Attend any lecture about dry eye and you will hear the “I” word, Inflammation. It is well established that dry eye is an inflammatory condition. How about contact lens wear?

Ocular inflammation during contact lens wear is associated with serious complications such as microbial keratitis, however, there may be more subtle inflammatory mechanisms. [1] In a January 2017 publication, the authors propose that contact lens wear is intrinsically inflammatory and examined whether uncomplicated contact lens wear meets the classical and the contemporary clinical definitions of inflammation. The classical definition consists of rubor (redness), calor (heat), tumor (swelling), dolor (pain) and functio laesa (loss of function). Cellular and biochemical reactions define the contemporary, sub-clinical definition of inflammation.

The authors determined that all clinical and sub-clinical criteria are met with hydrogel lens wear. Most clinical criteria are met with silicone hydrogel lens wear. The authors concluded that the chronic, low grade, sub-clinical inflammation of the anterior eye during contact lens wear (termed ‘para-inflammation’) is a protective. The harmless up-regulation of the immune system maintains the eye in an ‘amplified’ state of alert’, ready to ward off any extrinsic noxious challenge.

Classification of this inflammatory status may lead to the development of new contact lens engineering techniques or pharmacological strategies to modulate contact lens induced inflammation. This may lead to contact lens with added safety and comfort.

Your opinion is most appreciated. Do you think contact lenses are intrinsically inflammatory?