyeglasses.
Contact lenses do provide a new type of freedom, but for some people, they do not always offer the sharpness and clarity that a high-quality pair of eyeglasses provides.
What Can Be Done?
Be willing to try several different diagnostic or trial lenses while being fit. Most eye doctors will try three to four different types of lenses before considering other options like discontinuation of contact lenses.
Your eye care professional may recommend an alternative lens design besides regular soft lenses. Many of these options provide superior vision compared to soft disposable lenses. Some of these lenses include the following:
- Rigid gas-permeable contact lenses
- Custom-designed astigmatism lenses by SpecialEyes
- Hybrid lenses (part soft, part rigid) by Synergeyes
- Scleral lenses
- Kerasoft lenses
Contact Lens Intolerance
For some people, wearing contact lenses may be nearly impossible. Symptoms of a contact lens intolerance may include:
- Dry, itchy eyes
- Redness
- Irritation and inflammation
- Pain or discomfort when putting in contact lenses
- Abrasions or ulcers on the cornea
Common causes of contact lens intolerance include:
- Improper use, storage, or cleaning
- Reaction to the cleaning solution
- Allergies
- Dry eyes
- Contact lenses that are not properly fit
What Can Be Done?
A contact lens intolerance may be easily managed if there is a known underlying cause. Treatments are available for conditions such as allergies and dry eyes.
Ensuring you take proper care of your contacts can also help. If you think your contact lens solution is causing the irritation, try switching to a different brand.
If poor-fitting contact lenses are causing your discomfort, see a eye care professional right away. They can assess your fit and possibly recommend alternative lens options.
Keratoconus
Keratoconus is a condition where the cornea becomes thin and bulges like a cone. Symptoms may include:
- Blurry vision
- Distorted vision
- Increased sensitivity to light
- Eye redness or swelling
This condition often affects both eyes and slowly gets worse over time. That said, persons with late-stage disease may not be able to wear contact lenses. If the cornea changes shape, it may feel uncomfortable to wear contacts or they may not fit properly.
What Can Be Done?
If you have keratoconus, contact lenses may still be an option. Your eye care provider may recommend you try hard contact lenses. This type of contact lens can provide sharper vision than soft lenses, particularly when the cornea is unevenly shaped.
Other treatments for keratoconus may include:
- Intacs: With this treatment, a curved device surgically placed in the cornea to improve vision.
- Corneal cross linking (CXL): This procedure uses eyedrops and a special UV light to strengthen and flatten the cornea.
- Corneal transplant: When the cornea is seriously affected, a corneal transplant may be recommended.
Frequent Eye Infections From Wearing Contacts
People who wear contact lenses are at higher risk for developing eye infections. Symptoms of an eye infection include:
- Blurry vision
- Eye redness
- Eye pain
- Tearing or eye discharge
- Extra sensitivity to light
- Feeling like there is a foreign body in the eye
You may be at greater risk for infection if you:
- Use extended-wear lenses
- Sleep while wearing contact lenses
- Have germs growing underneath the lens
- Have bacteria, fungi, or parasites in the eye
- Don't properly clean or store your contacts
Frequent or severe infections can lead to scarring of the cornea, which may permanently affect your vision. If you are at high risk for this complication, contact lenses may not be right for you.
What Can Be Done?
If you have a history of getting eye infections from wearing contact lenses, there are some things you can do to reduce your risk:
- Wash your hands before touching your contacts
- Properly clean and store your contact lenses
- Don't sleep with your contacts on
- Give your eyes a break from contact lenses
- Wear daily disposable contacts
If you have a moderate or severe eye infection, it's generally recommended that you refrain from wearing contact lenses until it has resolved. That's because the lens can further irritate the inflamed eye.
That said, some types of infection can lead to serious vision loss and even blindness. To avoid such complications, it's important to seek medical attention right away. If eye infections are a common problem for you, speak to your eye care provider about alternatives to contact lenses.
You Work in a Dusty or Dirty Environment
It may be hazardous to wear contact lenses in certain work environments. This includes situations that involve:
- Exposure to chemical fumes
- Intense heat
- The risk of chemical splashes
- Low humidity
- Dusty areas
- Flying particles
- Exposure to high levels of infrared radiation
If you are exposed to such conditions, it's possible for chemicals or small particles to become trapped behind the contact lens and cause damage to the cornea. Another concern is potentially losing a contact lens while on the job. This can impact one's ability to see and may pose a safety hazard.
What Can Be Done?
If there are hazards to wearing contact lenses at work (or any environment), plan to wear glasses instead.
If you choose to wear contacts, take extra precautions by:
- Using appropriate eye protection
- Bringing your glasses (or second pair of contacts) as a back-up
- Staying up-to-date on eye wash protocols
Signs Contact Lenses Are Irritating Your Eyes
Symptoms that contact lenses are irritating your eyes include:
- Discomfort
- Excess tearing or other discharge
- Increased sensitivity to light
- Itching or burning
- Redness
- Blurred vision
- Swelling
- Pain
If you experience significant eye discomfort while wearing contact lenses, its important to take them out immediately to give your eyes a break. If you continue to have bothersome symptoms, see your eye care provider right away.
Summary
Not everyone is a suitable candidate for contact lenses. For some people, it may be difficult or nearly impossible to wear them. This may be due to a variety of reasons such as having allergies, dry eyes, a history of eye infections, or a poor lens fit. Fortunately, it's possible to treat and/or manage many of these underlying causes. If you are having problems with wearing contacts, let your eye care provider know—they may be able to recommend a solution.
