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Inflammation found to cause discomfort in contact lens wear
Analysis of tears in symptomatic and nonsymptomatic contact lens wearers suggested that inflammatory processes, due to increased concentration of leukotriene B4, may be involved in the sensation of discomfort that contact lenses cause in some wearers.
The study recruited 22 symptomatic and 23 asymptomatic subjects. In the symptomatic group, three subjects had previously dropped out of lens wear due to discomfort and wore contact lenses again for the study. The other 19 subjects continued to wear contact lenses, despite symptoms, for refractive error correction. The asymptomatic patients were able to wear contact lenses for at least 8 hours a day without symptoms.
Tears were collected over 5 consecutive days from both eyes of each subject after at least 5 hours of lens wear. In the laboratory, the samples were examined for the concentration of tear lactoferrin, lysozyme, lipocalin 1, prolactin-induced protein, proline-rich protein 4, leukotriene B4 (LTB4), cysteinyl leukotrienes and prostaglandins.
The concentration of LTB4 was significantly higher in the symptomatic group, while no difference was found for other proteins and inflammatory mediators. Because LTB4 is highly chemotactic for lymphocytes and mast cells and is involved in vasculature responses, the authors suggested that inflammatory processes triggered by penetration of lymphocytes and mast cells into the conjunctiva may be involved in the sensation of contact lens-induced discomfort.
Future investigation, extended to other arachidonic acid derivatives, is warranted, according to the authors.
According to the literature, the number of people discontinuing lens wear is approximately equal to the number of new fits each year, the authors noted.
“Despite improvements made during the last decade in lens design, materials and wearing schedules, comfort during lens wear continues to be problematic,” they pointed out. – by Michela Cimberle
Disclosure: The authors reported no conflict of interest