Tight Lens Syndrome

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KEY POINTS

• Tight lens syndrome is when a soft contact lens fits too tightly and squeezes your cornea. This can put you at risk for a serious infection, sores, permanent scarring, and vision loss.
• Treatment depends on how serious the problem is and what caused it. You may need a wetting solution, a looser-fitting lens, or a different type of lens.

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What is tight lens syndrome?

Tight lens syndrome is when a soft contact lens fits too tightly and starts to stick to your cornea. The cornea is the clear outer layer on the front of your eye. When a contact lens on your eye shrinks, it can squeeze the front of your eye like a suction cup and cause the cornea to swell. Tight lens syndrome can put you at risk for a serious infection that can cause a corneal ulcer, which can cause permanent scarring and vision loss.

What is the cause?

Tight lens syndrome may be caused by contact lenses that are not fitted properly. It is more often caused by lenses that dry out. Soft contact lenses are like sponges. They expand and soften when they absorb moisture. When they dry out, they shrink and harden. Your lenses can dry out for many reasons:

• Your eyes may not produce enough tears to keep them moist.
• Hot, dry, or windy conditions may cause moisture to evaporate from the lenses.
• Soft contacts absorb less moisture over time, so older lenses are more likely to dry out.
• Contact lens solutions may cause dry eyes, especially if you change to a different solution.

What are the symptoms?

Symptoms may include:

• Discomfort
• Redness
• Decreased vision when you wear your lenses, or when you wear glasses right after taking out your contacts

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 hard to remove from your eye.

How is it treated?

Treatment depends on how serious the problem is and what caused it. You may need to 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 take care of myself?

• Wear contact lenses as prescribed by your eye care provider. Do not wear contacts when you sleep.
• Do not put contact lenses in your mouth or use saliva to moisten or clean them. This may increase your risk of eye infection.
• Do not use eye drops or change contact lens solutions without your eye care provider’s approval.
• Follow your treatment plan. Keep all appointments for provider visits or tests.

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.