Imagine waking up every morning with crystal-clear vision, without having to fumble around on your nightstand for your glasses. For many, this convenience is a dream come true thanks to extended-wear contact lenses . But are they really the right option for you? In this article, we’ll explore everything you need to know about these lenses in detail, from how they work to the potential risks and available alternatives.

What are Extended Wear Contact Lenses?

Contact lenses are primarily classified into two categories based on their recommended use: daily wear and extended wear. Daily wear lenses are designed to be removed before bedtime, while extended wear lenses are approved to be worn even overnight. This fundamental distinction lies in the lens material and design, designed to ensure eye health even with continuous wear.

Key Differences with Daily Wear Lenses

The main difference between the two types lies in the lens’s ability to breathe. Extended-wear lenses are generally thinner than daily-wear soft lenses or made from a material called silicone hydrogel . This advanced material allows for greater oxygen permeability, crucial when wearing lenses continuously. Silicone hydrogel lenses allow oxygen to reach the cornea, the front, clear part of the eye, even when the eyelid is closed during sleep. This oxygenation is vital for maintaining corneal health and preventing complications.

Most extended-wear soft contact lenses are approved for continuous wear of up to seven days, although some even go up to 30 days, always under the supervision and recommendation of an eye care professional. There are also rigid gas permeable extended-wear contact lenses, an alternative for certain wearers.

It’s crucial to understand that these wear periods are the maximum recommended periods. Not everyone can tolerate wearing extended-wear lenses for this long, and some simply can’t wear contact lenses overnight at all. Your optician or ophthalmologist will determine, after a personalized fitting and follow-up, whether you’re a candidate for overnight contact lens wear and how many days of continuous wear are safe for your eyes.

Benefits of Extended Wear Contact Lenses

The main and most obvious advantage is comfort . Waking up with clear vision without relying on glasses is a big draw for many people. This is especially helpful for people with active lifestyles, athletes, or those who simply prefer the freedom of not wearing glasses during the day.

In addition to comfort, extended-wear lenses can be a solution for people with certain visual conditions or specific lifestyles, such as:

• People with high myopia or hyperopia who prefer not to rely on bulky glasses.
• People with astigmatism who are looking for more complete and natural visual correction than glasses.
• People with active lifestyles who engage in sports or outdoor activities where glasses may be uncomfortable or impractical.
• People who work in dusty or splash-prone environments where eyewear can become dirty or damaged.

Risks Associated with Prolonged Use

Despite the comfort, it’s essential to be aware of the risks associated with prolonged contact lens wear. Numerous studies have shown that the risk of eye infections is higher among people who sleep in contact lenses. This risk increases because bacteria and other potentially dangerous microorganisms can adhere to the lenses and become trapped between the lens and the ocular surface.

The warm, moist environment under contact lenses, especially with the eyelids closed during sleep, is an ideal breeding ground for these microbes. Furthermore, contact lenses, even silicone hydrogel ones, reduce the supply of oxygen to the cornea. This reduction in oxygen diminishes the eye’s natural ability to fight corneal infections.

Contact lens-related infections can range from annoying conjunctivitis to more serious conditions such as Acanthamoeba keratitis or fungal eye infections, which can cause permanent vision loss in severe cases. Continuous contact lens wear for several days significantly increases the risk of these complications.

Types of Associated Eye Infections

It is important to know some of the types of eye infections that can be associated with prolonged contact lens wear:

• Bacterial conjunctivitis: Inflammation of the conjunctiva, the transparent membrane that covers the white part of the eye and the inside of the eyelids. It causes redness, discharge, and itching.
• Microbial keratitis: Infection of the cornea caused by bacteria, fungi, or parasites. It can be very painful and, if not treated promptly, can cause scarring of the cornea and affect vision.
• Acanthamoeba keratitis: A serious corneal infection caused by a parasite called Acanthamoeba. It is particularly dangerous and difficult to treat, and can cause severe visual damage.
• Fungal infections: Corneal infections caused by fungi. Less common than bacterial infections, but equally serious.

