Are You a Candidate for Soft Bandage Lenses for Dry Eye?

Sometimes dry eye disease becomes so severe that prescription eye drops and lifestyle changes don’t alleviate the symptoms. For some people, therapeutic contact lenses may be the next step in treatment, providing a targeted approach to protecting and healing the corneal surface.

Dry Eye Symptoms and Complications

Common symptoms include:

• Burning or stinging
• Blurred vision, especially when reading
• A scratchy or gritty feeling like something is in your eye
• Strings of mucus in or around the eyes
• Redness
• Difficulty wearing contact lenses
• Excessive tears
• Sensitivity to light

What Is a Soft Bandage Lens?

“Bandage lenses are just what they sound like. They create a covering for a scratch just as a Band-Aid would, helping protect the open wound from infection and reabrasion while the cornea heals,” says Viola Kanevsky, a doctor of optometry based in New York City and a spokesperson for the American Optometric Association.

They’re a “cushion to protect the healing cornea from the abrasive effects of the eyelid,” Kanevsky says.

This barrier helps reduce irritation caused by blinking, airflow, and environmental exposures like pollution or smoke, and provides a “scaffold” for eyes to recover, says Anat Galor, MD, a spokesperson for the American Academy of Ophthalmology and an ophthalmologist at the University of Miami in Florida. “In many patients, this protective effect can lessen pain and improve comfort by shielding exposed or irritated corneal nerves,” Dr. Galor says.

They’re also used alongside eye drops, Galor says. “When patients use eye drops while wearing a bandage contact lens, the lens may help retain medication on the ocular surface longer, potentially prolonging its effect,” she says.

Are You a Candidate for Soft Bandage Lenses?

Soft bandage lenses are usually reserved for severe or complicated cases of damage to the cornea.

• Corneal abrasions
• Corneal erosions
• Corneal diseases, such as bullous keratopathy
• Postsurgical corneal healing
• Conditions like Stevens-Johnson syndrome (a rare, severe, adverse drug reaction that affects the skin and mucous membranes)
• Severe dry eye

They’re more commonly used for corneal abrasions; postoperatively, including after corneal transplant; and when the surface of the eye needs to be protected, Galor says.

They aren’t commonly used for dry eye, though, according to Nicole Bajic, MD, an ophthalmologist at the Cole Eye Institute at Cleveland Clinic in Ohio. “It’s not something I would recommend routinely. It’s in very select cases in which the drops are not providing adequate relief,” Dr. Bajic says.

Another instance is if the epithelium (the surface of the cornea) has become damaged, injured, or broken down from scratches, erosions, or poor healing, and is causing severe dry eye symptoms like stinging, sharp pain, or the feeling that something is stuck in the eye, Galor says.

Kanevsky uses bandage contact lenses more frequently for conditions like recurrent erosions and abrasions, especially in children and older adults because they can reduce pain while allowing the cornea to heal.

“Sometimes I will use them when the dry eye has caused an erosion or abrasion, but this is a short-term solution,” she says.

What It’s Like to Wear Bandage Contact Lenses

In many ways, wearing a bandage contact lens feels like wearing a regular soft contact lens.

“In general, bandage contact lenses are fairly comfortable and often feel similar to regular soft contact lenses,” says Galor. “Many patients notice improved comfort because the lens protects the corneal surface and reduces friction from blinking.”

However, unlike standard contact lenses, bandage lenses are left in place overnight instead of being removed.

Kanevsky usually places and removes the lenses herself, rather than having patients handle them at home. “I do not allow patients to handle their own bandage lenses unless it’s an emergency,” she says.

People with bandage lenses need follow-up appointments so their eye doctor can monitor healing and check for complications. The replacement schedule depends on the condition being treated and how the eye is responding, Galor says.

How long the lenses stay in place varies depending on why they’re being used. Minor scratches in the eye may heal within days, while chronic conditions may require much longer use.

“For uncomplicated corneal abrasions or routine postoperative healing, bandage contact lenses are often only needed for several days to about one week,” Galor says. In more chronic or severe conditions, such as neurotrophic keratopathy, they could be worn much longer, Galor says.

“I may leave a lens in place for up to one month in these situations before exchanging it. Ultimately, the lens is worn as long as needed to support healing while balancing the risk of complications, such as infection,” she says.

After the Cornea Has Healed

Bandage contact lenses are generally not considered a long-term treatment for severe dry eye disease and most other conditions.

People may also encounter lens-related surface problems, Galor says. “Over time, deposits and buildup can accumulate on the lens surface, which may affect comfort or vision and sometimes requires more frequent lens exchange,” she says.

The Takeaway

• Soft bandage contact lenses are a type of therapeutic soft lenses designed to protect the cornea, reduce friction from blinking, and support healing of the eye’s surface in cases like corneal abrasions, erosions, and postsurgical healing.
• They feel similar to regular soft contact lenses but are worn continuously, including overnight, for days or weeks at a time, and are inserted, monitored, and removed by your eye doctor.
• Because long-term wear can increase the risk of infection and other complications, doctors usually transition patients to treatments that address the underlying cause of dry eye once the cornea has healed.