Understanding Contact Lenses and Dry Eye

If you wear contact lenses, or are thinking about trying contact lenses, you might have heard about dry eye as a potential concern. But what’s the connection between contact lenses and dry eye? Let’s break it down in simple terms so you can make the best choice for your eyes.

What is Dry Eye?

Dry eye is a condition where your eyes don’t make enough tears, or the tears evaporate too quickly. This can cause discomfort or even blurry vision.

Woman_applying_a_contact_lens_with_a_focused_expression.

Some Reasons Why Contact Lenses Can Cause Dry Eye

For many people, contact lenses are a convenient alternative to glasses. But for others, they can cause or worsen dry eye symptoms. Here’s how:

  • Increased Tear Evaporation

Contact lenses sit directly on the eye, creating a barrier between your tear film and the air. It leads to a thinner tear film with a higher rate of evaporation.

  • Absorbing Moisture

Contact lenses absorb tears from your eyes to keep themselves hydrated. This can leave your eyes dry and less comfortable.

  • Reduced Oxygen Flow to the Eyes

Contact lenses may block oxygen from getting to your eyes. Think of it like your skin—when it doesn’t get enough air, it can become dry and flaky.

  • Poor Hygiene Lens Deposits and Build-Up

Over time, proteins, lipids and debris can build up on contact lenses. This may make tears less effective in moisturising the lens. The condition worsens when one does not clean the lenses properly.

  • Reduced Blink Rate

When wearing contact lenses, some people blink eyes less frequently, which can reduce the spread of tears across the eye’s surface.

Young_boy_playfully_pointing_at_his_nose_with_wide_eyes.

Symptoms of Contact Lens-Induced Dry Eye

  • Redness and irritation
  • A gritty or burning sensation
  • Blurred vision
  • Excessive tearing (a reflex response to dryness)
  • Sensitivity to light

Tips to Prevent or Relieve Dry Eye in Contact Lenses Wearer

 

  1. Use the Right Contact Lenses. 

    Generally, wearing daily disposable lenses are less prone to dry eye since you start with a fresh pair of lenses every day. However, different lens materials also play a vital role in retaining moisture.

  2. Use Rewetting Drops. 

    Applying preservative-free artificial tears can retain contact lenses’ material and eye moisture. 

  3. Practice Good Hygiene. 

    Cleaning, storing, and rinsing your lenses properly is a key to prevent the buildup of protein or deposits that could worsen dry eye. 

  4. Limit your Wearing Time. 

    Take a break in between if you are wearing contact lenses for more than 8 hours a day. Besides, give your eyes a break by switching to glasses during your rest day. 

  5. Consider Alternative Vision Correction

    If dry eye persists despite these measures, you may want to speak to an ophthalmologist to discuss about options like ICL, LASIK, SMILE pro or TransPRK

When to See an Eye Care Professional?

If your dry eye symptoms persist, dry eye services are available at the following locations; Nexus Bangsar South, Cheras South, Shah Alam, Seremban, Kuching, Johor Bahru, and Penang.

Besides, attending a contact lens fitting clinic is recommended if you are having problems finding suitable contact lenses. Prevention is always better than cure. 

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Dry Eye Disease: Assessment & Treatment

Dry eye is a disease of the tear film that involves the ocular surface. To understand dry eye disease, it’s crucial to explore throughout the tear film. 

The tear film consists of three layers: 

  • Lipid layer: as a barrier to stop tear from evaporating
  • Aqueous layer: waste is removed and flushed out of the eye’s surface
  • Mucin layer: as a protective lubricant, ensuring smooth tear distribution across the eye’s surface. 

With each blink, a protective layer of tears is distributed. Any malfunction within this system will lead to dry eye disease.

Close_up_view_of_an_eye,_emphasizing_the_tear_film,_cornea,_and_lens_to_illustrate_ocular_anatomy.

How would I know if I have Dry Eye Disease?

