Contact lenses aid visual rehabilitation, provide symptom relief in dry eye disease
Click Here to Manage Email Alerts
Key takeaways:
- Contact lenses provide visual rehabilitation, symptom relief and ocular surface protection in dry eye disease.
- Soft contact lenses and scleral contact lenses play different roles in dry eye management.
Contact lenses benefit patients with dry eye and ocular surface disease by providing visual rehabilitation, symptom relief and ocular surface protection, according to a review published in Indian Journal of Ophthalmology.
“This review describes the role of soft lenses and rigid gas-permeable scleral lenses in the
management of DED associated with OSD,” the study authors wrote. “The efficacy of contact lenses, lens selection and optimal lens fit are reviewed for specific indications.”
Soft contact lenses
When soft contact lenses are used to protect the cornea, reduce corneal desiccation, improve corneal wound healing and provide pain relief, they are known as therapeutic contact lenses or bandage contact lenses.
Bandage contact lenses provide pain relief in ocular surface disease (OSD) caused by chemical or thermal burns, Stevens-Johnson syndrome and postsurgical conditions, although they may be insufficient once there is neuropathic pain.
They can also aid healing of epithelial defects, help manage Sjögren’s syndrome and ocular manifestations of graft-versus-host disease, and promote wound healing after cataract surgery.
Further, bandage contact lenses can be used successfully in drug delivery and both corneal protection and sealing.
Scleral contact lenses
Scleral contact lenses rest on the sclera, vaulting the cornea and limbus. This creates a fluid reservoir in the space between the lens and the cornea that acts as a “liquid bandage,” the study said, enabling scleral contact lenses to protect the ocular surface from both desiccation and mechanical eyelid effects.
In dry eye disease (DED), scleral contact lenses relieve symptoms and protect the ocular surface. They also can heal epithelial defects and serve as a means to provide continual drug delivery to the ocular surface.
Duration of wear may be an important factor when using scleral contact lenses in Sjögren’s syndrome, but further studies are needed to investigate the success of these lenses in this disorder. On the other hand, scleral contact lenses have been effective in managing discomfort and photophobia in patients with Stevens-Johnson syndrome.
In patients with persistent epithelial defects, the fluid reservoir bathes the ocular surface and promotes epithelial healing by providing constant drug delivery; however, close monitoring is needed to rule out secondary infection.
In exposure and neurotropic keratopathy, scleral contact lenses prevent further desiccation, provide corneal hydration and heal epithelial defects, making the lenses an option before surgical intervention.
“Contact lenses play an important role in the management of DED,” the study authors wrote. “[Bandage contact lenses] and rigid gas permeable [scleral contact lenses] not only aid in visual rehabilitation but are also useful for therapeutic indications and provide symptomatic relief.”
Perspective
Back to Top
Eye care providers hear complaints of DED symptoms from many of their patients. Sometimes it is graduate students experiencing it after spending many hours on the computer finalizing a paper, and often it is more senior patients who present with complaints of blur and foreign body sensations that last most of the day. With great sympathy, practitioners often first educate patients on DED and work to set appropriate expectations for what may be ahead.
Thankfully, there are now numerous treatments available for DED. But sadly, this does not mean that it can be completely resolved for all patients or that it will be a quick and easy journey. This review article focuses on one such treatment option: contact lenses. The authors provide a good review and even cover less commonly available options such as the PROSE lens (prosthetic replacement of the ocular surface ecosystem, BostonSight), as it has been reported to be a great option to consider for certain patients suffering from severe symptoms and in need of improvements to their functional vision. It was also wonderful that the authors mentioned the importance of insertion and removal training with contact lenses, and there is room for even more to be highlighted about this in follow-up publications.
Collapse
Read more about
Click Here to Manage Email Alerts