Therapeutic Contact Lenses (TCL) are frequently used to manage a variety of corneal and ocular surface diseases (OSDs). Indications for TCL include pain relief, enhancing corneal healing, corneal sealing, corneal protection, and drug delivery. Bandaged contact lenses (BCL) provide symptomatic relief for painful corneal disorders, such as bullous keratopathy, epidermolysis bullosa, and epithelial abrasion/erosion. Postoperatively in photorefractive keratectomy or laser epithelial keratoma, BCL also relieves pain. It is often used to improve corneal healing in severe OSDs such as severe dry eye syndrome, Stevens-Johnson syndrome/toxic epidermal necrosis, and gas permeable scleral contact lenses. BCL is used to improve healing after keratoplasty, trabeculectomy, and amnion transplantation. Adhesive BCL with or without adhesive is used to seal small corneal perforations and sometimes as a bridge treatment prior to keratoplasty in larger corneal perforations.
In patients with eyelid conditions such as trichinosis, ptosis, and eyelid scarring, BCL is also effective in forming a mechanical barrier to protect the cornea. A relatively new use of TCL is in ocular drug delivery using TCL to maintain therapeutic concentrations of drugs on the ocular surface. Contraindications to the use of TCL include infectious keratitis, corneal anesthesia, and significant exposure keratopathy with improper eyelid positioning or movement. Complications of TCL include infectious keratitis, corneal hypoxia and related complications, corneal allergy and inflammation, and poor lens fit. Overall, TCL is effective for corneal and OSD treatment, but contraindications and complications should be considered.
Contact lenses play an important role in the therapeutic management of corneal and ocular surface diseases (OSDs). There are two types of contact lenses used for therapeutic purposes: soft lenses and scleral lenses. They exert their therapeutic effect by forming a mechanical barrier between the cornea and the external environment, moisturizing the corneal epithelium, increasing corneal wound healing, and providing pain relief. Therapeutic lenses are used to manage a variety of corneal conditions, including bullous keratopathy, corneal erosion, corneal epithelial defects, and post-surgical conditions such as keratoplasty and post-laser vision correction.
OSD is an umbrella term that encompasses a variety of conditions that affect the surface of the eye. These conditions include dry eye syndrome, blepharitis, meibomian gland dysfunction, and immunological disorders. Current conservative management options for OSD include the use of artificial tears, topical antihistamines, steroids and immunology,1 and therapeutic contact lenses (TCL). The purpose of this review article is to evaluate the indications, contraindications, complications, and fitting principles of contact lenses in corneal and OSD treatment.