The history of the contact lens is a long, strange, and mostly uncomfortable one, with original lenses composed of hard glass that could only be worn for a few hours at a time.
Fortunately, we’ve come a long way since then, and with the recent development of silicone hydrogel, contacts have become more thin and breathable than ever before, allowing for extended periods of wear- sometimes up to a month straight!
It’s this huge leap in convenience that makes extended wear lens so popular. In fact, I used to wear mine for two to three weeks at a time, myself.
But just because a lens has been approved for continuous wear, doesn’t mean it’s completely safe to do so.
In this article, we’ll explore the risks associated with overnight wear, the benefits of
taking them out at night, and the implementation of healthy alternatives.
Which brings us to our first point:
1. Sleeping with Contacts Reduces the Flow of Oxygen
Even if your contacts say you can leave them in overnight, there’s always a risk of infection.
Research by the American Association of Opthalmology has shown that those who use extended-wear lenses increase their likelihood of developing Ulcerative Keratitis (a potentially blinding form of inflammation) at a rate 10-15 times that of their daily lens counterparts.
This is due to the construction of the cornea.
In order to remain transparent, the cornea has no blood vessels or blood flow, so it relies on getting its oxygen straight from the air.
Unfortunately, contact lenses reduce this flow of oxygen. And when paired with closed, sleeping eyelids, your corneas are further cut off from the oxygen they need.
When starved of oxygen, cells within the eye swell and create gaps for bacteria to sneak into, resulting in inflammations such as the aforementioned Ulcerative Keratitis.
But that’s not all…
Lack of oxygen can also cause:
Abnormal Blood Vessel Growth (Corneal Neovascularization)
Like a branches growing toward a light source, blood vessels from surrounding tissues in the eye can grow over the cornea in an attempt to provide oxygen to starved corneal tissue.
This condition can interfere with vision. It is also one of permanence as there is no way to remove these blood vessels once they are created. When it comes to Corneal Neovascularization, “prevention” is the operative word.
Sleeping with contacts also puts your eyes at risk for cell damage.
This is because cells at the surface of the Cornea, i.e., Epithelial Cells, are extremely sensitive to low oxygen levels. Over time, these cells react by swelling and subsequently loosening their attachment to the cornea.
When this occurs, the protective surface layer of the cornea is compromised, allowing for bacteria to sneak in and bind to the cells, causing infection.
Due to their loosened attachment to the cornea, swollen Epithelial Cells can also fall away completely, putting the eye at risk for abrasions and ulcers.
2. Contacts Need Regular Cleaning
A contact lens placed over the eye is essentially a closed system, with very little matter exchanged with the outside world. Any microbes or bacteria that were on the contact to begin with are now safely protected within their hydrogel dome, immune to the eye’s best defense mechanism- the blink.
When your contacts are slept in and not changed or cleaned regularly, these microbes are given a chance to settle in and wreak serious havoc.
One such microbe is so detrimental to the irresponsible contact wearer, that it even has a disease named after it:
Amoeba are tiny microbes that live in virtually every source of water including tap. When your contacts are slept in and not changed regularly, the parasitic amoeba is given free reign to flourish and breed on and in the cornea.
Acanthamoeba Keratitis is nearly exclusive to contact wearers, particularly those with poor lens hygiene. In fact, in a 2012 study by the journal of Opthalmology, it was determined that the risk for the disease increased 6.5 times with even occasional overnight lens use.
Effects of this parasitic infection include permanent visual impairment/blindness as the amoeba can and will burrow down into the cornea itself. Once burrowed, the amoeba create a double-walled cyst that further disrupts healthy function of the eye.
Not surprisingly, symptoms of the disease also include extreme pain.
3. Sleeping in Contacts Puts Increases the Risk of Corneal Abrasions
During my days as an overnight contact wearer, I noticed that whenever I’d trade my contacts for glasses, there was a distinct feeling as though a piece of sand or grit was rubbing against my eye whenever I blinked.
Of course, I didn’t make the connection at the time that this was in any way related to sleeping in my contacts, but it did cause me to schedule an appointment with an eye doctor who was able to make such a connection.
During the check-up, my doctor was able to determine that the mysterious grain of sand was not a grain of sand at all, but a corneal abrasion resulting from dried contact lenses rubbing against my cornea.
