For many people with farsightedness, nearsightedness, astigmatism and other common refractive errors, wearing contact lenses or glasses represents an opportunity for relatively inexpensive temporary vision correction.

There are some advantages of wearing contacts over wearing glasses, including a glasses-free appearance and ability to stay active. While contact lenses aren’t as carefree as long-term vision correction through LASIK, they offer reasonably good temporary vision correction short term.

But most people who wear contacts eventually run into issues. They may use their trusted brand for many years successfully, and then BOOM! Suddenly, their eye begins showing signs that it’s reacting poorly to contact lenses.

It’s called contact lens intolerance (CLI), and this overlooked issue can be a real problem with alarming consequences. In this article we’ll explore contact lens intolerance, including symptoms, causes, treatment options and alternative procedures such as LASIK and other vision correction options.

What is contact lens intolerance (CLI)?

There are an estimated 41 million contact lens wearers in the United States and most of them have experienced contact lens intolerance (CLI) at one time or another.

Symptoms of CLI typically come about as a side effect of prolonged contact lens wear or overwear. Essentially, the eyes begin to show signs of rejection to contact lenses as a foreign body, causing redness, pain and other symptoms.

What are the symptoms of Contact Lens Intolerance?

With contact lens intolerance (CLI), contact lens wearers may find they can no longer apply or wear contact lenses for any length of time without pain. Mild symptoms include dry eye syndrome, burning, stinging or grittiness. In serious cases, CLI can result in infections, or even corneal abrasions and ulcers.

Typical symptoms can include:

  • Dry eyes
  • Redness
  • Itchy, irritated eyes
  • Eye pain
  • Stinging eyes with contact lens insertion
  • Excessive tearing
  • Inflammation
  • Corneal ulcers
  • Corneal abrasions
  • Foreign body sensation

Since many eye conditions can exhibit similar signs, never assume that CLI is causing your symptoms. Always consult an eye doctor for an accurate diagnosis and effective treatment options to find relief.

If contact lens intolerance becomes a recurring problem that decreases the amount of time you can tolerate contact lenses, or prevents you from wearing contact lenses altogether, switch back to glasses and make an appointment with an eye care professional. An eye doctor can give you recommendations to keep eyes comfortable.

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What causes CLI?

Contact lens intolerance is generally related to a developed allergy to either the lens material or the cleaning solution. Most often, this occurs with long term wear, but can also result from poor contact lens hygiene, excessive contact lens time in the eye, or deposits on the contact lens.

If you’ve been wearing contact lenses for years or have ever been lax on following your eye doctor’s care instructions and are now experiencing discomfort, it could be symptoms of CLI.

What complications can result from contact lens wear?

Contact lens intolerance (CLI) is just one complication that can occur when contact lenses are worn for an extended time. Other potential contact lens complications include giant papillary conjunctivitis, eyelid drooping, visual distortion, corneal ulcers, infections and more.

Giant papillary conjunctivitis (GPC) is an uncomfortable condition in which small bumps called papillae form under the eyelid, usually the result of an allergic reaction to the contact lenses themselves.

Wearing contact lenses for a long time can eventually lead to corneal distortion, an alteration of the shape of the cornea that can temporarily affect vision, as well as corneal ulcers, or sores. These sores are painful and can lead to scarring which can permanently decrease vision. Overwear of contact lenses puts contact lens wearers at heightened risk of all these conditions.

Treatment of contact lens complications may include: antibiotics, corticosteroid eye drops, allergy eye drops, discontinuing contact lens wear in favor of prescription glasses, or even surgery. Patients who are candidates for laser eye surgery such as LASIK may wish to consider making an appointment with a trusted laser eye institute to explore eye care options. LASIK can keep most patients completely out of glasses and contacts to eliminate CLI symptoms entirely.

Why can’t my eyes tolerate contacts?

Many contact lens wearers develop lens intolerance after long-term use, often due to a buildup of proteins or other contaminants on the lens. This, in turn, stimulates an immune response in the eye every time the contact lens is put in place.

Lens intolerance is common, due to the unique characteristics and anatomy of the eye. The cornea is the only part of the human body that takes oxygen directly from the air, rather than indirectly via the lungs. Wearing contacts places a barrier between that oxygen and the surface of the eye. For this reason, contacts are usually designed to allow oxygen to permeate the lens, but an accumulation of bacteria, oils, dirt and more can block oxygen from reaching the cornea.

It’s important to note that because there are many root causes of CLI, one should seek medical attention for proper diagnosis and treatment. Remove your contact lenses immediately and take them with you to your appointment to aid your eye doctor in the diagnosis.

Can you develop an intolerance to contacts?

Anyone can develop contact lens intolerance, or CLI. In fact, most of the 41 million-plus people wearing contacts in the U.S. today have or will experience it at some point. One of the greatest risk factors for CLI is poor lens hygiene.

