A recent study in Australia has demonstrated that changes related to meibomian gland secretions and morphology, tear evaporation, lid-parallel conjunctival folds and palpebral conjunctival health may successfully predict symptoms of discomfort in contact lens wearers.

The study found that tear properties such as volume, meniscus height, breakup time, osmolarity and lipid layer thickness were not successful in predicting symptoms of discomfort. Lid-wiper epitheliopathy approached significance as a factor, but the area under the curve was not sufficient to have it considered as a predictive discriminator.

Researchers also developed an equation to distinguish symptomatic from asymptomatic lens wearers based on the significant predictors: Symptom discriminant function score = 3.378 (meibomian gland secretion grade) + 0.224 (meibomian gland morphology grade) + 0.61 (tear evaporation rate without contact lenses) + 0.439 (lid-parallel conjunctival folds grade) - 0.346 (palpebral conjunctival health grade) -4.625. The researchers did note that equation needs validation to confirm its accuracy with a new cohort of lens wearers.

Researchers believe that contact lens practitioners can monitor new lens wearers if they present with the significant predictors or eventually develop the specific signs. They concluded that diagnosis of clinical markers of contact lens discomfort could help clinicians set realistic expectations for the wearer and provide preventative measures.

Siddireddy JS, Tan J, Vijay AK, Wilcox M. Predictive potential of eyelids and tear film in determining symptoms in contact lens wearers. Optom Vis Sci. 2018;95(11):1035-45.