Contact lenses are exactly what their name describes. They are lenses in contact with your eye. Pretty much anything in contact with your eye — that isn’t your eyelid — is creating an increased risk for damage. Now, contacts are safe. They’re super safe, actually. But for them to be the safest possible, they have to fit just right, be made of materials that your eye doesn’t mind, be cleaned or replaced regularly, etc... Basically, it’s a list of things that may or may not be true of your contacts on any given day.
How do contacts cause scars?
When there is a problem with contacts, it’s almost never dramatic. There’s never a time when someone is just doing great with contacts, only to experience eye explosion out of the blue. Instead, there are little micro-abrasions that then become mildly inflamed or infected. If this has happened to you then it would’ve made you say, “My eye’s all red and irritated. This contact hurts.” After that, you’d take the contact out for a couple days, and everything returns back to normal.
And everything did return to normal... except for one tiny change. In that spot where there was a tiny ulcer (the inflamed spot on the front of your eye), the collagen got weird looking. Corneas are clear because the collagen composing the cornea is perfectly arranged and aligned to be transparent. It becomes opaque when there’s a spot that’s different because it got inflamed and then healed.
Can these scars be healed?
Sadly, there’s no way to rearrange collagen in a scar and make it perfectly transparent and strong again. But it’s only kind of sad because it has no effect on the vision unless the scar is huge and right in the middle of your cornea. Also, it has no affect on your ability to get LASIK except for pretty unusual circumstances — like if the scar is huge and right in the middle of your cornea.
Now that we perform LASIK entirely with lasers, it allows us to program treatments customized to each specific eye. Got a scar that’s in the most superficial 100 micrometers of your cornea? No problem. We just program the laser to have a depth of 130 micrometers. As science fiction as it seems, the laser doesn’t have to start at the very front of your cornea and tunnel down like a knife would. It starts at whatever depth it is programmed to start.
If you read the title of this article, you’ll probably notice that I never answered the question. That’s because the answer is “no” and an answer like that always sounds sad. But beyond that, it’s hard to get the right answer in the absence of the right question. LASIK can’t fix scars, but it doesn’t need to fix them. If you’re looking to get out of contacts, then LASIK can do that for you if you’re a good candidate. You can have corneal scars AND good vision. It’s the best of both worlds because, in my opinion, those scars add character.
Author: Joel Hunter, MD is an Ophthalmologist, Refractive Surgeon, and the Founder of Hunter Vision, a LASIK Orlando Clinic in Florida. A recognized and respected specialist in vision correction who has performed a countless number of refractive surgeries, Joel gives lectures across the country and trains fellow doctors in the newest LASIK surgery techniques.