Unfortunately, risky contact lens behaviors are more common than most patients would like to admit. According to a survey conducted by the Centers for Disease Control and Prevention (CDC), approximately 50 percent of contact lens wearers report not complying with their eye doctor’s contact lens care instructions. What’s more, most contact lens wearers reported at least one habit that would be considered poor contact lens hygiene.

Examples of poor lens hygiene

  • Topping off cleaning solution rather than allowing the case to fully dry and replacing the solution.
  • Storing or rinsing lenses in tap water
  • Showering or swimming in contact lenses
  • Wearing lenses longer than recommended
  • Napping or sleeping overnight in contact lenses
  • Wearing damaged or potentially contaminated contact lenses
  • Improper handwashing – or no handwashing – before insertion or removal
  • Not replacing a contact lens case as recommended

Contact lens wearers suffering redness, dry eyes, excessive or absent tear flow or other discomfort should consider alternative options for vision correction like glasses. Many patients find relief through surgical vision correction.

Why are my contacts bugging me?

In most cases, discomfort from contact lenses is caused by poor contact lens hygiene: overwear, improper cleaning and storage, swimming/showering with contacts in, worn or damaged lenses and more. However, underlying health conditions, dryness, and contact lens intolerance can also spur discomfort.

Can your eyes start to reject contacts? 

Introducing a foreign material to the eye like a contact lens is not without some risk. In addition to contact lens intolerance, long term wear of contact lenses can raise risk factors for eye infections, abrasions to the cornea and more.

Usually, an eye care professional can treat their patients’ CLI symptoms so they can resume wearing contact lenses. However, in situations where symptoms recur despite trialing other contact lens brands or cleaning solutions, some patients may need to switch back to wearing glasses or seek a more permanent solution from a laser eye institute, like LASIK, if they aren’t willing to return to full time glasses wear.

Why is my eye irritated after taking off contacts?

There could be multiple reasons for irritation after contact lens removal, including worn, damaged or poorly fitted lenses, or improper technique during removal. Eye irritation can also happen when the eye becomes overly accustomed to the environment under the lens.

Your contact lenses create their own little ecosystem of sorts, one that is somewhat isolated from the outside atmosphere. In a perfect world, a contact wearer will always have a fresh, clean pair of contacts in place, which allows oxygen to permeate the lens as designed.

Sometimes, though, contacts may lose oxygen permeability and your eyes can adapt to a slightly altered environment under the lens. Once you remove the lenses, your eyes are exposed more directly to the conditions in the surrounding atmosphere, and you may experience short-term irritation as your eyes re-adapt to the natural air. Many patients report a foreign body sensation for a while as their eyes adjust.

Can you be allergic to soft contact lenses? 

It is not uncommon to have, or later develop, an allergy or intolerance to one or more of the components of contact lenses. You may experience redness, a gritty sensation and dry eye, or conversely, your eyes tear excessively.

Contact lens wearers can also be allergic to contact lens cleaning solution. If you experience eye irritation of any kind, it’s important to see an eye doctor for a proper diagnosis so the true cause of this discomfort can be identified and treated.

In the event that a patient cannot identify and resolve symptoms of CLI, it may be time to give them up for good and return to wearing glasses. Alternatively, a patient can consider permanent vision correction such as LASIK, or the range of possible vision correcting surgeries allowed by modern technology.

How do you stop contact irritation?

The most reliable way to stop irritation from contact lenses is to stop it from occurring in the first place. Follow your eye doctor’s instructions for contact lens use, lens cleaning and proper lens hygiene to prevent contamination or wear and tear that can irritate or damage your eyes.

For mild irritation, try soothing artificial tears recommended by your eye doctor, or ask about treatment that could help your eyes produce their own quality tears. If you experience prolonged or worsening irritation, pain or vision disturbances, seek medical care. These symptoms could indicate a dangerous infection or injury that could damage your vision permanently. Remember, red, irritated eyes, ongoing dry eye, pain and swelling are not normal and shouldn’t be ignored.

Are there other contact lens options that can reduce CLI?

Besides LASIK, there is a refractive vision correction procedure that uses a contact lens that is inserted under the cornea rather than manually placing it on top of your cornea daily. This procedure is called EVO ICL (also called EVO Visian ICL, or simply Visian ICL, as it was previously called). ICL stands for Implantable Collamer Lens (ICL). The ICL is a thin clear lens surgically implanted into the eye as a long-term solution for short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism. This eliminates the reaction of the contact lens on the surface of the cornea and interaction with the eyelid. Learn more about ICL here.

Brinton Vision offers ICL procedures as well as LASIK and other alternative refractive vision correction procedures. The doctors at Brinton Vision would be happy to do an evaluation and recommend the best procedure for your vision needs.

Seek a Permanent CLI Solution at Brinton Vision

Get in touch with the care team at Brinton Vision for a thorough eye evaluation to find out if you have developed CLI. Our team will work with you on alternative vision correction options such as LASIK laser eye surgery that can help you achieve clear vision without the discomfort of contacts and glasses.

If you’re considering LASIK, take a moment for a quick self-test to see if you might be a candidate for LASIK or one of the six other laser vision correction procedures we offer.

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