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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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when wearing contact lenses, what are the lids responsibility

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when wearing contact lenses, what are the lids responsibility in making the contact lense comfortable. I have blephartis and want to know why this condition makes lens wear uncomfortable.

Doctor DanB : Hello and thanks for your question. Are you available to chat?
Doctor DanB : Blepharitis causes a dysfunctional tear film. The inflammation that results from the bacteria in the tear-film caused by blepharitis makes the tear-film (layer of tears that coats the eye) unstable. Then, when a contact lens is placed over the cornea, further preventing oxygen from reaching the cornea, the inflammation in the tear-film causes the symptoms of blepharitis, including contact-lens intolerance. Does that make sense?
Doctor DanB : Does this information help address your concerns? Do you have any other concerns or questions about this topic?    It appears as though you are not in the chat room currently.    I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need.   If you would like to ask further questions or clarification regarding anything I've said, please let me know and I will be happy to address your concerns. Your feedback is important to me and will help me improve my encounter with future customers.  Please rate your encounter with me by providing feedback; any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated.  If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied.  My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry! 

not really, because if a contact is over the eye, how is the tear-film even hitting the cornea if the contact is over the eye.

Doctor DanB :

There are tears underneath the contact lens. The contact lens does not act like a water-tight bandage over the cornea, but the contact lens acts more like a ship in a sea (floats within the tear film, on top of the cornea).

Doctor DanB :

Does that make sense?


oh yes, so when i blink the tear film lipids from the eye lids makes its way to the overall tears that the contact lens is floating on?


Dam Doc, i never knew Lasik can cause this tear film in the eyelids to dry up like mine. This has been the cause of my bad vision. My tear film is not their. My doctor also abadndoned me and left me with no doctor. I am scared for my vision.


do you know of any contact lenses besides schleral, preferably daily wear that i can wear with this eye lid condition


preferably that can protect my eye

Doctor DanB :

I'm sorry; I had to step away to see a patient (I'm in clinic right now).


You got it right about the blinking and the tear film.


Unfortunately, there are some surgeons who do not either mention that risk of dry eye that can result from corneal refractive surgery, or who do not do a sufficient dry eye evaluation in their patients who are going to have surgery. But yes, LASIK can definitely mess with your tear film. The daily disposable, high dK lenses are going to be the best to wearl; however, I would suggest that you actually get a pair of glasses (for right now--I know--that's exactly what you didn't want to do after LASIK) and stay out of contacts for right now, if you need anything at all, at least until you can get your dry eyes under control. I would recommend seeing a corneal specialist as a second opinion to get you better controlled with your dry eyes before you try going into contact lenses. Make sense?


yes, i want to wear glasses, but seems that this tear film thing is causing higher order aberrations, basically my eyes are dry and the first layer of the optics where the light goes to the eye is missing, the tear filme, so causing glasses not to work. I guess i should just get the glasses even though i wont be seeing good, just alright, Thanks for your help. I will take your advice and I should of took your advice when you told me that you yourself wouldnt do lasik that you are seeing just fine with the glasses,

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Customer: replied 4 years ago.

one more question, if lasik caused this tear film thing, will these treatments effect this differently then a person who just got this condition over time

Well, I suspect that you had some of these tendencies (including blepharitis) before your surgery. But yes, LASIK can permanently make things worse. However, most people can still get to where their dry eye is treated sufficiently, even after LASIK. It is the uncommon person who, despite all dry eye treatments, is permanently worse off with their dry eye than they were before. However, since you've had LASIK now, I wouldn't mess around with any old doctor. I would recommend seeing a corneal specialist to get a complete dry eye workup so you are doing exactly what needs to be done to treat all of the risk factors you have for dry eye.