Eye pain: when to get help

Why speed matters

Wearing contact lenses carries a risk of serious problems such as eye infections and corneal ulcers, which are open sores on the surface of the cornea. The FDA notes that these conditions can develop very quickly and can be very serious, and in rare cases can cause blindness. It also says plainly that you can’t judge the seriousness of a problem yourself: you need an eye care professional to look.^[1]

Serious problems aren’t common with scleral lenses, but they aren’t impossible. In a study of 157 keratoconus eyes that had worn scleral lenses successfully for at least a year, physiological adverse events were recorded in 9.6% of eyes, including microbial keratitis (a corneal infection) in 0.6%.^[5] Researchers have also described a corneal infection called Acanthamoeba keratitis in scleral lens wearers, and linked the risk to care habits such as storing lenses overnight in saline instead of disinfecting solution, not rubbing lenses during cleaning, and topping off solution in the case.^[6]

The symptoms to watch for

The FDA lists these as symptoms of eye irritation or infection: discomfort, excess tearing or other discharge, unusual sensitivity to light, itching, burning, or gritty feelings, unusual redness, blurred vision, swelling, and pain.^[1] Some of these, like mild grittiness late in the day, can have everyday causes. But if any of them is new, getting worse, or comes with pain, treat it as urgent.

What to do with the lens

The FDA’s instructions are specific:^[1]

1. Remove your lenses right away and don’t put them back in.
2. Contact your eye care professional right away.
3. Don’t throw the lenses away. Store them in their case and take them with you. Your eye doctor may use them to find the cause of your symptoms.

If the lens won’t come out after a few gentle tries with drops and the plunger on the lower third, stop and get help rather than forcing it. A lens can’t get lost behind your eye: the membrane that lines your eyelids folds back over the white of the eye, closing off the space behind it.^[7] See stuck lens for the steps.

Who to call, in order

1. Your fitter or the eye doctor who manages your lenses. They know your eyes and your lenses. Save their after-hours number in your phone now, before you need it.
2. Another eye doctor’s office if yours isn’t reachable. Ask whether they can see you today.
3. Urgent care or an emergency room if you can’t reach an eye care professional and you have warning signs. Tell staff right away that you wear scleral lenses, and bring your lens case, your solutions, and your glasses.

When you call, describe what you feel, which eye, when it started, and anything unusual: a nap in your lenses, water exposure, a new product, or a dropped lens you reinserted.

Burning right after insertion

Stinging or burning the moment a lens goes in can mean something other than saline got into the lens. If you use a hydrogen peroxide system, peroxide that hasn’t fully neutralized can cause stinging, burning, irritation, or eye damage.^[3] Remove the lens straight away. If the burning doesn’t stop once the lens is out, call your eye doctor today.

Lower your risk day to day

• Wash your hands before handling your lenses.^[2]
• Keep water away from your lenses and case: tap, bottled, distilled, lake, or ocean water.^[1]
• Rub and rinse your lenses as directed, use fresh solution every night, and don’t top off.^[1]
• Replace your case every three months, or as your eye care professional directs.^[1]
• Don’t sleep in your lenses unless your eye doctor has specifically told you to. The FDA warns that sleeping in daily wear lenses may increase your chance of infection or irritation.^[4]

For the full routine, see the daily routine.