Dry Eye: How to Safely Wear Contact Lenses Without Worsening Symptoms

As symptoms of dry eye escalate, some people start taking their contacts out partway through the day just to get relief, says Annette Bade, OD, the associate dean of clinics at High Point University’s School of Optometry in North Carolina.

The good news? Dry eye doesn’t automatically rule out contact lens wear, she says. “For many dry eye patients, the question is not ‘Can you wear contact lenses?’ but rather ‘Under what circumstances can you wear contact lenses successfully?’” she says.

Here, learn about how contact lenses and dry eye are connected, and get expert advice on how to safely wear contacts when you have dry eye.

Contact Lenses and Dry Eye: What’s the Link?

Every type of contact lens affects the tear film that covers the eye to some degree, says Beth Friedland, MD, an emeritus professor of research and an adjunct clinical professor at the University of North Carolina School of Medicine’s department of ophthalmology in Chapel Hill.

“When you put any kind of a foreign substance, like a contact lens, between the surface of the lid and the surface of the cornea, you affect that tear film,” she says.

“A contact lens sits directly within the tear film, effectively splitting it into a layer in front of the lens and a layer behind it,” says Dr. Bade. That disruption reduces tear film stability, increases tear evaporation, and creates areas of dryness on the surface of the eye between blinks, she says.

“Every lens also moves slightly with each blink, adding friction, and reduces how much oxygen reaches the cornea,” says Bade. Chronically low oxygen levels may add to corneal stress and inflammation, and the risk can climb significantly, depending on which type of lenses you wear, she adds.

How to Safely Wear Contact Lenses if You Have Dry Eye

Because some lenses trap more debris or block more oxygen than others, the right type can mean the difference between irritated eyes and comfortable ones, says Dr. Friedland.

Here are some other tips on how to comfortably wear contacts when you have dry eye.

Choose the Right Lenses

Daily disposables are often the best starting point because you begin each day with a fresh lens that has no accumulated protein, fat, or buildup from your environment, says Bade.

“The increased oxygen transmission supports corneal health and may reduce the ‘tired eye’ sensation often reported at the end of the day,” says Bade.

But even fresh contact lenses can be difficult for people with dry eye, says Friedland. And contact lenses that people wear continuously for a week are more likely to cause dry eye problems than daily disposable contacts, she says.

For more significant dry eye, scleral lenses hover over the cornea and hold a reservoir of fluid between the lens and the ocular surface, says Bade. “This continuously bathes the cornea in saline throughout [daily] wear,” she says.

Pay Attention to How Long You’re Wearing Contacts

Many practitioners will say a reasonable starting range for contact wear is 8 to 12 hours a day, but they’ll adjust this recommendation depending on your dry eye symptoms or other factors that may mean you need to shorten the amount of time you wear them, says Bade. Scheduled breaks from your lenses can also help, she says.

Use Lubricating Drops Proactively

“Rewetting drops or lubricating drops approved for contact lens wear can help maintain moisture and reduce friction,” says Bade. Many people benefit from using eye drops proactively, before symptoms get bad, rather than waiting, she says.

Give Your Eyes a Break From Screens

“Extended computer, tablet, and phone use reduces blink rate, which leads to faster tear evaporation and worsening dryness,” says Bade. She recommends the 20-20-20 rule: Every 20 minutes, look at something 20 feet away for 20 seconds.

A simple blink exercise can also help after a stretch of screen time, says Friedland. “Squeeze your eyes tight, as tight as you can, for about six seconds, and then relax,” she says. That releases oil from the eyelid glands and can improve comfort, at least temporarily, she says.

Know the Warning Signs

Increasing dryness, burning, grittiness, discharge, redness that doesn’t improve after taking your lenses out, or blurry vision that only briefly clears with blinking are all reasons to remove your contacts, says Bade.

Periodic blurry vision that doesn’t clear with a few blinks, along with pain, itching, or an urge to rub your eyes are other cues that it’s time to switch to glasses, says Friedland.

“Don’t rub your eyes when you’ve got contact lenses in; it’s not a good idea,” she says.

Avoid Habits That Make Things Worse

“Sleeping in contact lenses, even ones approved for extended wear, can worsen dryness and inflammation and substantially raise the risk of corneal infection,” says Bade. Wearing lenses past their replacement schedule or reusing old cleaning solution instead of fresh each time also lets deposits build up and worsens friction, she says.

See Your Eye Doctor Regularly

Symptoms like severe pain, sudden vision changes, significant light sensitivity, persistent redness, or discharge call for prompt medical attention rather than waiting it out, says Bade. Pain or vision loss should never be written off as “just dry eye,” she says.

Ask About Treatments That May Help

In-office treatments like intense pulsed light or heat and massage therapy can improve oil gland function and make contact lens wear easier, she says.

Friedland sees similar results with those treatments, plus eyelid hygiene, warm compresses, and prescription drops used before and after lens wear. “It’s very rare that we have to say you can’t wear your contact lenses anymore,” she says.