William Ngo, OD, BSc is a Clinical Researcher at the Centre for Contact Lens Research.
Papas E, Ciolino JB, Jacobs D, Miller WS, Pult H, Sahin A, Srinivasan S, Tauber J, Wolffsohn JS, Nelson JD. The TFOS International Workshop on Contact Lens Discomfort: Report of the Management and Therapy Subcommittee. Investigative Ophthalmology and Visual Science 2013 54:TFOS183-TFOS203.
In the management of contact lens discomfort the first step involves assessing the status of the lens and patient. This includes and is not limited to identifying the type of lens they’re using, the environment, onset of symptoms, and use of drops. Once this is established, the next step is to identify and treat non-contact lens related factors such as systemic and ocular diseases that would contribute to lens discomfort (e.g. keratitis). From here, we can begin to search for obvious lens factors that may be the cause of discomfort, such as physical defects on the lens, poor lens fitting, or deposition.
If a patient is still experiencing discomfort with a clinically acceptable lens, then some options to consider at this point would include changing the replacement frequency, the material, and or care system. It is also advisable to use tear supplements and wetting agents to improve comfort. Oral azithromycin, as well as a change in diet to include more omega-3 and omega-6 fatty acids have also shown to improve contact lens discomfort.
There is no straight solution for contact lens discomfort and each case must be considered individually.
For further details, please refer to The TFOS International Workshop on Contact Lens Discomfort: Report of the Management and Therapy Subcommittee.