Contact Lenses: Who Should (and Shouldn't) Wear Them?

Contact lenses are a fantastic alternative to glasses for millions of people around the world. They offer crisp vision, freedom from frames, and are suitable for various lifestyles—from everyday office wearers to elite athletes. But as beneficial as they are, contact lenses aren't for everyone.

In this post, we explore the indications (who should wear them) and contraindications (who should avoid them), so you can better understand if contact lenses are the right fit for your eyes and your life.

✅ Indications for Contact Lens Use

Contact lenses are not just cosmetic or convenience items—they’re a vital tool in vision correction and even therapeutic management of eye diseases. Here are the most common scenarios where contacts are recommended:

Refractive Errors
Myopia (Nearsightedness)
Hyperopia (Farsightedness)
Astigmatism
Presbyopia
Modern lenses are available in spherical, toric, and multifocal designs to suit all of the above.
Cosmetic Reasons
Colored lenses for enhancing or changing eye color.
Prosthetic lenses for disfigured or scarred eyes (often post-trauma or surgery).
Irregular Corneas
Conditions like keratoconus, pellucid marginal degeneration, or post-LASIK ectasia require special lenses like RGP, scleral, or hybrid lenses.
Contact lenses help smooth out corneal irregularities for sharper vision.
Therapeutic Use
Bandage contact lenses for healing corneal abrasions, ulcers, or post-surgical protection.
Used to relieve pain or shield the cornea in cases like recurrent corneal erosions or bullous keratopathy.
High Refractive Errors
When spectacle lenses become thick and heavy (e.g., in high myopia or anisometropia), contacts offer a more comfortable, cosmetically pleasing, and visually superior option.
Sports and Active Lifestyles
Contacts offer a wider field of view and eliminate the risk of glasses falling or fogging up.
Especially ideal for athletes and outdoor workers.
Occupational Needs
Certain professions (like photographers, performers, or athletes) benefit from frame-free vision.

❌ Contraindications for Contact Lens Use

Despite their many benefits, there are situations where contact lenses may be unsafe, impractical, or harmful. These include medical, behavioral, and environmental factors.

Poor Ocular Surface Health
Dry eye syndrome (moderate to severe): Insufficient tear film can make lens wear uncomfortable or harmful.
Blepharitis or meibomian gland dysfunction: Inflammation can increase the risk of infection and intolerance.
Corneal infections or ulcers: Active eye infections are a strict no-go for lens wear.
Allergic Conjunctivitis
People with seasonal or chronic allergies may experience discomfort, excessive lens deposits, and redness.
Uncontrolled Systemic Conditions
Diabetes, thyroid disease, or autoimmune conditions can affect corneal healing or dryness, making lens wear risky unless tightly managed.
Poor Hygiene or Compliance
Contact lenses require strict hygiene routines. If a person is unlikely to follow proper cleaning, storage, and wearing schedules, they risk serious complications like microbial keratitis.
Occupational Hazards
Environments with dust, chemicals, or fumes (e.g., construction, laboratory work) may not be suitable for lens wear.
Psychological or Physical Limitations
People with cognitive impairments, tremors, or severe anxiety may struggle with lens insertion and removal.
Children or elderly patients who cannot manage lens care independently may need supervision or alternative vision correction methods.
Severe Refractive Instability
Conditions like progressive keratoconus or rapid prescription changes may require specialist intervention before lenses are considered.

⚠️ Relative Contraindications (Use with Caution)

In some cases, contact lenses can be used, but with careful monitoring or modified approaches:

Mild dry eye → May tolerate daily disposables or scleral lenses with good tear reservoir.
Pregnancy or hormonal fluctuations → Can alter corneal shape or tear quality; monitor lens fit closely.
Occasional non-compliance → Daily disposables reduce infection risk and maintenance burden.

📝 Summary Chart

Indications	Contraindications
Refractive errors (myopia, hyperopia, astigmatism)	Active eye infections or corneal ulcers
Irregular corneas (keratoconus, post-surgery)	Severe dry eye or chronic blepharitis
Cosmetic or prosthetic needs	Poor hygiene or non-compliance with lens care
Sports, active lifestyle, outdoor professions	Allergic conjunctivitis with significant lens intolerance
Therapeutic (bandage lenses, post-surgical)	Uncontrolled diabetes or autoimmune disorders affecting the eye
High prescriptions causing lens thickness in glasses	Occupational exposure to dust or chemicals

👁️ Final Thoughts

Contact lenses are a powerful and versatile vision correction option, but they’re not suitable for everyone. A detailed eye exam, along with a discussion about your lifestyle and health, will help determine if lenses are right for you.