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This page is for people with severe dry eye with damage to the cornea, strong pain on the surface of the eye, or a corneal wound that is struggling to heal. Here you will find what a bandage contact lens is, who it may suit, how it is fitted and what is important to know about follow-up and risks.
What a bandage contact lens is
A bandage contact lens, also called a therapeutic contact lens, is a soft contact lens placed on the cornea (the clear layer at the front of the eye) to protect it, not to correct vision. The lens is usually made of silicone hydrogel, a material that lets a lot of oxygen through to the cornea. The lens separates the eyelid from the damaged eye surface, so that each blink does not rub it. This may ease the pain and give the top layer of the cornea time to heal.
Who the lens may suit, and who it may not
A bandage lens may be suitable in conditions such as:
- A wound in the surface layer of the cornea (the epithelium) that does not heal, or that keeps reopening (recurrent corneal erosion).
- Severe dry eye with damage to the eye surface, for example in Sjögren's syndrome or after a bone marrow transplant.
- Filamentary keratitis, a condition in which small strands of cells and mucus form on the cornea and cause pain.
- Strong pain on the surface of the eye caused by exposure of the eye surface or by the eyelid rubbing against it.
The lens may not be suitable when there is an active eye infection, severe untreated eyelid inflammation, or when it is not possible to attend close follow-up visits. It is important that you can follow the instructions and get in touch quickly if something changes.
Before you start
- Make sure you can attend follow-up visits on time. This is part of the treatment, not an extra.
- Tell us if you wear ordinary contact lenses, and if you have had eye infections in the past.
- Tell us about conditions that weaken the immune system, diabetes and medicines you take, because they may affect the risk of infection.
- Ask what to do and whom to contact if a problem appears outside working hours.
How the lens is fitted at the clinic, step by step
- Examination. The condition of the cornea and eyelids is examined with a slit lamp, as part of dry eye testing.
- Choosing a lens. A lens of a size and curvature that suit your eye is chosen.
- Placing the lens. The lens is placed on the eye. Numbing drops are sometimes put in first, especially when there is pain.
- Checking the fit. We check that the lens is centred, moves slightly with blinking and does not press on the eye.
- Instructions and drops. You receive an explanation of the rules of use. Additional drops are often prescribed, such as preservative-free lubricating drops, and if needed also drops to prevent infection.
- Follow-up. You come back for regular visits. At these visits healing is checked, and it is decided when to replace the lens and when to remove it. This is done at the clinic.
What it feels like, and rules of use
Many people feel pain relief a short time after the lens is placed. At first you may be aware of the lens or have a mild foreign-body sensation. Vision may be slightly blurred, mainly because of the condition of the cornea itself.
General rules, which the doctor will adapt for you:
- Do not remove the lens yourself, unless you have been instructed to.
- Sleep with the lens in only if the doctor has told you to.
- Do not swim or get into a hot tub, and avoid water directly in the eye, because water may carry bacteria to the lens.
- Do not rub your eye, and do not use drops that were not prescribed for you without asking first, because some drops are not suitable for use with a lens.
- Use the drops prescribed for you carefully and attend all follow-up visits.
Possible side effects and risks
- Corneal infection (infectious keratitis): this is the most important risk. A lens that stays on a damaged eye increases the risk of infection, which may be serious and harm vision. This is the reason for close follow-up.
- The lens falling out or moving.
- A lens that is too tight, which may cause redness and pain.
- Deposits on the lens and discomfort, especially in a very dry eye.
When to see a doctor straight away: pain that gets worse instead of better, marked redness, discharge, strong sensitivity to light, reduced vision, or a white spot visible on the eye. If you cannot get to the clinic, go to an eye emergency department.
When the lens is removed
The lens is removed when the eye surface has healed enough, when it is no longer helping, or when there is a sign of a problem such as infection or a lens that is too tight. Removal is usually done at the clinic, after which the cornea is examined again. In some patients, for example with recurrent corneal erosion or very severe dryness, it may be necessary to go back to a lens in the future. Even then, every period of lens use is done under supervision and follow-up, exactly as the first time. Do not use a lens left over from a previous treatment without a new examination and instructions.
After removal it is important to continue treatment that prevents the problem from coming back, such as lubricating drops, a night-time ointment if prescribed, and treatment of the cause of the dryness.
How the lens fits with other treatments
A bandage lens is usually a solution for a limited period, until the eye surface heals. It is combined with treatments that address the cause of the dryness. In severe dry eye, it is sometimes combined with autologous serum eye drops, which may help the cornea heal, and with punctal plugs, which keep more tears on the eye.
Cost
The cost is set and discussed at the consultation, according to the treatment that suits you.
Want a basic explanation first?For basic information on contact lenses and dry eye: the guide on the Mitzmutz site
Frequently asked questions
Is this the same as an ordinary contact lens?
It is similar to an ordinary soft lens, but it is specially chosen to let a lot of oxygen through to the cornea and to suit the treatment. It is not intended to correct vision, and it is used only under a doctor's supervision.
How long does the lens stay in the eye?
It depends on the reason for the treatment and on how quickly the eye heals. The doctor will decide at follow-up visits how long to leave the lens in, when to replace it and when to remove it.
Can I sleep with the lens in?
A bandage lens sometimes stays in the eye during sleep as well, but only if the doctor has told you to. Follow only the instructions you have been given.
What should I do if the lens falls out?
Do not put it back in your eye yourself. Contact the clinic for instructions, and in the meantime continue the drops prescribed for you.
Home care not enough? We can look into it.
At the dry eye clinic in Haifa we find out what is causing the dryness and build a personal treatment plan.
Sources
- Shah C, Raj CV, Foulks GN. The evolution in therapeutic contact lenses. Ophthalmol Clin North Am. 2003;16(1):95-101.
- Jones L, Downie LE, Korb D, et al. TFOS DEWS II Management and Therapy Report. Ocul Surf. 2017;15(3):575-628.
- Akpek EK, Amescua G, Farid M, et al. Dry Eye Syndrome Preferred Practice Pattern®. Ophthalmology. 2019;126(1):P286-P334.
- Gomes JAP, Azar DT, Baudouin C, et al. TFOS DEWS II iatrogenic report. Ocul Surf. 2017;15(3):511-538.
The information on this site is general only. It is not medical advice and does not replace an examination by an eye doctor.