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Keys to comfortable contact lens wear

Contact lens wearers discontinue lens wear at a rate much higher than you might expect.  A study published in 2010 found dropout rates as high as 16% to 30%.  Half of those surveyed felt that contact lens comfort was the number one reason for contact lens dropouts.

So what are some of the ways to combat contact lens discomfort?

Many patients benefit from the use of artificial tears to deal with mild issues of contact lens discomfort.  Patients should stay away from drops designed to “get the red out.”  These drops contact a vasoconstrictor that doesn’t treat the underlying dryness problem, and can cause rebound redness side effects.

Simple warm compresses on the closed eyelids before insertion in the morning can also help comfort.  Warm compresses help open the meibomian glands at the eyelid margin that secrete oils that are important to a good quality of tear film.  These oils prevent the tear film from evaporating too quickly.  Daily warm compresses that help improve tear film quality can be very helpful to improve contact lens wear comfort.

A healthy diet can also play a part in tear film health.  Consumption of foods rich in omega-3 fatty acids such as salmon and other fish can help improve the oil layer of the tear film to help slow evaporation.   Because many patients do not get enough omega-3s from their diet, supplementation with fish oil and flaxseed oil can be beneficial.

With regard to the contact themselves, the use of daily disposable contact lenses can greatly increase lens comfort.  Proteins and lipids build up on contact lenses over time, so the use of daily disposable lenses eliminates the buildup of these biofilms on the lenses.  Daily disposable lenses also are helpful if there is an allergy component to poor contact lens comfort, since you are throwing away any allergens that bind to the lens as you throw away your contacts every day.

Newer contact lens materials such as silicone hydrogels allow more oxygen to reach the cornea.  This can decrease corneal edema which can be a factor in contact lens comfort.  Silicone hydrogel brands include Johnson and Johnson’s Acuvue Oasys, Ciba Vision’s Air Optix, Coopervision’s Biofinity, and Bausch and Lomb’s Purevision.

Finally, one of the most overlooked aspects of lens comfort is the contact lens care products that are used.  Many store brand generic solutions, while cheaper, were designed before today’s newer materials came to the market.  Therefore generic solutions with today’s contact lenses don’t always mix.  Hydrogen peroxide systems such as Clear Care are probably the most effective as removing proteins and lipids from contact lenses.  This product becomes pH neutral over the course of roughly 6 hours, and therefore must be used carefully.  Newer multipurpose solutions such as OptiFree Puremoist (which contains an effective wetting agent called Hydraglyde) and Bausch and Lomb’s Biotrue are probably the newest and best solutions to recently come to market.