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Contact Lens - Related Complications

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Contact lenses are one of the most commonly used medical devices for ocular problems. Regular use of contact lenses might cause serious eye problems.

Medically reviewed by

Dr. Asha Juliet Barboza

Published At January 25, 2023
Reviewed AtJanuary 25, 2023


Contact lenses are one of the most regularly used medical devices. These are worn directly over the cornea. These are used to correct refractive errors and moderate-to-severe eye problems. Also, cosmetic contact lenses are becoming popular because of their aesthetic value. Several people using contact lenses are developing eye problems. Recent scientific studies have pointed out that regular contact lenses may cause pathologic changes in the human eyes, which can be very harmful.

What Are Contact Lenses?

Contact lenses are plastic-like devices that are fitted over the cornea. These lenses are classified into four types according to their use and rigidity, and they are:

A. Soft Contact Lenses: These are made up of soft, flexible plastic materials. These lenses help in the passage of oxygen. Silicone hydrogel is used to fabricate these lenses. Due to their flexibility, these lenses are very comfortable.

B. Rigid Gas Permeable (RGP) Contact Lenses: These lenses are durable, easy to use, and less prone to fracture. These lenses are also permeable.

C. Extended Wear Contact Lenses: These types of lenses can be used for a much longer duration of time. These are also made up of flexible materials.

D. Disposable (Replacement Schedule) Contact Lenses: These types of contact lenses are used for single-use purposes.

Different materials are used to fabricate contact lenses. These are:

1. Polymethyl Methacrylate (PMMA): Lenses made up of these materials are rigid and have no oxygen permeability.

2. Hydroxyethyl Methacrylate (HEMA) Hydrogel: These materials are biocompatible and expensive. Their oxygen permeability is less, and protein deposition on the lens surface is one of their main drawbacks.

3. Rigid Gas Permeable: These are silicon-containing materials. These materials are hydrophobic, durable, and have high oxygen permeability.

4. Silicone Hydrogel: Silicone hydrogel materials are durable and have high oxygen permeability. As silicon is a hydrophobic (repels water) material, hydrophilic (mixes with water) materials are added to it to make them hydrophilic.

5. Polyvinyl Alcohol (PVA): These materials are inexpensive and easy to fabricate. These have poor oxygen permeability.

What Is the Use?

Various contact lenses can be used for various purposes. These are:

  • Soft contact lenses are used to correct myopia (a vision problem where near objects are visible but not far objects), hyperopia ( a vision problem where far objects are visible but near objects appear blurred), astigmatism (blurred vision), presbyopia ( gradual loss of ability to focus on nearby objects).

  • Multifocal contact lenses have bifocal design. Here two types of lenses are used, one for distant vision and another for near vision.

  • Tinted contact lenses are used to treat color blindness.

  • Orthokeratology or ortho-k lenses are used to reshape the cornea to improve vision.

What Is the Cause of Complications?

Contact lens-related complications are characterized by persistent or episodic ocular discomfort related to using contact lenses. The risk factors are:

1) Contact Lens-Related Factors:

  • Inappropriate material.

  • Faulty design of the lens.

  • Improper fit of the lens.

  • Improper care system.

  • Faulty use.

2) Environmental Factors:

  • Ocular surface condition.

  • External environmental factors like heat and humidity.

  • Occupational factors.

What Are the Complications?

Several complications are associated with the use of these lenses. These are:

1) Hypoxia-Induced Changes: The avascular cornea gets oxygen and nutrients from the tear film. Excessive wear of polymethyl methacrylate and rigid contact lenses are responsible for such hypoxic changes because of the disruption of contact with the tear film. Corneal changes observed due to the hypoxic conditions are:

  • Corneal epithelial thinning.

  • Stromal edema.

  • Ocular and limbal erythema.

2) Superior Epithelial Arcuate Lesion (SEAL): This lesion occurs in the superior cornea, within about 2 mm (millimeter) of the superior limbus (border between cornea and sclera), between the limbus and the contact lens rim. Improper lens fit and lens design are responsible for this. This is characterized by the following:

  • White or opalescent epithelial lesion.

  • Burning sensation in the eye and a scratchy feeling.

  • Watery eyes.

  • Eyelid retraction or drooping

3) Allergic and Toxic Reactions: Allergic reactions due to contact lens wear are serious complications. Several factors cause this. Irritation or allergic reaction caused by surfactants, lubricants, and buffer solution present on the lens solution. These chemicals cause solution-induced corneal staining (SICS), less commonly known as preservative-associated transient hyperfluorescence (PATH). An annular staining pattern in the peripheral corneal region characterizes this. Silicone hydrogel materials absorb the chemicals in the lens solution and release these materials into the ocular surface. Severe cases are manifested with features of:

  • Corneal irritations.

  • Conjunctival hyperemia (dilation of blood vessels of the eye).

  • Limbal epithelial changes (breakdown of epithelium in the cornea, corneal scarring).

  • Delayed hypersensitivity caused by these chemicals may cause limbal stem cell deficiency (breakdown of the epithelial cells on the limbus).

