"Allergic" to Contacts

"Allergic" to contact lenses
Patients tell me this all the time...that they switched to/from some contact lens brand and they were "allergic" to it.

Highly unlikely. Very possible to be "allergic" to a chemical-based contact lens solution, and also certainly possible to have an inflammatory event associated with the design, fit or stiffness of a particular contact lens (silicone hydrogel lenses are notorious for causing "GPC" b/c of their stiffness or high modulus), but I would consider it to be exceedingly rare (impossible?) for someone to actually have a true medical "allergy" or adverse reaction to a contact lens MATERIAL.

I guess I probably can't say that its IMPOSSIBLE, but I know all about contact lenses and I have never, not one time heard any medical professional say anything about contact lens material allergy, nor have I ever read anything about it. When contact-lens-associated inflammatory events are mentioned in the journals, they are ALWAYS attributed to either contact lens SOLUTION allergy, or an inflammatory event like GPC that is from mechanical lid interaction or "rubbing". Thats not being "allergic" to the material. This may sound like splitting hairs, but there is a big difference in both the mechanism and treatment of a IG-E antigen based type-1 or type-4 hypersensitivity reaction (true medical allergy) vs a mechanical rubbing that causes an ocular inflammation.

Almost no one is "allergic" to a contact lens or contact lens material.


  1. I got punctal plugs in a few days ago. Since getting the plugs, my contacts burn when I put them in then slowly the burn goes away, but leaves my eyes a but red.

    I use Biotrue and have used it before the plugs and didn't experience this burn. Does this make sense or is it just a coincidence? Are all contact solutions with preservatives essentially the same or should I be looking for one that doesn't burn?

    By the way, I have tried preservative free and those burn too (even after waiting for the proper amount of time).

  2. I think it's probably coincidence that it burns now. I any come up with any great reason why punctual plus could/would cause burning with contact lens insertion.

    Yes you hold be searching for a contact lens solution that does not burn. They shouldn't burn. Theyre not all the same - they're all slightly different. Try some til you find one that doesn't burn

    If "preservative free" artificial tears "burn", that's just bc your cornea is desiccated. That's a symptom of true, clinically dry eye. It's your EYE that is the problem, not the preservative free artificial tears...although you probably already knew that, since you've had medical intervention for dry eye (plugs)

  3. is there any recommended treatment for an inflammatory event like GPC? I've worn contacts for 57 years, and 4 months ago got new ones I wear once a week for a few hours, during which burning and scratching feelings build up. I wore a single lens for 8 hours on Sunday, and my lid is very swollen but the eye looks fine, so it sounds like GPC.

    1. yes. steroids, aka "anti-inflammatory". prescription only.


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