Upper eyelid tissue may play key role in rigid contact lens discomfort

Early discomfort from rigid contact lenses is most likely caused by interactions between the lens and the upper eyelid, rather than the cornea or lower eyelid, according to a study.

In a randomized, subject-masked trial, researchers investigated whether selectively numbing different ocular surface regions could identify the tissues most responsible for lens-related discomfort. Participants (N = 10) underwent sensitivity testing of the cornea, upper lid, and lower lid using a Cochet-Bonnet aesthesiometer. One site in one eye was treated with topical anaesthetic, while the same site in the other eye received saline as a placebo. Comfort was then assessed after rigid lens application.

Although numbing any targeted site significantly reduced its mechanical sensitivity, only anaesthetising the upper lid marginal conjunctiva improved initial comfort compared to placebo. No significant comfort changes were seen when the cornea or lower lid were anaesthetised.

Reference
Navascues-Cornago M, Maldonado-Codina C, Read ML, et al. Effect of selective topical anaesthesia on the initial comfort of rigid contact lenses. Cont Lens Anterior Eye. 2025;102474. doi: 10.1016/j.clae.2025.102474. Epub ahead of print. PMID: 40774861.