4) Contact Lens-Induced Papillary Conjunctivitis: Conjunctival inflammation is caused by silicone hydrogel lenses. The inflammation can be of two types; local and generalized. While local inflammation is asymptomatic, the generalized reaction is caused by an immunologic reaction caused by the denaturation of tear film coating on the lens surface. The hydrophobic nature of these lenses is responsible for depositing lipid substances on the lens surface. This is manifested by:

  • Conjunctival erythema (dilatation of blood vessels).

  • Pruritus (itching of the eyes).

  • Mucoid discharge.

.5) Microbial Keratitis: This corneal infection is caused by bacteria and fungi. Hypoxic conditions and microtrauma induced by the lens lead to the accumulation of microorganisms. Gram-negative bacteria, such as Pseudomonas aeruginosa, Haemophilus influenzae, and gram-positive species, such as Streptococcus pneumoniae, are responsible for bacterial-induced keratitis. Contact lens-induced acute red eye response is a common condition associated with it. This is manifested by:

  • Severe unilateral conjunctival injection.

  • Pain and redness in the eye.

  • Photophobia (a problem associated with exposure to light).

Contact lens-associated peripheral ulcer (CLPU) is associated with sterile circular epithelial lesions at the periphery, and anterior stromal infiltrates. A grayish-white infiltration characterizes fungal keratitis with feathery borders with satellite lesions.

How to Treat It?

The treatment includes:

  • Use appropriate lenses to suit the requirements.

  • To change lenses on a regular schedule.

  • Use of lubrication along with lenses.

  • Change lens solution on a regular interval.

  • Use lenses with high oxygen permeability.

  • Infectious conditions can be treated using topical antibiotics (Ciprofloxacin, Levofloxacin), and corticosteroids can also be applied. Topical application of Natamycin (5 percent), Amphotericin B (0.15 to 0.30 percent), topical Voriconazole (1 percent), and Miconazole (1 percent) is indicated in fungal infections.


Contact lenses are one of the most regularly used ophthalmic devices. Several eye problems can be treated with contact lenses. Selection of proper lenses and maintaining lens hygiene are very important to reduce complications caused by contact lenses. Moreover, proper diagnosis is required to treat lens-related complications.

Frequently Asked Questions


What Is the Most Common Issue With Wearing Contact Lenses?

Infectious keratitis is the most common issue faced while wearing contact lenses. It is a cornea infection (a layer of the eye). If left untreated, it can lead to total loss of vision.


How Can Complications Due to Contact Lens Be Avoided?

Good hygiene while wearing contact lenses helps to prevent complications. It should be removed before sleeping, showering, swimming, or involving in any water activities. Infections from contact lenses can be avoided by using disposable lenses, which can be changed daily.


Who Should Not Wear Contact Lenses?

Those who are allergic to contact lenses should avoid them completely. Those with recurrent infections after wearing lenses should avoid or limit their use. Those with dry eyes or lack lubrication in the eye should also avoid using a lens.


Is Contact Lens Considered Safe for Eyes?

Yes, following appropriate eye health and hygiene practices helps to use contact lenses safely. Cleaning them and storing them appropriately helps to use them safely. Disposable lenses help to prevent any infections of the eye if used properly.


Can Using Contact Lenses Hurt the Eyes?

Ill-fitting contact lenses can cause strain on the eyes. It can be very tight or very loose, irritating to the eyes. If the lens causes eye drying, appropriate lubricants can be used.


Can Contact Lens Be Worn Every Day?

There is generally no issue with using contact lenses daily. However, if there is redness of the eye or irritation of any kind, it must be discontinued. The dryness of the eyes can be avoided by using eye lubricants.


Is a Lens Preferable to Glasses?

Wearing a lens or glasses is based on an individual’s choices. Someone who is not comfortable wearing glasses may prefer to wear lenses. Proper hygiene should be followed to prevent any infections while using contact lenses.


Is It Possible for Contact Lens to Cause Swelling in the Eyes?

Contact lenses do not usually cause swelling in the eyes. If there is redness, watering, or swelling, it could be due to some infection or irritation to the eye. Hence, it is advisable to remove the lens and seek appropriate treatment.


How Long Can a Contact Lens Last?

Contact lenses can be used for around two weeks to two months. It is best to follow the doctor’s advice or the instructions on the cover. Sleeping with lenses can reduce their life.


What Happens if the Contact Lens Is Left Unremoved?

Sleeping with contact lenses can increase the risk of eye infections by six to eight times. It increases the risk of corneal tears. Wearing contact lenses for longer hours can cause irreversible damage to the eyes.


Can a Physician Take Out a Contact Lens?

A contact lens that is missed can be removed by an experienced doctor. While facing difficulty in removing the lens, care should be taken not to be rough on the eyelid, as it can cause scratches to the layers of the eye and the lens. An experienced ophthalmologist can help remove this without causing much pain or discomfort.

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Dr. Asha Juliet Barboza
Dr. Asha Juliet Barboza

Ophthalmology (Eye Care)


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