Criteria for using bandage lens

[Julie1]

Dr. G,

How do you decide when to use a soft lens as a bandage lens for a dry eye patient? Do you think that patients with lower Schirmer's scores benefit more than someone who has moderate dry eye? I tried wearing Oasys, Acuvue Advance, and Proclear earlier this summer. All three brands felt comfortable the first day (with rewetting drops), then the days after that first day were horrible. I'm also not as dry as your most dry patients that have been able to successfully wear the contact lenses. My Schirmer's is a 5 in my right eye and a 7 in my left. My TBUT is a 3 and 9, respectively.

Thanks,
Julie

[DrG]

Julie, I'm sorry I missed your question.

As you can see from the cases I have discussed here, the criteria are typically pain, and/or persistent corneal surface damage that is of a sight threatening nature. In this case, the contact lens actually improves eye comfort and facilitates healing of the corneal surface.

Of course, there are many, many people who struggle to wear contact lenses who do not fit the above category, and have few or no symptoms when they don't wear the lenses.

I'm not quite sure if I understand your problem completely. Is it that the lens spoils after one day of wear, or that your eye is too painful following one day of wear such that even a brand new lens doesn't help? Surely, the doctor must be able to see some sign the following day if that is the case.