How should I approach the management of dry eye syndrome in patients who are also using contact lenses?

Management of dry eye syndrome in patients using contact lenses should include:

• Advise modification of contact lens wear by reducing wearing time and removing lenses if dry eye symptoms occur to help alleviate discomfort ¹.
• Suggest changing the type of contact lenses or lens solutions, and recommend consultation with an optometrist for tailored advice ¹.
• Recommend preservative-free tear substitutes where possible, especially for contact lens users, to reduce the risk of allergic or toxic reactions associated with preservatives ¹.
• Use low-viscosity tear drops during the day to minimize blurred vision and discomfort, and consider more viscous ointments or gels for overnight use ¹.
• Advise on lifestyle measures such as warm compresses, lid hygiene, and lid massage if blepharitis or Meibomian gland dysfunction is present, which can contribute to dry eye symptoms ¹.
• Consider moisture chamber eyewear (e.g., wrap-around glasses or specialist goggles) to protect the ocular surface from environmental factors that exacerbate dry eye ¹.
• Encourage modification of environmental factors, such as increasing humidity, avoiding air conditioning or drafts, and reducing prolonged digital device use to improve symptoms ¹.
• Arrange follow-up within 4–6 weeks after starting tear substitutes to assess symptom relief and consider switching to alternative preparations (e.g., sodium hyaluronate or lipid-based) if symptoms persist ¹.
• If symptoms do not improve after 4–12 weeks of primary care management, consider referral to a specialist for further assessment and treatment ¹.