Do you recall when ophthalmologists diagnosed dry eye with a slit lamp and treated it with only artificial tears? Those days when the options of treating dry eye disease were limited, addressing dry eye disease had a relatively lower efficiency. Nowadays, our knowledge of ocular surface disease has grown to encompass advanced and highly specialized testing.

Here is a list of the modernising testing techniques that ophthalmologists use for dry eye disease diagnosis. 

Dye staining of cornea and conjunctiva

Sodium fluorescein dye would be the most common dye being used for checking epithelial cells integrity. This yellow dye helps to stain and localise the dry spot on the cornea, and it is also useful for tear break-up time assessment and epithelial basement membrane dystrophy (EBMD) evaluation. 

Eye_surface_stained_with_sodium_fluorescein_dye_under_cobalt_blue_light,_highlighting_areas_of_dryness_and_damage_for_dry_eye_disease_assessment.

While other dyes such as Lissamine green and Rose bengal are preferred for conjunctival staining. They could assess the inflammation of the ocular surface by staining dead cells on the cornea and bulbar conjunctiva.

Lid expression

Gentle pressure applied to the lid margin to assess the meibomian gland function is recommended to assess eyelid health. Those white clogs indicate blockage of the meibomian gland. As a result, lesser lipids are secreted and tears will be easily evaporated.

Close_up_view_of_meibomian_gland_dysfunction_showing_white_clogs_along_the_eyelid_margin,_indicative_of_blocked_glands_affecting_tear_production.

Meibography

Meibography with infrared imaging techniques allows assessment of meibomian gland structure and identification of gland loss. Losing of meibomian glands will greatly reduce the amount and quality of the tear lipid layer.

Comparison_of_meibomian_gland_structure_in_normal,_shortened,_and_gland_loss_conditions_using_meibography,_showcasing_changes_in_tear_lipid_layer_secretion.

Blinking quality

Habit of incompletely blinking, or diseases that cause difficulty in closing eyes completely also causes dry eye disease. The tears distribution and exposed tears surface are causing tears to be easily evaporated. 

Detailed_image_of_an_eyelid_with_partially_closed_eyes,_highlighting_incomplete_blinking_which_can_contribute_to_tear_evaporation_and_dry_eye_disease.

Tear lipid layer thickness assessment

It measures the stability of the lipid layer and likelihood of evaporative dry eye by assessing the interference pattern produced by the inner and outer surfaces of the lipid layer in tear film.

Microscopic_view_of_tear_lipid_layer_interference_patterns_on_the_cornea,_showing_the_stability_of_the_tear_film_in_assessing_evaporative_dry_eye.

Tear break up time

It can be tested via sodium fluorescein dye or an non-invasive way, using placido disc. The break up zone of the tears can be visualised and the time it takes for the tears to break is recorded.  A shorter break up time indicates more severe dry eye disease.

Infrared_imaging_of_an_eye_using_a_placido_disc_to_evaluate_tear_break_up_time,_demonstrating_the_effectiveness_of_advanced_diagnostics_for_dry_eye_management.

Tear meniscus measurement

It accesses the volume of tears. It can be measured using infrared or visible light.

Close_up_view_of_the_lower_eyelid_highlighting_the_tear_meniscus_for_assessing_tear_volume_and_dry_eye_conditions.

 

When Every Assessment Combines into One Single Measurement…

Advanced_eye_diagnostic_devices,_including_C.DIAG_and_I-DRA,_used_for_non_invasive_assessment_of_dry_eye_disease_and_meibomian_gland_function.

C.DIAG and I-DRA, are both equipped in OasisEye Specialists, are non-invasive dry eye diagnostic aids. They could provide one step assessment in analysing the patient’s tear film, meibography and anterior eye structure imaging. Referring from the results, the ophthalmologist could offer treatment to address the causes of dry eye disease.

They are well known for:

  • Non-invasive (no dye required)
  • Quick
  • Automated analysis
  • Imaging function available

 

Which Types of Dry Eye Disease Do I Have? 

