Dry Eye Dx and Tx: Treat Dry Eye Before Specialty CL Fitting

Learn how managing ocular surface and lid conditions before fitting specialty contact lenses can lead to life-changing outcomes for patients.

Category	Detail
Condition	Dry eye disease, meibomian gland dysfunction, blepharitis
Key Mechanisms	Ocular surface inflammation and lid disease impair specialty contact lens tolerance and vision stability
Target Population	Patients seeking specialty or scleral contact lenses
Care Setting	Specialty contact lens clinics and ophthalmology/optometry practices

Undiagnosed and undertreated dry eye, MGD, and blepharitis commonly cause patient dissatisfaction with specialty contact lenses.
Validated dry eye symptom questionnaires (e.g., CLDEQ-8, SPEED, OSDI, DEQ-5, DEQS) should be used at initial visits to identify ocular surface disease.
Pre-treatment and ongoing management of ocular surface and lid disease improves specialty lens outcomes and patient satisfaction.

Use validated dry eye questionnaires tailored to patient history and symptoms at initial evaluation.
Perform thorough slit lamp and external exam documenting lid condition, ocular surface staining, and meibomian gland function.
Obtain detailed patient history focusing on dry eye symptoms and contact lens tolerance.

Develop individualized ocular surface treatment plans prior to specialty lens fitting.
Provide patients with written instructions on ocular surface treatments to maintain during lens wear.
Counsel patients on the importance of consistent management of lid disease and dry eye for lens success.

Failure to diagnose and treat dry eye and lid disease can lead to patient dissatisfaction, lens intolerance, and poor visual outcomes.

Patients requiring specialty or scleral contact lenses, often with complex ocular surface conditions

Successful specialty lens wear depends on preemptive dry eye and lid disease management, patient education, and adherence to treatment regimens.

Incorporate dry eye symptom questionnaires routinely at initial specialty lens evaluations.
Document ocular surface and lid findings meticulously before lens fitting.
Set realistic patient expectations regarding the effort and consistency needed for ocular surface management.
Treat dry eye and lid disease proactively to optimize specialty lens comfort and visual outcomes.
Provide clear, written treatment instructions to enhance patient compliance.