Medical Contact Lenses
What Are Medical Contact Lenses?
While regular contact lenses primarily correct nearsightedness, farsightedness, or astigmatism, medical contact lenses serve a therapeutic purpose. We prescribe them to protect damaged tissue, deliver medication, or provide a smooth surface when your cornea is irregular. They may or may not include vision correction, depending on your needs.
These lenses are often thicker or made from different materials than standard contacts. We select the design based on what your eye needs to heal or stay comfortable.
Bandage contact lenses are the most common type we use for medical purposes. They act like a protective shield over your cornea while it heals from injury or surgery. Scleral lenses are larger lenses that vault over the cornea and rest on the white part of your eye, creating a fluid-filled space that can soothe and protect.
- Soft bandage lenses for corneal abrasions or after procedures
- Scleral lenses for severe dry eye or irregular corneas
- Prosthetic lenses to cosmetically mask iris or corneal irregularities and help reduce light sensitivity
- Drug-eluting lenses are an emerging option with limited availability and narrow indications, such as a daily disposable lens that releases an antihistamine for allergy-related itch. They are not typically used to heal the cornea.
We may recommend medical contact lenses for a variety of eye problems. Conditions like recurrent corneal erosion, where the surface layer of the cornea repeatedly breaks down, often respond well to bandage lenses. Severe dry eye, keratoconus, and corneal scarring are other common reasons.
You might also benefit from these lenses after refractive surgery, corneal transplants, or if you have a painful corneal abrasion. Our eye doctor will evaluate your specific situation to determine if medical contact lenses are right for you.
- Exposure keratopathy from incomplete eyelid closure
- Ocular graft-versus-host disease
- Stevens-Johnson syndrome and ocular cicatricial pemphigoid
- Limbal stem cell deficiency
- Aniridia or large iris defects causing glare and photophobia
When Our Eye Doctor May Recommend Medical Contact Lenses
After PRK and other surface procedures, we typically place a bandage contact lens to protect the healing tissue and reduce discomfort. After LASIK, a bandage lens is used only if the surface epithelium is disturbed. After corneal transplant, a bandage lens may be used early on if there is an epithelial defect or surface irregularity.
If you suffer a corneal abrasion from a scratch or foreign object, a bandage lens can relieve pain and speed healing. We typically monitor you closely during the first few days to ensure the injury is improving. We prescribe antibiotic prophylaxis while the lens is in place and monitor closely.
Some patients experience ongoing corneal issues that require long-term management. Recurrent corneal erosion, where the surface of your eye does not stay attached properly, can cause repeated episodes of pain and blurred vision. A medical contact lens helps keep the cornea stable and reduces flare-ups.
- Recurrent erosion syndrome
- Corneal dystrophies that cause surface breakdown
- Persistent epithelial defects that will not heal on their own
- Neurotrophic keratitis where corneal nerves are damaged
In neurotrophic keratitis, the cornea is less sensitive and infection risk is higher. If a protective lens is used, it requires strict supervision, antibiotic coverage when appropriate, and discussion of additional options such as biologic therapies.
Your cornea needs a healthy tear film and smooth surface to function properly. When injury or disease disrupts this, a medical contact lens creates a protective environment. The lens shields damaged areas from your eyelid's rubbing motion and allows natural healing processes to work more effectively.
We often combine the protective lens with other treatments like lubricating drops or antibiotics. This multi-layered approach gives your eye the best chance to recover fully.
When standard dry eye treatments like artificial tears and prescription drops do not provide enough relief, we may turn to specialty contact lenses. Scleral lenses are particularly helpful because they create a reservoir of fluid over your cornea throughout the day. This constant moisture bath can often improve comfort and vision.
These lenses are custom-fitted to your eye's unique shape. You fill them with preservative-free saline solution before inserting them, and that fluid stays trapped between the lens and your eye surface.
Scleral lenses are designed for daytime wear. Plan to remove, clean, and refill them daily. Some users need a midday refill to reduce fogging.
