Contact Lenses and Dry Eye: How to Stay Comfortable All Day

Dry eye is the number one reason people stop wearing contact lenses. Studies show that up to 50% of contact lens wearers experience dryness and discomfort — and in a desert climate like Las Vegas, that number is even higher. But contact lens dropout is not inevitable. With the right lens choice, proper care habits, and — when needed — treatment for the underlying dry eye condition, most patients can wear contact lenses comfortably.

Contact lenses sit on the tear film and interact with it continuously. Several mechanisms contribute to contact lens-related dryness:

Tear film disruption. The contact lens divides the tear film into a pre-lens layer and a post-lens layer. The pre-lens layer is thinner and more prone to evaporation than the natural tear film.

Increased evaporation. Contact lenses — particularly soft lenses — absorb water from the tear film to maintain their hydration. In a dry environment like Las Vegas, this water absorption accelerates tear evaporation.

Reduced oxygen transmission. Even with modern high-oxygen lenses, contact lens wear reduces the oxygen available to the cornea, which can affect corneal metabolism and tear film stability.

Mechanical irritation. Lens deposits, edge design, and lens movement can all contribute to ocular surface irritation.

Lens material is the single most important factor in contact lens comfort for dry eye patients.

Modern silicone hydrogel lenses transmit significantly more oxygen than traditional hydrogel lenses and are the standard recommendation for most patients. However, silicone hydrogel lenses can have higher modulus (stiffness) and may cause more mechanical irritation in some patients.

Alcon DAILIES TOTAL1 uses a water gradient design — the lens surface is nearly 100% water, while the core maintains structural integrity. This creates a surface that is exceptionally smooth and lubricious, minimizing friction and evaporation. It is one of the best options for dry eye patients.

Bausch + Lomb ULTRA and similar lenses use phosphorylcholine — a molecule that mimics the phospholipid layer of the tear film — to attract and retain moisture. These lenses maintain hydration well throughout the day.

Daily disposable lenses are generally the best choice for dry eye patients. Fresh lenses every day means no deposit buildup, no cleaning solution interactions, and consistently optimal surface properties. The convenience also encourages better compliance with replacement schedules.

Standard artificial tears with preservatives can irritate the ocular surface with frequent use. Preservative-free artificial tears (in unit-dose vials) are safe to use as often as needed and can be used with contact lenses in place.

Do not use rewetting drops that are not specifically formulated for contact lens use — some artificial tears are not compatible with contact lens materials.

Every 20 minutes of screen use, look at something 20 feet away for 20 seconds. This stimulates blinking and allows the tear film to redistribute across the lens surface.

Air conditioning, airplane cabins, and outdoor wind all accelerate tear evaporation. Consider wearing glasses in these environments, or use preservative-free drops more frequently.

Wearing lenses beyond their replacement schedule allows deposits to accumulate, reducing oxygen transmission and increasing surface friction. Daily disposables eliminate this issue entirely.

If contact lens discomfort is driven by significant meibomian gland dysfunction or aqueous deficiency, treating the underlying condition — with IPL therapy, OptiPlus RF, prescription drops, or other interventions — will improve contact lens comfort more than any lens change alone.

For patients with severe dry eye who want to wear contact lenses, scleral lenses are often the best option. The fluid reservoir between the lens and the cornea provides continuous hydration throughout the wearing period — something no soft lens can match. Many patients with Sjögren's syndrome, severe MGD, or other serious dry eye conditions wear scleral lenses comfortably when no other lens works.

Las Vegas's desert climate — with humidity often below 20% — creates one of the most challenging environments for contact lens wear in the country. At Trendsetter Eyewear, we take this into account when recommending lens materials and care regimens for our patients.

Call (702) 479-5222 or schedule a contact lens consultation at our Summerlin, Las Vegas location. We will find the right lens and care plan to keep you comfortable.