Tight Lens Syndrome

What is tight lens syndrome?

Tight lens syndrome is a group of symptoms that occur when a soft contact lens fits too tightly and starts to stick to the cornea (the clear outer layer on the front of the eye).

Soft contact lenses are like sponges. They are made of stretchy material that absorbs water. Like sponges, soft contacts expand and soften when they absorb moisture. But when they are allowed to dry out, they shrink and harden.

When a lens on your eye shrinks, it can squeeze the front of your eye like a suction cup. This causes discomfort, redness, and even blurring due to swelling of the cornea.

How does it occur?

Your lenses can dry out for various reasons:

• You don't produce enough tears to keep them saturated.
• Hot, dry, or windy conditions may cause moisture to evaporate from the lenses.
• Soft contacts can become less absorbent with time, so older lenses are more likely to dry out.
• Lenses may become less absorbent if they dry out during storage.
• The lens may fit too tightly.

What are the symptoms?

The symptoms are:

• discomfort
• redness
• decreased vision when you wear your lenses

How is it diagnosed?

Your eye care provider will ask about your symptoms and check to see if the lens moves normally on your eye. If the lens doesn't move very much, your provider will suspect tight lens syndrome. Also, a tight contact lens may be difficult to remove from your eye.

How is it treated?

Treatment of tight lens syndrome depends on how serious the problem is and what caused it. All you may need to do is use rewetting drops every so often. The drops add moisture to the lens while it is on your eye.

Sometimes the lens may have to be replaced with one that is not as tight on your eye or one that allows more oxygen to reach your cornea. Sometimes your provider will recommend that you stop wearing contacts for a time or change to a new type of lens that is less dependent on moisture to keep its shape.

How can I prevent problems from tight lens syndrome?

Know the warning signs of tight lens syndrome. If you have any of the symptoms, don't wait. Take your lenses out and have your eye care provider check your eyes right away. Tight lens syndrome can put you at risk for a serious infection called a corneal ulcer, which can cause permanent scarring and vision loss.

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site: http://www.hopkinsmedicine.org/wilmer/

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