Conditions like keratoconus cause your cornea to become cone-shaped instead of smoothly curved. This irregularity makes it hard to see clearly with glasses. Scleral or rigid gas-permeable medical lenses can vault over the irregular surface and create a new, smooth front surface for your eye.
Corneal scarring from injuries, infections, or previous surgery can also benefit from medical contact lenses. The lenses both improve vision and protect the fragile scarred tissue from further damage.
How We Diagnose and Fit Medical Contact Lenses
We begin with a thorough examination of your eyes using a slit lamp (exam microscope). This allows us to see the fine details of your cornea and identify any damage, irregularities, or disease. We will ask about your symptoms, how long you have had them, and what treatments you have already tried.
Understanding your daily activities and visual needs helps us choose the best type of medical lens for your situation. We also review your medical history to check for conditions that might affect lens wear or healing.
Precise measurements are critical for medical contact lenses to work properly. We use specialized equipment to map the curvature of your cornea and measure its diameter. For scleral lenses, we also measure the white part of your eye to ensure the lens will rest comfortably.
- Corneal topography to map the surface shape
- Keratometry to measure curvature
- Pachymetry to check corneal thickness
- Detailed measurements of eye dimensions
- Anterior segment OCT to assess scleral lens vault and clearance
- Scleral topography or profilometry to map the shape of the white part of your eye
During the fitting, we will place trial lenses on your eye to assess the fit and comfort. We check how the lens moves with blinking, whether it centers properly, and if it is providing the coverage you need. You might try several different lenses before we find the ideal one.
We will also teach you how to insert and remove the lens if you will be managing it at home. For some medical situations, we handle all lens changes in the office. The appointment may take longer than a regular contact lens fitting because of these extra steps.
After we fit your medical contact lens, we schedule follow-up appointments to monitor your progress. The first check is often within a few days to make sure the lens is working as intended and your eye is responding well. We look for signs of healing, reduced symptoms, or any problems that need adjustment.
During this trial period, we may modify the lens parameters or switch to a different type if needed. Your feedback about comfort and vision helps us fine-tune the treatment for the best outcome.
Treatment Options and How Medical Contact Lenses Work
Bandage contact lenses work by covering the damaged area of your cornea and reducing friction from blinking. This protection allows the corneal cells to regenerate without constant disruption. The lens also helps maintain moisture at the healing site, which is essential for cell growth.
Most bandage lenses are made from soft, breathable materials that allow oxygen to reach your cornea. We typically leave them in place continuously for several days to a few weeks, depending on how quickly your eye heals.
When a bandage lens is used for an epithelial defect, we typically prescribe prophylactic antibiotic drops and schedule frequent follow-ups to lower the risk of infection.
We often prescribe medical contact lenses alongside other treatments for the best results. You may need to use antibiotic drops to prevent infection, steroid drops to reduce inflammation, or lubricating drops for comfort. Some medications can be used while wearing the lens, while others require specific timing.
- Antibiotic drops to prevent or treat infections
- Lubricating artificial tears for additional moisture
- Anti-inflammatory medications to reduce swelling
- Medications to promote healing in specific conditions
Use steroid drops only if we prescribe them and we are monitoring you. Steroids can worsen infections and are not used if herpetic or fungal disease is suspected. Never use topical anesthetic drops at home. For scleral lenses, avoid ointments while the lens is on the eye, do not place preserved drops in the lens bowl, and separate drops from lens insertion or removal by at least 10 to 15 minutes.
Before recommending medical contact lenses, we typically try simpler treatments when appropriate. Frequent preservative-free artificial tears, ointments, moisture chamber glasses, or punctal plugs may be sufficient for mild to moderate dry eye. For minor abrasions, time and lubrication alone might be enough.
If you have an infection or severe inflammation, we may need to clear that up with medication before fitting a medical lens. We always choose the least invasive effective treatment first and escalate only when necessary.