Dry eye disease can be classified into two main types: aqueous deficient dry eye and evaporative dry eye.  

Illustration_of_an_eye_with_a_focus_on_tear_drops_symbolising_eye_hydration_and_dry_eye_treatment

Aqueous deficient dry eye

The following factors can lead to aqueous deficient dry eye:

  • Aging
  • Sjogren syndrome
  • Laser eye surgery
  • Tear gland damage 
  • Contact lens wear

These clinical findings suggest for aqueous deficient dry eye:

  • Corneal staining
  • Reduced tear break up time
  • Low tear meniscus

Evaporative dry eye

The following factors can lead to evaporative dry eye:

  • Windy conditions or dry air 
  • Reduced blink rate, results from long hours of near work or driving 
  • Lack of lipid or abnormal quality of lipid due to blocked meibomian glands or eyelid diseases (e.g. blepharitis, meibomianitis)

These clinical findings suggest for evaporative dry eye:

  • Corneal staining
  • Reduced tear break up time
  • Partial blinker/ Incomplete closure of eyelids
  • Meibomian gland blockage or loss
  • Reduced tear lipid layer thickness

What are the treatments for Dry Eye Disease?

The treatments aim to address the root cause of the dry eye disease. The options include:

  • Artificial tears 

Not only to lubricate and nourish your eyes but some artificial tears are also formulated for extra protection against tear evaporation and decrement of ocular inflammation. Hence it’s important to identify the underlying reasons for dry eye disease with an ophthalmologist for a right prescription.

Woman_applying_eye_drops_for_relief_from_dryness_and_irritation,_promoting_eye_hydration.

  • Blephasteam

Blephasteam safely and effectively warms the eyelids to restore the flow of oil (meibum) from the meibomian glands. The heat and moisture provided by Blephasteam typically slightly above 40 Degrees Celsius melt the secretions that block the meibomian glands in case of MGD, making it easier to remove the secretions using massage and pressure of the eyelids.This specific temperature range is chosen because it is effective for liquefying the meibum (the oily secretion from the Meibomian glands) without causing discomfort or damage to the delicate skin of the eyelids or the eye itself. Blephasteam reproduces an environment that naturally enhances tear film quality and stability by reinforcing the thickness of the tear film lipid layer, that improves the eye surface health and daily comfort.

Person_using_a_heated_eye_mask_for_dry_eye_therapy,_improving_tear_quality_and_eyelid_gland_function.

  • BlephEx

BlephEx stands as a pioneering medical tool employed in the treatment of dry eye disease caused by an eyelid or meibomian gland disease. It is used to cleanse the eyelid by eliminating the scales and debris to prevent meibomian gland blockage and chronic eyelid inflammation. Following the procedure, an increase in the production of the lipid component of tears can be achieved to improve the stability of the tear film.

Close-up_of_a_BlephEx_device,_designed_for_precise_eyelid_cleaning_to_treat_dry_eye_disease_caused_by_meibomian_gland_dysfunction.

  • IRPL

Intense Regulated Pulsed Light (IRPL) is designed to address dry eye disease caused by meibomian gland dysfunction (MGD). This method utilizes a light pulse to stimulate meibomian glands, promoting the natural secretion of lipids to deter tears evaporation and alleviate eye dryness.

Intense_Regulated_Pulsed_Light_(IRPL)_device,_used_to_stimulate_meibomian_glands_for_effective_dry_eye_treatment.

  • Warm compression

It can be as simple as using a towel. Soak the towel in the hot but not scalding water, wring out the excess water, and apply it on your eye. Warm compression could melt the obstructed oil in the meibomian gland.

Senior_man_using_a_warm_compress_on_his_eyes_to_relieve_dry_eye_symptoms_and_improve_meibomian_gland_function.

  • Plug

A punctal plug is a small device that sits in the tear duct to help prevent the drainage of tears, which helps to keep the eyes moist. 

