How to Choose the Best Contacts for Dry Eyes, According to Eye Doctors
Dry eyes are uncomfortable for anyone, but when you wear contact lenses, any eye problem can be even more annoying. When your eyes get dry, lenses can feel irritating (or even just feel, when normally you can't notice they're even in). The thing is, contact lenses can also contribute to eye dryness.
Here's what you need to know about how contact lenses can cause dry eyes, the best contact lenses for dry eyes, and other things you can do to help keep eyes hydrated and feeling good if you wear contact lenses.
How can contact lenses contribute to dry eye?
First, a quick eye anatomy lesson: The front of the human eye is covered with a tear film that has a few different layers, Scott P. Drexler, OD, assistant professor of ophthalmology at the University of Pittsburgh School of Medicine, tells Health. There's a thin layer of lipids (fat) on top, a thicker layer of aqueous (water and proteins) in the middle, and a layer of mucus on the bottom. "Anything that will disrupt those layers is going to lead to a dry eye problem," Dr. Drexler says.
Disruptions can come from the environment, medications, staring at a computer all day, or even a ceiling fan or air conditioning unit. Natural aging, hormonal changes from menopause, and certain health conditions can also contribute to dry eye, says Esek Akpek, MDYou , professor of ophthalmology at the Johns Hopkins University School of Medicine.
Wearing contact lenses can also interrupt the eye's natural moisture and either cause or contribute to dry eye—and there are a few reasons why.
Think of soft contact lenses like sponges, says Dr. Drexler. "When you take a lens out of a case with solution, it's like a sponge that is fully hydrated. As you wear the lens, normal evaporation from the air around you and other things like ceiling fans or air conditioning take moisture out of the lens and your eye has to replace it from the tear film," he explains. When your eyes can't keep up with the tear production—the hallmark characteristic of dry eye syndrome—dryness ensues. It's why people who wear contacts may start blinking a lot towards the end of the day—the eyes are attempting to get more moisture to the lens.
Contact lenses can also cause irritation alongside the lid margin, particularly where the edge of the lens touches the bottom lid, Dr. Akpek says. This constant low-key rubbing can cause the glands to get inflamed and lead to dry eyes.
Finally, contact lenses also can contribute to dry eye by decreasing corneal sensation, Dr. Akpek says. When you constantly have something sitting on your cornea, it has to adjust. "In order for a person to be able to tolerate them, corneal sensation goes down." This can lead to decreased tear secretion and decreased regeneration of the corneal epithelial cells (the surface cells that protect the cornea from the outside world). "Like the skin, corneal skin is shed on a regular basis; every 7 to 10 days the entire corneal epithelial layer renews itself," Dr. Akpek says. "If there's a decrease in corneal sensation, regeneration is delayed." You may not necessarily feel dryness or discomfort because of the reduced sensation, she says, which means you might not recognize something is wrong until it's really wrong.
What should you look for in contact lenses with dry eye?
Just because you have dry eye doesn't mean you're destined to a life of dry and irritated eyes if you're a contact lens wearer. Certain features in your contact lenses can make them better (or worse) at keeping your eyes hydrated and comfortable.
Two big factors eye doctors consider when prescribing contact lenses are oxygen transmission and water content, Dr. Drexler says.
- Oxygen transmission: This just means how much air gets through the lens. "When you put a lens on an eye, it covers the cornea. The cornea gets nutrition from tear film and the air around it, so we want the air to go through the lens to get to the cornea and keep it healthy," Dr. Drexler says. If a contact lens has low oxygen transmission, it will lead to dryness short-term and long-term, it can impact the health of the cornea. Having more moisture in the eye improves oxygen transmission.
- Water content: It sounds counterintuitive, but lenses with lower water content can help improve dry eyes, because they require less water from your eye to stay hydrated, Dr. Drexler says.
Certain lens materials and technologies can also help increase moisture and keep the lens (and your eyes) moist and comfortable. Most newer lenses are made of silicone hydrogel, Dr. Wexler says. Silicone is pretty resistant to moisture loss, so these lenses tend to stay moist for longer. Some lenses also have a special coating on the surface that retains moisture.
There are a few specific types of soft contacts that use these new materials and technologies and are known for helping keep the eyes moist and avoiding dry eye, according to the experts interviewed for this piece. Those types and brands are: Acuvue Oasys, Biofinity Energys, and Air Optix Aqua Hydraglyde. (Note: Before you make any changes to your eye care routine, it's important to check in with your eye doctor. And just a reminder: You do need a prescription for contact lenses before you decide to buy a pair.)
Proper fit is important, too. Fit refers to how tight the contact lens is, and how large an area it covers. "This is important because if a lens is too large, there's more of a chance it will rub in the wrong places and cause inflammation and even swelling, Dr. Akpek says. Even though different brands of lenses are made from similar materials, the lens manufacturing design can differ, so they all fit a bit differently, Dr. Drexler says. This is one of the reasons you should always get a proper contact fitting at your eye doctor's office.
What are other ways to reduce dry eye from contact lenses?
While it's important to use contact lenses that fit your eye health needs, the way you wear contact lenses and take care of them when they're not in your eyes can have an impact too. Here, experts share tips on how to care for your contacts if you deal with dry eye, or they lead to increased symptoms.
- Check your solution. Some people find that their contact lens solution aggravates eyes and contributes to dryness, Dr. Drexler says. Chemicals from multipurpose solution absorb into contact lenses when they're being stored, so when you put the lenses into your eyes, the solution also makes its way into your eyes. For some people, this may be irritating. If you think that may be the case for you, Dr. Drexler suggests switching to a name-brand solution. "They keep the pH and chemical levels very low [compared to generic alternatives], which tends to minimize those complications. Generic ones are made to sit on the shelf longer and have stronger preservatives," he says.
- Replace your lenses when you're supposed to. If you have dailies, throw them out every night. If you have biweeklies, set a reminder in your calendar every two weeks to toss the old pair and start with a fresh one. If you wear your lenses longer than they're meant to be worn, they'll get dry, Dr. Drexler says. "Following the replacement schedule that is appropriate for the lens is one of the best things you can do," he says.
- Change the storage solution everyday. Some contact lens wearers don't change the multipurpose solution in their cases, Dr. Drexler notes. That's not good—you should be dumping and refreshing the storage solution every night. "Solution has properties to keep the lenses clean and moist," he says. "So if you're not replacing it every time, you're basically putting the lenses in an ineffective medium."
- Use rewetting drops. If your eyes tend to get dry throughout the day, try using a lubricating eye drop that's made to be used with soft contact lenses.
- Take blinking breaks. Seriously. "When you stare at a computer all day, you don't blink as much, and when you don't blink, there's more water evaporation and more dryness," Dr. Drexler says. Using a lubricating drop is a good way to combat that, but taking visual breaks can help, too. Throughout the day, make it a point to stop focusing on the screen, blink a few times, and use rewetting drops, before you start focusing again.
It's also important to note that everyone's eyes are different. The contacts that fit and feel comfortable on your eyes will be different from what works for someone else. Your eye doctor will be able to figure out what to try next (and next, and next) if the contacts you're wearing seem to make your eyes dry. They'll also help you figure out if there's something else contributing to your dry eyes beyond just your contact lenses.
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