- Autologous serum tears or platelet-rich plasma tears
- Self-retained amniotic membrane devices for nonhealing defects
- Prescription immunomodulators for dry eye disease
- Lid disease treatment such as warm compresses and lid hygiene
If standard bandage lenses or initial treatments are not providing adequate relief, we may recommend more advanced options. Custom scleral lenses designed specifically for your eye shape may address complex problems that off-the-shelf lenses cannot. These require more detailed fitting and are typically more expensive.
For very severe cases, we might consider prosthetic lenses with special tints to improve appearance or reduce light sensitivity. We discuss all options with you, including the benefits, risks, and costs involved.
Caring for Your Eyes While Wearing Medical Contact Lenses
How you care for your medical contact lenses depends on the type and your specific situation. Some bandage lenses are designed to stay in your eye continuously, and we handle all removal and replacement in the office. Other lenses require daily removal, cleaning, and reinsertion at home.
If you manage your lenses at home, always wash your hands thoroughly with soap and water before touching them. Use only the cleaning solutions we recommend, as some products can damage medical lenses or irritate your healing eye. Follow our instructions exactly to avoid complications.
To reduce complications, follow these rules every time:
- Never expose lenses or cases to tap water, shower water, or saliva.
- Do not top off old solution. Use fresh disinfecting solution every time.
- Rub and rinse lenses as directed, even with no-rub solutions.
- Replace your storage case every 1 to 3 months.
- Do not share lenses or cases.
- For scleral lenses: disinfect daily with the system we prescribe, and fill the lens only with sterile, preservative-free saline vials. Do not use multipurpose solution or tap water in the lens bowl.
- Use the recommended inserter and remover tools, and keep them clean and dry.
All contact lenses carry risks. Your risks are higher with overnight wear, poor hygiene, or active surface disease. Possible problems include the following.
- Infection or corneal ulcer that can threaten vision
- Corneal swelling or hypoxia, especially with extended wear
- Corneal neovascularization with long-term hypoxia
- Sterile corneal infiltrates or contact lens acute red eye
- Allergic or toxic reactions to solutions
- Giant papillary conjunctivitis from lens deposits
- Increased risk if you sleep in lenses or get water in your eyes while wearing them
While wearing a medical contact lens, watch for changes that might indicate a problem. Increased redness, pain, or discharge could signal an infection or other complication. If your vision suddenly becomes blurrier or you see halos around lights, the lens may have shifted or your eye may need evaluation.
- Increasing eye pain or discomfort
- New or worsening redness
- Discharge or crusting around your eye
- Sudden vision changes
- Feeling like something is stuck under the lens
- A new white spot on the clear part of your eye
- Worsening light sensitivity or headache with nausea
While wearing medical contact lenses, we recommend avoiding activities that could expose your eye to bacteria or injury. Swimming in pools, lakes, or hot tubs can introduce harmful organisms. Contact sports or activities with flying debris put your healing eye at risk. Avoid showering while lenses are in, and keep lenses and cases away from all water.
You should also avoid rubbing your eyes, even if they feel itchy. Rubbing can dislodge the lens or damage the healing tissue underneath. If you have discomfort, use the lubricating drops we prescribed instead. If lenses feel dry or foggy, use the lubricating drops we prescribed or contact us for guidance on safe removal and reinsertion.
Some discomfort is normal when you first start wearing a medical contact lens, but it should improve within a day or two. Using preservative-free lubricating drops can help ease minor irritation. If the discomfort persists or worsens, do not try to push through it.
Never use over-the-counter redness-reducing drops without asking us first. These products can mask symptoms of serious problems and may interfere with healing. Contact our office if comfort does not improve or if you have concerns.
If you suspect infection or your symptoms are worsening, remove the lens immediately and contact us. Never use topical anesthetic drops at home.
Follow-Up Care and What Happens Next
Follow-up visit frequency depends on your condition and how well you are healing. For bandage lenses after surgery or injury, we often see you within two to three days, then weekly until the lens is removed. For chronic conditions requiring long-term lens wear, visits may be monthly at first, then every three to six months.