And although corneal abrasions can be caused by a number of things such as poking the eye with a fingernail or actually getting sand in your eye, one of the most common causes of the injury is that of the overdried, slept-in contact rubbing against the eye.
Though common, the corneal abrasion is not a condition to be taken lightly.
When paired with contacts, corneal abrasions must be treated with care as they increase the risk of infection in the eye.
As previously stated, bacteria love to take advantage of weaknesses in your eyes’ immune system, and the sheltered ravine of a micro-abrasion is a great place for a wayward amoeba to start a family.
Though you most small abrasions clear up within a short time (1-3 days), sleeping with contacts in during this period is highly discouraged.
Benefits of Sleeping “Naked”
Ultimately, my decision to stop using extended-wear lenses came down to two factors: finding a stylish pair of glasses that I couldn’t pass up, and my refusal to endure another morning of dry, irritating contacts.
And the results were immediate:
1. No More Morning Discomfort
If there is a better reason not to get out of bed in the morning than irritation caused by the simple act of opening the eyes, then I have not discovered it.
A former weekly contact wearer myself, my initial love of overnight contacts’ convenience was quickly overshadowed by the pain and frustration of a lens that had migrated, reformed, and dried throughout the night.
Rushing to the bathroom to douse my eyes in solution became my morning routine, with irritation and redness accompanying me over the course of my morning commute.
Squinting in pain during morning rush hour is no way to live.
Fortunately, the solution was simple: soak the contacts in solution overnight.
In addition to cleaning the lenses of impurities, soaking them in solution at night keeps allows them to maintain proper form, meaning they take less time to adjust when put in for the day.
During sleep, contacts have a tendency to drift along the eye and reform to the area upon which it settles. When readjusted in the morning, the lens takes time to resettle into its proper form. This process tends to be painful and irritating.
And speaking of painful and irritating things that can be prevented with nightly contact soaking.. .
2. Clearer Eyes
Sometimes referred to as CLARE, Contact Lens Acute Red Eye is a general description of inflammation and reddening in the outer surface of the eye caused by a build-up of protein, bacteria, and all other mixtures of foreign entities that can be built up within the contact lens.
It’s also virtually exclusive to those who sleep in their contacts.
Sleeping in contacts for so long had made me blind to the continual ring of redness around the edges of my eyes, and in the first week of my transition to dailies, I was blown away by how clear my eyes could and should always be.
However, even now, when working late nights or staying out too late with friends, I’ll come home and collapse on the couch without taking my contacts out. And as long as it doesn’t become a habit, it’s not going to irreparably damage your eyes.
Still, a little damage control never hurt anyone…
What to do if you Forget to Remove your Lenses.
It happens to the best of us- the steady drone of a Netflix documentary has somehow convinced you that the couch is a bed. And before you know it, you’re sleeping with your lenses in.
Don’t worry, it’s not the end of the world. However, there’s a good chance the lens will have moved in the night.
Here’s what you can do to minimize the damage of locating the lens:
1. Hydrate the Eye
When the contact is dry, vision is blurred, making it hard to tell whether or not the contact is still in place. Adding saline solution or contact-friendly eye drops such as “Clear Eyes” or “Opti-Free” will help to loosen the lens, making it easier to remove safely.
2. Locate the Contact
After washing your hands, lift the eyelid and check in the mirror to see whether or not the contact has migrated. If your vision is still blurry, then it may have either moved from the center of the eye, or fallen out during sleep.
Common hiding spots for the wayward contact include the corners of the eye and upper eyelid.
3. Remove the Lens
An easy way to remove a lens that has drifted is to first move the lens over to the center of the eye. If the lens is stuck to the side of your eye, try sliding it over to the center by looking in the opposite direction.
If the lens has moved to the upper portion of the eyelid, you can slide the lens down toward the center by using a downward rubbing motion with the back of the thumb against your closed eyelid.
Once centered against the eye, or at least visible, you should be able to pinch and remove the moistened lens..
4. Know When to Call the Doctor
If the lens is still in your eye but too far back or to the side, don’t be afraid to call the doctor.
Speaking from personal experience, your doctor will be able to locate the lens by applying a dye to the eye. Then, by using tools for just such purpose, they can remove the lens without incident, a result not promised by the average person attempting to extract a foreign body from the distant recesses of their own eyeball.
Still sleeping with contacts? Why or why not? Share your experience with extended-wear lenses in the comments section below!