Researchers recently observed dysbiosis in the lid microbiome of symptomatic contact lens wearers, and they found lid margin exfoliation reduced the number, frequency of isolation and ratio of gram-positive rods and cocci.

The study evaluated 30 experienced contact lens wearers. Their eyelid margin physiology, tear properties and comfort scores were assessed, and the number, type, frequency and lipase activity of lower eyelid margin bacteria were measured.

The team discovered that symptomatic lens wearers had a higher ratio of the number and frequency of gram-positive rods and cocci. For these symptomatic contact lens wearers, exfoliation of debris at the lid margin reduced the number and ratio of gram-positive rods to cocci from baseline to seven to 10 days after treatment. They added that the number of bacteria, the ratio of rods to cocci and lipase activity correlated with lash contamination and anterior blepharitis, while bacterial lipase correlated with meibomian gland secretions and tear evaporation rates. The investigators also found that lid treatment produced a significant reduction in CLDEQ-8 scores and converted 10 symptomatic contact lens wearers to asymptomatic lens wearers.

“The ocular microbiota, especially in contact lens wearers, may possess the potential of modifying meibum, thereby destabilizing the tear lipid layer leading to contact lens discomfort,” the study authors concluded. 

Siddireddy JS, Vijay AK, Tan J, et al. Effect of eyelid treatments on bacterial load and lipase activity in relation to contact lens discomfort. Eye Cont Lens. November 29, 2019. [Epub ahead of print].