When contacts irritate eyelids, most of the time taking them out, cleaning and disinfecting them, and waiting it out for a day or two will cause the eyelid irritation to resolve itself. But sometimes when contacts irritate eyelids, the resulting problems are more serious. There are some different kinds of eyelid irritation. Some of the most common are:
- Corneal irritation
- Corneal ulcer
- Subconjunctival hemorrhage
Blepharitis means inflammation of the eyelid margins, where the eyelashes are located. Symptoms of blepharitis include itching, redness, and irritation of the eyelids, and sometimes a “gritty” sensation. Lubricating drops do little or nothing to relieve blepharitis. The two main types of blepharitis are seborrheic blepharitis and staphylococcal blepharitis. Seborrheic blepharitis is the most common and is generally not caused when contacts irritate eyelids. It usually involves not only the eyelids, but the scalp, eyebrows, and ears.
Staphylococcal blepharitis is a staph infection of the edge of the eyelid. The lashes may mat together, and the patient may feel as if there’s a foreign body in the eye. Doctors may prescribe topical antibiotics for this type of blepharitis, but unfortunately, it usually doesn’t help much. In many cases, recovery is a matter of removing contact lenses and waiting for the infection to pass while practicing daily eyelid hygiene with warm wet compresses and careful removal of debris.
Conjunctivitis can easily result when contacts irritate eyelids. Sometimes called “pinkeye,” conjunctivitis leads to redness, irritation, and excessive watering of the eye. An allergy or infection cause it. Common pus-producing bacteria cause bacterial conjunctivitis. Eyes will be crusty and irritated, and there may be pus discharge. There is usually a definite feeling of there being a foreign object in the eye. Often, bacterial conjunctivitis is dormant for three days before showing up in the eye. It is easily spread on towels and washcloths. It usually resolves itself without treatment, though occasionally antibiotics are used.
Chemical eyelid irritation can also trigger conjunctivitis. This occurs when a person is allergic to the cleaning and storage solutions used in cleaning contact lenses. Giant papillary conjunctivitis is “allergic” conjunctivitis caused by repeated physical irritation of the conjunctiva, which can result when contacts irritate eyelids. The patient must avoid wearing contact lenses until the condition resolves.
Corneal irritation is also known as keratitis. It occurs when the cornea of the eye (the transparent membrane over the iris) develops inflammation. It is usually painful and results in temporary visual impairment. When contacts irritate eyelids, corneal irritation can develop. These cases often involve the buildup of Gram-negative bacteria on the contacts.
Corneal irritation must often be treated with antibiotics, either topical or oral. In severe cases, intravenous antibiotics must be used. Contact lenses must not be used until corneal irritation has had a chance to resolve completely. Anyone with symptoms of corneal irritation should see a doctor.
Sometimes when contacts irritate eyelids, the result is a corneal ulcer. This is an open sore on the cornea. Eyelid irritation may aggravate tiny rips in the corneal surface and cause an infected ulcer to develop. The rips in the cornea may be caused by a scratch or trauma to the eye. Contact lenses on top of one of these tiny rips may allow bacteria to build up, resulting in an ulcer.
Symptoms of a corneal ulcer include eye pain, irritation, and watering, and in some cases a visible white or grayish spot on the cornea. Vision may be blurry, and there may be the pain when looking at bright lights. Cool compresses, meticulous hand and eye hygiene, and over-the-counter pain relievers like acetaminophen (paracetamol) can help with the pain. A doctor may prescribe antibiotics and prescription pain medication. In severe or unremitting cases, the only treatment may be a surgical corneal transplant.
Episcleritis is an inflammation of the episcleral tissue. This tissue lies between the sclera (the white part of the eye) and the conjunctiva. It can result when contacts irritate eyelids. Usually, episcleritis is mild and goes away on its own within 7 to 10 days. It can be recurrent, however. With simple episcleritis, recurrence usually occurs at one to three-month intervals. Stress, hormonal changes, and allergies may be a factor in recurrent episcleritis. Many, if not most people with episcleritis do not seek medical treatment.
Episcleritis isn’t as painful as corneal irritation or ulcers, but there may be annoying discharge and sensitivity to lights. In some cases, episcleritis may be caused by systemic diseases like rheumatoid arthritis or lupus, so in some cases, contact lens-based eyelid irritation may not be to blame. Treatment generally involves eye and hand hygiene and sometimes wetting drops to help relieve discomfort. Prolonged cases may require the use of corticosteroids or dexamethasone sodium phosphate.
Subconjunctival hemorrhage shows up as a bright red patch on the white of the eye. The area has many fragile blood vessels that can easily be broken or ruptured, and this results in blood leaking into the space between the sclera and the conjunctiva (the membrane over the white of the eye). The condition can result when contacts irritate eyelids. Though it looks painful, it usually is not.
A subconjunctival hemorrhage usually heals itself without treatment, though eyelid irritation, when caused by contact lenses, means that contact lenses should be avoided until the condition clears up. Because the condition is not painful, it is not necessary or recommended for patients to take aspirin or NSAIDs (non-steroidal anti-inflammatory drugs). Artificial tears may be used on the affected eye but should not be used more than absolutely necessary because the artificial tears may slow healing. Contacts irritating eyelids can be a temporary discomfort that resolves overnight, or it can be as dangerous as a corneal ulcer, which requires comprehensive medical treatment. Avoiding eyelid irritation from contacts is simple, though occasionally a person can do everything as he or she is supposed to and still have their contacts irritate eyelids.
Anyone handling contact lenses should first wash their hands thoroughly with plain soap and water and dry them with a lint-free towel. Contact lenses must be cleaned and disinfected as directed by an eye doctor. Daily wear contact lenses that are worn for periods over two weeks may require weekly treatment to remove protein deposits on the lenses. In general, the more often lenses are replaced, the less care and handling they require.
Lenses should be handled only with clean hands, and the tips of the bottles of the solutions must never touch any surface. Contact lens cases must be thoroughly washed out with hot water daily and allowed to dry. Anyone using cosmetic or theatrical contact lenses should never share them with another person. This is a recipe for not only eyelid irritation, but also for a painful eye infection.
Contact lenses are great for vision correction, and they can be fun too, with hundreds of types of theatrical, cosmetic, and special effect lenses available. When handled according to directions and cleaned and stored correctly, contact lenses will probably not cause any problems. But mishandling them, or not cleaning or storing them properly, or continuing to use them after the period in which they should have been discarded can easily make contacts irritate eyelids. Eyelid irritation will usually clear up on its own, but if an infection results, medical treatment may be necessary.