Advances in Extended Wear Lenses and Risk Mitigation

Fortunately, advances in extended-wear contact lens materials have significantly reduced these risks in recent years. Some of the most important advances include:

• Silicone hydrogel: Most modern extended-wear lenses are made with silicone hydrogel, a material that allows significantly more oxygen to pass through to the cornea compared to previous extended-wear lenses. This reduces the risk of corneal hypoxia, a condition that makes the cornea more susceptible to inflammation and infection.
• Disposable Lenses: Nearly all soft lenses prescribed for extended wear today are disposable and designed to be replaced after one to four weeks of wear. More frequent replacement reduces the buildup of proteins, lipids, and other deposits on the lenses, which can cause ocular inflammation, discomfort, and create an environment conducive to the growth of infectious microorganisms.
• Rigid gas permeable (RGP) lenses: Extended-wear lenses made from rigid gas permeable materials are also available. Some eye care professionals prefer extended-wear RGP lenses because they cover less of the eye’s surface. Additionally, extended-wear RGP lenses move more freely with each blink, reducing the risk of debris and infectious microbes accumulating beneath the lenses.

Flexible Use: A Safer Alternative

To further minimize the risks of continuous wear, many eye care professionals recommend flexible use of extended-wear contact lenses, rather than continuous wear for several days without interruption. In flexible wear, disposable EW lenses are typically removed at night before bed, but may be worn occasionally overnight, for example, on a weekend camping trip or for daytime naps.

Although flexible wear is not as comfortable as continuous extended wear (it requires proper lens care with a cleaning and preservation solution each time the lenses are removed), it can be a less risky option than full extended wear.

Daily Disposable Contact Lenses: The Safest Option

Despite improvements in the safety of extended-wear lenses, sleeping in contact lenses still carries a higher risk of complications than removing them daily. For this reason, most eye care professionals recommend daily disposable contact lenses as the preferred alternative to extended-wear lenses.

While daily disposable lenses aren’t as comfortable as extended-wear lenses, removing and disposing of them after each use completely eliminates the risks associated with sleeping in contact lenses. You wear a new pair of sterile lenses every day, minimizing deposit buildup and the risk of infection.

Other Alternatives: Refractive Surgery

Another viable alternative to extended-wear contact lenses for many people is LASIK or another type of refractive surgery . These surgeries permanently correct vision, completely eliminating the need for glasses and contact lenses. Generally, to be a good candidate for surgical vision correction, you must be at least 18 years old and have a stable eyeglass prescription for at least 12 months.

Important Recommendations and Precautions

If you decide to wear EW contact lenses overnight, it is essential to follow these recommendations to minimize risks:

• Consult your eye care professional: Before starting to wear extended-wear contact lenses, a complete examination and fitting by an optician or ophthalmologist is essential. They will determine if you are a good candidate and recommend the most appropriate type of lens for your eyes.
• Follow the instructions for use: Strictly follow the wearing time recommended by your eye care professional and the lens manufacturer. Do not exceed the indicated period of continuous use.
• Impeccable hygiene: If you wear flexible lenses, be sure to clean and disinfect them properly every time you remove them, using the solutions recommended by your professional.
• Regular checkups: Have regular eye exams as recommended by your optician or ophthalmologist. These checkups are crucial for detecting any problems early.
• Pay attention to symptoms: Pay attention to any eye symptoms such as blurred vision, redness, irritation, pain, or discharge. If you experience any of these symptoms, remove your lenses immediately and consult an eye care professional without delay.

Frequently Asked Questions (FAQ)

Can I wear extended-wear contact lenses if I have dry eyes?

People with dry eyes may not be good candidates for extended-wear lenses, as they can aggravate dry eye. Consult your eye care professional to evaluate your individual case.

What should I do if my eyes hurt when wearing extended-wear contact lenses?

If you experience pain, redness, blurred vision, or any other eye discomfort, remove your lenses immediately and consult an eye care professional as soon as possible. Do not ignore these symptoms.

How often should I replace my extended-wear contact lenses?

Replacement frequency depends on the type of lens and your eye care professional’s recommendations. Always follow their instructions and those of the lens manufacturer.

Are extended-wear contact lenses more expensive than daily wear contact lenses?

Cost can vary depending on the brand and type of lens. In general, extended-wear lenses may be slightly more expensive than daily lenses, but in the long run, the cost can be similar or even lower if worn continuously for several days.

Can I swim or shower with extended-wear contact lenses?

Swimming or showering while wearing contact lenses is generally not recommended, as water may contain microorganisms that can cause infections. Consult your eye care professional about specific recommendations for your lens type and activities.

Conclusion

Extended-wear contact lenses offer great comfort and visual freedom, but they are not without risks. While technological advances have improved their safety, it is essential to be aware of the potential risks of infection and follow the recommendations of your eye care professionals. Daily disposable lenses are presented as a safer alternative for most people. The best option for you will depend on your individual needs, lifestyle, and eye health. A consultation with your optician or ophthalmologist is the crucial first step in determining if extended-wear contact lenses are right for you and to ensure safe and healthy wear.