These appointments are crucial for monitoring your progress and catching any problems early. We examine your eye under the microscope, check the lens fit, and make sure the treatment is working as planned.
For bandage lenses protecting a healing injury, removal typically happens once the cornea has sealed and recovered. Simple abrasions usually require a few days, while PRK, recurrent erosions, or nonhealing defects may require longer under close supervision. We will confirm healing during your exam before taking the lens out. Some patients feel immediate relief when the lens comes off, while others may need continued lubrication for a while.
If you are wearing medical lenses for a chronic condition, we may replace them periodically to maintain their effectiveness and hygiene. Scleral lenses generally last six months to two years before needing replacement, depending on wear and care.
Once your medical need resolves, we will discuss your ongoing vision correction options. Some patients return to their previous glasses or regular contact lenses. Others find they no longer need correction, or their prescription has changed due to the healing process.
If you were wearing medical lenses for a chronic condition, you might need to continue with specialty lenses long-term, even after the acute phase passes. We work with you to find the most practical and comfortable solution for your lifestyle.
Certain symptoms warrant urgent attention, even between scheduled appointments. Severe eye pain, especially if it feels sharp or stabbing, needs immediate evaluation. Sudden vision loss, seeing flashes of light, or a curtain coming over your vision are all emergencies.
If any of the following occur, remove your lens immediately and seek urgent eye care.
- Severe or rapidly worsening pain
- Sudden significant vision loss
- Eye discharge that is thick, yellow, or green
- Extreme light sensitivity with headache
- Trauma to the eye while wearing the lens
Frequently Asked Questions
Some medical contact lenses are prescribed for short, supervised continuous wear, such as bandage lenses after surface procedures. Sleeping in lenses increases infection risk and is only done when your doctor specifically instructs you to do so and monitors you closely.
Scleral and rigid gas-permeable lenses are not intended for overnight wear. Unless we have told you otherwise for a short, defined period, remove your lenses before sleep.
Medical contact lenses prescribed for therapeutic purposes are often covered differently than cosmetic vision correction lenses. Many insurance plans, including Medicare, may cover medically necessary lenses when we document the condition properly. We can help you understand your specific coverage and provide the necessary documentation for claims. Coverage varies by plan and diagnosis, and may involve medical benefits for fitting and separate material fees. We can help with preauthorization when needed.
The duration varies with your diagnosis. A bandage lens for a simple corneal abrasion is often needed for only 1 to 3 days. Conditions like PRK recovery, recurrent corneal erosion, severe dry eye, or keratoconus may require longer or ongoing use under close follow-up.
Most patients find that medical contact lenses actually reduce pain rather than cause it. Bandage lenses particularly help relieve the discomfort of corneal injuries by protecting nerve endings from exposure. You may feel slight awareness of the lens initially, but significant pain is not expected and should be reported to us right away.
If your medical contact lens falls out, do not attempt to rinse and reinsert it on your own unless we have specifically taught you to do so. Contact our office immediately for guidance. In many cases, we will ask you to come in so we can examine your eye and replace the lens properly under sterile conditions. If you have been trained to manage your lenses at home, handle them only with clean, dry hands, and use sterile saline for rinsing. Do not use tap water. For scleral lenses, use the inserter as instructed and refill the bowl with preservative-free sterile saline.
We generally recommend avoiding eye makeup while wearing medical contact lenses for healing purposes. Makeup particles can get under the lens, cause irritation, or introduce bacteria to your vulnerable eye. For long-term medical lens wear, we may allow makeup once the eye has stabilized, but you should apply it after inserting lenses and remove it before taking lenses out.
Getting Help for Medical Contact Lenses
If you are experiencing eye pain, vision problems, or have been told you might benefit from medical contact lenses, schedule an appointment with our eye doctor for a thorough evaluation. We will assess your condition, discuss whether therapeutic lenses are appropriate for you, and create a personalized treatment plan. Early intervention often leads to the best outcomes for most eye conditions.