Dry eye syndrome – what to choose: contact lenses or laser vision correction

Contact lenses are deservedly infamous: they are cheap, comfortable, and guarantee optimal visual comfort for large visual defects. Those who switch from corrective glasses to lenses have the impression that nothing better could happen to them. Meanwhile, contact lenses can become a source of trouble – and not only if you handle them incorrectly. What is the issue?

Can wearing lenses trigger or aggravate dry eye syndrome symptoms

We know that the use of contact lenses for diagnosed dry eye syndrome (DS) is difficult, and often not possible at all. But were you aware that it is the wearing of lenses that can trigger and aggravate dry eye symptoms? Why? Because the secretion of the tear glands is not effectively distributed on the surface of the eye. If daily frequent moistening of the eyes and lenses with dedicated drops with sodium hyaluronate does not work, and day by day we have more and more problems with putting on lenses, because the eyes revolt – burning, pinching, tearing, we have a feeling of sand under the eyelids – it is worth seeing an ophthalmologist. Among contact lens wearers, the rate of dry eye syndrome can be as high as 75%, and the risk of developing MND increases with age and is higher in women.

In a healthy eye, the contact lens floats on the tear film over the cornea and iris. If the tear film is interrupted and the eye produces too few tears, the lens sticks to the surface of the eye and simply irritates it. With fresh lenses, just taken out of the package, the discomfort may be of minor intensity, but with each passing day, as the lenses become less and less hydrated and begin to draw moisture just from the tear fluid and, in addition, begin to coat them with protein deposits, it will increase. If, in addition, some microcracks, invisible to the naked eye, appear on the lenses, the discomfort will be really big. One solution is to wear daily disposable lenses, but even they – once the dry eye syndrome caused by two-week or 24-hour lenses appears – will not be as comfortable to wear as they should be.

Anyone who uses contact lenses knows very well that it is worth paying special attention to several issues:

• We wear lenses for as long as they were intended: if we break this rule, we will not avoid irritating our eyes, and we may even end up causing dry eye syndrome.
• If we already have dry eye syndrome or do not tolerate contact lenses in the best way, we treat them as an occasional substitute for corrective glasses: for the swimming pool, for a big outing, etc. It is not advisable to wear contact lenses while watching TV or working in front of a monitor, as the eyes dry out particularly quickly then.
• We only buy lenses from a reliable source and of the highest quality – there really is a lot to choose from. People with dry eye syndrome are advised to use lenses with hyaluronic acid, especially silicone hydrogel lenses, preferably daily disposable.
• Lenses are cleaned and stored as directed, in appropriate solutions (saline is not suitable for storing contact lenses because it dries them out) and containers.
• On a daily basis, we use moisturizing drops, which can be applied directly to the eye with the lens. The sodium hyaluronate contained in them not only moisturizes, but also coats the eye with a protective film.
• Do not wear lenses during a cold, due to the increased risk of transferring germs to the eyes. Be especially careful if you have an ocular disease, such as conjunctivitis.

Laser vision correction vs. dry eye syndrome

If, despite all the rigors, our eyes can’t tolerate contact lenses anyway, and with glasses our visual comfort is much worse, is it worth considering laser vision correction?

Dry eye syndrome is considered a relative contraindication to the procedure laser vision correction.

Patients in the advanced stage of the disease often show pinpoint epithelial defects in the lower part of the cornea or within the eyelid stroma. The lesions occur bilaterally and are very chronic in nature. There is no complete cure for dry eye syndrome, and the symptoms of the disease usually persist throughout life. In such a case, the doctor decides whether laser intervention can be undertaken or whether it could further aggravate the symptoms.

In the case of so-called secondary dry eye syndrome, associated with the use of medications or just contact lenses, the symptoms of which may regress or diminish after their withdrawal, laser vision correction can be considered right away, which will free us from the need to reach for contact lenses, and thus eliminate them as a cause of causing and aggravating the symptoms of dry eye syndrome.