Hypotonic Artificial Tears Can Reduce Some Contact Lens Discomfort

Woman using eye drops
Clinicians may wish to recommend appropriate artificial tears for contact lens wearers to ensure continuation of their use.

The installation of a preservative free, hypotonic, HA-Trehalose artificial tear in contact lens wearers with dry eye disease (DED) significantly improves symptoms and may reduce associated signs, according to a study published in Contact Lens and Anterior Eye.

Researchers conducted a prospective, single-arm, observational pilot study to evaluate the efficacy of a bioprotective 0.15% hyaluronic acid (HA)-3% Trehalose artificial tear in managing dry eye symptoms in contact lens wearers. The study included 33 contact lens wearers aged 18-45 years with symptoms of ocular discomfort. Participants used 1 drop of the artificial tear 4 times per day for 84 days. They were assessed using the Visual Analogue Scale (VAS) for dry eye symptoms (pain, photophobia, dry eye sensation, blurry vision, foreigh body sensation, itching, tingling, burning, and sticky eye feeling), Ocular Surface Disease Index (OSDI), Contact Lens Dry Eye questionnaire (CLDEQ-8), and Berkeley Dry Eye Flow-Chart (DEFC). The researchers also performed tear break-up time (TBUT), ocular surface staining, tear meniscus, and visual acuity (VA) analyses.  

Investigators observed a statistically significant improvement in all VAS symptoms from baseline to day 84 except for tingling and burning and sticky eye feeling (OSDI, CLEDQ-8, and DEFC (P <.05)). Corneal and conjunctival quality also improved (P <.04 at day 84 vs baseline). Changes in TBUT, conjunctival staining, and tear meniscus were not statistically significant. VA was unaffected , and no adverse ocular or systemic events were reported.

“The use of artificial tears or wetting agents improve the signs and symptoms of dry eye and therefore the discomfort with contact lenses,” according to the researchers. The study notes that these results demonstrate potential efficacy of the artificial tear HA-Trehalose in the improvement of CLD. 

Study limitations include small sample size, short duration, and an uncontrolled design. 


Fernández-Jimenez E, Diz-Arias E, Peral A. Improving ocular surface comfort in contact lens wearers. Cont Lens Anterior Eye. Published November 25, 2021. doi:10.1016/j.clae.2021.101544