Contact Lens Complications
Eye problems linked to contact lens wear, from irritation to infection
Quick Facts
- Type: Eye surface and corneal problems
- Common causes: Poor hygiene, overwear, water exposure
- Range: Dryness to sight-threatening infection
- Seek urgent care: Painful red eye, blurring, or discharge
Overview
Contact lenses are a safe and effective way to correct vision for most people, but wearing them carries some risk to the eye's delicate surface. Contact lens complications cover a spectrum, from mild dryness and irritation to serious infections of the cornea that can threaten vision. Many problems arise because a lens reduces oxygen reaching the cornea and can carry germs onto the eye if not cared for properly.
The good news is that the great majority of complications are preventable. Following hygiene rules, not sleeping in lenses unless approved, keeping lenses away from water, and attending regular eye checks dramatically lowers the risk. Recognizing the warning signs early helps catch problems before they become serious.
Most complications fall into a few groups: dryness and irritation, allergic or inflammatory reactions on the inner eyelids, reduced oxygen to the cornea from overwear, and infection, which is the most serious. Many people experience minor discomfort at some point, and these mild problems usually settle quickly once lenses are removed. The aim of good lens care is to keep small, reversible issues from becoming sight-threatening infections. A simple guiding principle helps: if an eye is red, painful, or your vision is affected, take the lenses out and get advice.
Symptoms
Warning signs that a lens is causing a problem include:
- Redness of the eye
- Pain, stinging, or burning
- Blurred vision
- Excessive watering or discharge
- Sensitivity to light
- A gritty, foreign-body feeling
- Dryness or discomfort that worsens through the day
A useful rule is to remove your lenses and seek advice if your eyes are red, painful, or your vision is affected. A painful red eye with blurred vision in a lens wearer should be treated as urgent.
Causes
Complications usually stem from how lenses are worn and cared for, or from the lens reducing oxygen to the cornea.
- Poor hygiene: Not washing hands, reusing or topping up solution, or dirty lens cases introduce germs.
- Overwear: Wearing lenses too long each day, sleeping in lenses, or not replacing them on schedule.
- Water exposure: Swimming, showering, or rinsing lenses in water raises the risk of serious infection.
- Poor fit or dryness: An ill-fitting lens or low tear production causes irritation.
Risk Factors
- Sleeping in lenses or extended-wear use
- Poor lens and case hygiene
- Swimming or showering in lenses
- Wearing lenses longer than recommended
- Pre-existing dry eye or eyelid disease
- Smoking, which worsens dryness and healing
Diagnosis
An optometrist or ophthalmologist examines the eye with a slit lamp microscope and may:
- Apply dye to reveal scratches, dryness, or ulcers on the cornea
- Check the fit and condition of the lenses
- Take a sample for culture if infection is suspected
- Assess tear production and eyelid health
Identifying whether the problem is simple irritation or a sight-threatening infection such as keratitis guides treatment. The examiner pays particular attention to the cornea, looking for any white spot, ulcer, or area of cloudiness that would indicate infection rather than harmless irritation. They will also ask about how the lenses are worn and cleaned, whether they are slept in, and any water exposure, since these details point toward the likely problem and the right advice. When infection is a possibility, samples may be taken before treatment so the responsible organism can be identified.
Treatment
Treatment depends on the specific problem.
- Stopping lens wear: The first step for almost any complication is to remove lenses and not wear them until the eye is healed and cleared.
- Lubricating drops: For dryness and mild irritation.
- Antibiotic or other medicated drops: If infection is present, prompt treatment is needed; corneal infections require urgent specialist care.
- Changing the lens or routine: Switching lens type, reducing wear time, or improving hygiene to prevent recurrence.
For ongoing dryness or irritation, an eye care professional may suggest a different lens material, a daily disposable lens that is replaced every day, or a different cleaning system. Reducing the number of hours lenses are worn and building in lens-free days also helps the eye recover. Most mild problems settle quickly once lenses are stopped, but corneal infections can be serious and must be assessed promptly. After any significant complication, lenses should not be worn again until an eye professional confirms the eye has fully healed and it is safe to resume.
Prevention
- Wash and dry hands before handling lenses
- Never sleep in lenses unless they are specifically approved for it
- Use fresh solution each time and never top up or use water
- Keep lenses and the eyes away from all water; remove lenses before swimming or showering
- Replace lenses and cases on schedule
- Give your eyes lens-free days and attend regular eye checks
- Remove lenses and seek advice at the first sign of redness or pain
When to See a Doctor
Remove your lenses and seek prompt care if you have:
- A red, painful eye
- Blurred vision
- Light sensitivity, watering, or discharge
- A white spot on the cornea
These can signal a serious corneal infection, which is an eye emergency. Do not put lenses back in until an eye professional says it is safe.
Frequently Asked Questions
What is the most serious contact lens complication?
Infection of the cornea (microbial keratitis) is the most serious, because it can scar the cornea and threaten vision. Sleeping in lenses and water exposure greatly raise this risk, which is why a painful red eye in a lens wearer needs urgent care.
Can I sleep in my contact lenses?
Only if your lenses are specifically approved for overnight wear, and even then it raises the risk of infection. For most people, sleeping in lenses is one of the biggest avoidable risk factors for serious eye problems.
Why should I keep lenses away from water?
Tap water, pools, and showers can carry germs, including organisms that cause hard-to-treat infections like Acanthamoeba keratitis. Always remove lenses before swimming or showering and never rinse them in water.
What should I do if my eye becomes red and painful?
Remove your lenses immediately and do not put them back in. If the redness, pain, or blurred vision does not quickly settle, see an eye professional the same day, as this can signal infection.
How can I prevent contact lens problems?
Wash your hands, use fresh solution, never sleep in lenses unless approved, keep lenses away from water, replace lenses and cases on schedule, and attend regular eye checks. Give your eyes occasional lens-free days.
References
- Centers for Disease Control and Prevention (CDC). Contact Lenses.
- American Academy of Ophthalmology. Contact Lens-Related Eye Infections.
- National Eye Institute (NEI). Contact Lenses.
- MedlinePlus, U.S. National Library of Medicine. Contact lenses.