editor's perspective
Managing Dryness in Contact Lens Wearers

Recent studies say that about half of all contact lens wearers experience dryness related to their choice of vision correction. Therefore when a patient tells us that he's uncomfortable or that he has dryness when wearing his contact lenses, we should rule out all other causes of discomfort.

Once you've linked a patient's troubles to contact lens wear, you can choose from many options to improve his discomfort and dryness. Manufacturers of lenses and solutions are really capitalizing on this pandemic problem. Modern research has described hormonal control of the lacrimal glands, explained the inflammatory nature of chronic dry eye and has led us to new treatments.

Some hydrogel materials have obtained FDA claims that they are beneficial for dry eye patients. Sometimes they work and sometimes they don't. Desmond Fonn's group at the Centre for Contact Lens Research, the University of Waterloo, Ontario, Canada, has shown that although some lenses dehydrate less on the eye, they may have similar dryness discomfort results to lenses that dehydrate more. His researchers have also shown that numerous lenses, even modern silicone hydrogels, decrease in wearing comfort as the day goes by. However, a number of studies show that switching from hydrogel lens wear to wearing other lens types reduces these symptoms. But is this just a placebo effect?

New eye drops for dry eye claim to act like a bandage and some even contain anti-inflammatory agents such as cyclosporin. Some contact lens eye drops actually clean lenses. A preapplication drop may make lens application more acceptable and using these drops during the day helps wash away debris. New pills that contain Omega-3 fatty acids from fish oil or flaxseed oil claim to improve dry eye symptoms. Recently, a number of solutions for lens care have claimed to improve end-of-day comfort.

Here's another list of helpful treatments to provide for all your patients:

• Encourage them to drink 50 ounces of water each day for every 100 pounds of their body weight
• Advise patients to avoid smoky and other bad environments. (Airplane humidity can be as low as four percent.)
• Make sure your patients keep all eyelid disease under strict control.
• Advise patients that, if possible, they should avoid drugs (including alcohol) that can cause dryness.
• Stress the importance of keeping contact lenses as clean as possible.
• Plugging the puncta may help for a while.

With all of these great options available, you'd think that dryness with contact lenses would rapidly become extinct!