A Guide to Clinical Contact Lens Management

Signs, Symptoms, Diagnosis and Management

Academy for Eyecare Excellence™
IN COOPERATION WITH
Centre for Contact Lens Research
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Discomfort

Characteristic Type Consistency Laterality
Alternatives
  • Burning
  • Gritty
  • Hot
  • Irritated
  • Itchy
  • Scratchy
  • Sore
  • Tired
  • Uncomfortable
  • Watery
  • Constant
  • Intermittent
  • Night
  • Near
  • Distance
  • Without lens
  • Unilateral
  • Bilateral

Symptoms

  • If immediately following insertion then consider damage to the lens or issues with the care system
  • Scratchy, gritty – usually associated with foreign body, lens defect or bacterial infection
  • Itchy– usually associated with allergic response; evert upper eyelids
  • Hot, burning – frequent symptom of viral infection
  • Dryness – assess pre-lens wetting
  • Tired, uncomfortable or sore – may be dryness, binocular vision disorder or incorrect prescription
  • End of day (EOD) discomfort is the most frequent type of discomfort reported and is present in about half of all CL wearers. EOD discomfort is often the cause of CL dropout

Signs

  • Variable depending on underlying cause; may see improperly fitting CL or poor wettability of the lens, or may see other ocular factors contributing to the discomfort

Etiology

  • Discomfort may be attributed to the lens(es), maintenance solutions or ocular factors

Prevalence

  • Common

Differential Diagnosis

  • Many factors can result in discomfort. Consider factors relating to the lens material, lens design and fit, care system, patient and the wearers working environment

Management

Management is directly dependent upon the source of discomfort. May need to change lens material, change to DW, reduce wear time, use rewetting drops, etc.

Change lens Consider SiHy lenses Consider refit to daily disposable replacement lens Consider GP lenses Change solution Review wearing schedule
Counsel patient on lens care Review Consider rewetting drops

Alcon Vision Care is uniquely poised to serve every contact lens wearer by addressing the full life cycle of their needs.