Therapeutic Use of Contact Lenses

Contact lenses may be used to enhance epithelial healing, prevent epithelial erosions, or control surface-generated pain. These lenses are sometimes referred to as bandage contact lenses. Typically, a disposable plano soft lens of high oxygen permeability is left on the eye for an extended period. Fitting principles are similar to those of other soft lenses, although for therapeutic use, a somewhat tighter fit maybe be preferable, as lens movement could further injure the healing epithelium. Some fitters prefer high-water-content lenses, but high oxygen permeability is usually the chief factor in lens selection.

Conditions and circumstances in which bandage contact lenses might be useful include

• bullous keratopathy

• recurrent erosions

• Bell palsy, exposure keratopathy

• keratitis, such as filamentary or post–chemical exposure

• corneal dystrophy with erosions

• post-surgery, such as corneal transplant, laser in situ keratomileusis (LASIK), or photorefractive keratectomy (PRK)

• nonhealing epithelial defect, such as geographic herpes keratitis, slow-healing ulcer, or abrasion

• eyelid abnormalities, such as entropion, eyelid lag, or trichiasis

• bleb leak after glaucoma filtration surgery

These patients need to be made especially aware of the signs and symptoms of infection, as the vulnerability to infection is increased by the abnormality of the cornea. Some practitioners prefer to use prophylactic topical antibiotics with these lenses.

Excerpted from BCSC 2020-2021 series : Section 3 - Clinical Optics. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.