Can Restasis Help Dry-Eye Contact Lens Wearers?

Our understanding of how the eyeball uses tears to maintain a moist, protective surface has expanded enormously over the past decade.

Dry eyes exist for a reason. Identify and treat the reason and the dryness will improve. Sounds simple enough, right?

Inadequate wetting is often caused by smoldering inflammation triggered by an underlying condition like rheumatoid arthritis, Sjogren's syndrome, or lupus. We also know that sex hormones play a critical role in tear synthesis - one reason why many menopausal/postmenopausal women experience dry eye discomfort.

Can folks with chronic dry eyes safely wear contact lenses? Years ago the answer was a flat 'No!'. More precisely, the answer was 'No, and don't ask me again!' Now it appears that some dry eye patients can tolerate contact lenses.

You may not know this but the puddle of tears that rests between the backside of the contact lens and the clear cornea serves as the actual focusing system. By itself the contact lens has very little focusing power. The contour of the contact lens shapes the tear puddle to create the desired refractive correction.

Not too long ago I wrote about how the mere presence of the contact lens numbs the corneal nerves. This phenomenon is also a big reason why some contact lens wearers experience dry eyes for the first time.

With any new dry eye patient it is essential that a complete dry eye evaluation be performed to exclude contributory (...and treatable) medical conditions. The specific type of contact lens will also need to be considered. Some brands of contact lenses behave like sponges, absorbing what little moisture remains on the ocular surface, whereas other brands are less thirsty.

Frequent use of preservative-free tear supplements is the mainstay of dry eye therapy. Topical cyclosporine (sold as the prescription eyedrop Restasis) quiets the smoldering inflammation mentioned above and allows the lacrimal glands to produce more abundant tears. Intuitively this sounds like a good solution for contact lens wearers. Sadly, recently published research cautions that Restasis offers no measurable improvement for contact lens wearers compared to only using artificial tears. Why pay more for a prescription eyedrop when an OTC remedy works just as well?

Remember, even if your doctor gives you permission to wear contact lenses, dry eye patients need to frequently apply their tear supplements and immediately remove the contact lens if there is any redness or discomfort.

REFERENCE: Eye & Contact Lens: Science & Clinical Practice, Jan 2008, pages 43-45.

Related Topics:

• WebMD Video: Comfortable Contact Lenses
• WebMD Video: Tips for Better Vision

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