A bandage contact lens — or therapeutic contact lens — is any contact lens used to relieve pain and help protect or heal the cornea and its nearby tissues. Patients usually wear them for a short time until their eye problem improves. However, they can be worn much longer for chronic eye conditions.
Pain control
The cornea is the transparent membrane on the front of the eye. It has more pain receptors than anywhere else in the body. When it is scratched or damaged from a disease, infection, inflammation or surgery, these nerve endings are exposed. They can then be activated by air currents and the eyelid during a blink, resulting in severe discomfort. A bandage contact lens (BCL) covers the exposed nerve endings to help manage pain.
Healing
Healing of the corneal surface requires that epithelium cells move from the edge of the cornea to the damaged part. A BCL allows these cells to move smoothly to their destination without interference from blinks.
Protection
A BCL is a barrier that helps protect the cornea. It keeps the cornea from getting hurt by growths, bumps or foreign bodies on the inside of the eyelid, a misdirected eyelash, or anything else that can cause injury. It also keeps the eye from drying out when the eyelids are injured, are turned out (ectropion) or in (entropion), or do not close completely (lagophthalmos).
Some advanced treatments of the cornea, such as superglue repair of a thin cornea, a corneal lens implant (keratoprosthesis) or fitting a rigid gas permeable medical contact lens, require a BCL for best results.
BCLs can also help keep fluid from leaking out of the eye after cataract or glaucoma surgery or when a corneal ulcer causes a full-thickness break (perforation).
Drug delivery
A new use of BCLs is to supply medication to the eye. Soft contact lenses can be used to release drugs that were soaked into the lens material. In this way, BCLs may be used instead of having to regularly put eyedrops into the eye.
Types of bandage contact lenses
Soft BCLs are selected based on what they will be used for. Most BCLs will stay in the eye overnight and will need to be breathable so that enough oxygen can reach the cornea while the eyes are closed. For other conditions treated with BCLs, it is more important that the lens does not break, fold up or move off the cornea. In these cases, sturdier BCLs are chosen that come in different shapes and sizes.
Rigid gas permeable (RGP) contact lenses are made out of a breathable material that retains its shape even when placed on an irregular cornea. This allows RGP lenses to focus light accurately even when the cornea is scarred or damaged. RGPs are custom-designed by your eye doctor to accurately fit your eyes.
When an RGP lens is required for good vision but is uncomfortable or damages the cornea, there are options that combine a soft and RGP contact lens
BCLs are usually placed on the eye and removed by the doctor. Follow the doctor’s instructions carefully. When the lens is worn overnight, an antibiotic eye drop is often prescribed to reduce the risk of infection. The use of artificial tears or rewetting drops that are approved for use with contact lenses is allowed. For most conditions, if the lens falls out of the eye, this is not an emergency and can be managed by returning to the eye clinic to have a new BCL placed on the eye.
In some cases — such as for dry eye management — the BCL will need to be removed at night and placed on the eye again in the morning. In this case, the clinic that initially fit you with your BCL should provide training on how to insert and remove the lens, as well as how to clean and take care of it.
Just like standard contact lenses, BCLs can lead to side effects or complications. This is especially true if they aren't used correctly. Some people may also be more sensitive to lens materials, solutions or wear. Always follow all of the doctor's instructions for wearing and cleaning your BCL.
Contact lenses can cause:
Eye allergies
Eye infections
Corneal ulcers
Corneal inflammation
Corneal swelling
Blood vessel growth in the cornea
Let your eye doctor know if you experience any symptoms of these side effects, such as:
Blurred vision
Eye pain
Eye redness
Discharge
Teariness
A change in the appearance of the eye (such as a white spot on the cornea)
The risk of a corneal ulcer goes up about fivefold when sleeping in lenses. The use of an antibiotic eye drop while wearing a BCL overnight should reduce the risk of ulcers.
A BCL is a medical device used to provide comfort and to heal and protect the eye. Since complications can arise, you should be seen regularly and follow your eye doctor’s instructions carefully to avoid complications from wearing a BCL.
Soft
Rigid gas permeable
Contact lens combinations