Illustration_of_tear_duct_anatomy_showing_the_path_of_tears,_relevant_to_punctal_plug_treatment_for_dry_eye_disease.

 

What can we help you with?

If you are suffering from dry eye disease, dry eye services are available at the following locations; Nexus Bangsar South, Cheras South, Shah Alam, Seremban, Kuching, Johor Bahru, and Penang.

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Dry Eyes

Are your eyes red and tired at the end of the day? Does your vision become blurry after long hours of screen time? These are common complaints of a patient with dry eyes. The recent COVID-19 pandemic in the past year has kept people indoors for work purposes and many are seeking treatment for dry eyes. Dry eyes is a condition when a person doesn’t have enough quality of tears to lubricate and nourish the surface of the eye.

The tear film

Tears are important in maintaining the health of the front surface of the eye and providing clear vision. The tear film consist of three layers which are:

  1. The outer layer of the tear film is the oil or lipid layer which serves to maintain tears on the surface and avoid evaporation. The oil is produced by the meibomian glands at the eyelid margins.
  2. The middle layer is the aqueous layer which makes up most of the tear layer. It consists of water and proteins that are produced by the lacrimal gland. It functions to lubricate the eye and wash away foreign particles.
  3. The innermost layer is the mucin layer that allows the even distribution of the tears on the surface. Without the mucus layer, tears would not stick to the eye surface.

Normal_vs_dry_eye_tear_film_comparison.

Types of dry eye

  1. Evaporative dry eye is due to tears being dried up quickly. This is caused by inflammation or blocked meibomian glands. These blocked glands cause reduced secretion of oil that leads to quick evaporation of tears.
  2. Aqueous deficient dry eye may be due to aging. The tears are produced by the lacrimal gland in the eyelids. As you grow older, certain medical conditions and side effects of medications can cause less amount of tears to be produced by the gland.

Illustration_of_an_eye_with_redness_and_irritation.

Symptoms of dry eyes

  • Below are the common symptoms experienced by those who have dry eyes.
  • Redness and eye pain
  • Stinging or burning sensation
  • Sandy or gritty sensation
  • Light sensitivity
  • Watery eyes
  • Heavy eyelids
  • Stringy mucus near the eye
  • Blurred vision

Causes_of_dry_eye_including_screens,_air_conditioning,_and_contact_lenses.

There are also some circumstances that can worsen dry eyes.

  1. Environmental changes such as windy, dusty or dry conditions can make dry eye symptoms worse. Any place with low humidity or high wind such as air-conditioners can cause the eye to dry faster.
  2. Activities such as computer or handphone use for extended periods of time can cause less blinking and lead to greater tear evaporation and dryness.
  3. Certain medications can cause dry eyes as a side effect which include antihistamines, antidepressants, certain blood pressure medications such as beta-blockers and birth control pills.
  4. LASIK and other corneal refractive surgery can sometimes cause dry eye and is usually temporary and resolves within a few weeks after the procedure.
  5. Mask-induced dry eye is also common nowadays especially worn for protection during the Covid-19 pandemic. A mask with poor fitting can cause the air we breathe to flow up across the surface of the eye and lead to evaporation and dryness.
  6. Contact lens associated dry eyes are also common among contact lens wearers as the contact lens can partially block oxygen from entering the eye. Although many contact lenses are able to allow larger amounts of oxygen to permeate the eye, the wearers can still experience dry eyes towards the end of the day.

Treatment for dry eyes

Dry eyes can be managed successfully and result in greater comfort, fewer dry eye symptoms and sometimes even sharper vision. Treatment usually depends on the root cause of your symptoms. Eye drops known as artificial tears can be used to moisturize the eyes and provide a relief for dry eyes. People with dry eyes that do not respond well to artificial tears will need to take additional steps to address their dry eye condition. One revolutionary non-invasive dry eye treatment available is Tixel, which uses thermal energy around the eyes to improve the quality of tears, hence reducing dry eye symptoms.

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