The evolution in therapeutic contact lenses.

Therapeutic soft contact lenses were first approved in the 1970s, but the variety of available materials and parameters continues to evolve. Currently, the armamentarium of therapeutic contact lenses allows the clinician to select lenses that not only protect the corneal surface but also assist in modulation of the healing process. This article summarizes the available contact lenses, the conditions most amenable to treatment, and the decision-making process that allows optimal selection of a therapeutic contact lens for a specific patient. Many of the hydrophilic soft contact lenses used for cosmetic correction are not approved for therapeutic use but have been used in an off-label manner as therapeutic lenses. Communicating with the patient is important when recommending the use of a therapeutic contact lens, explaining the goals of therapy, warning about the risks contingent upon contact lens use, and determining whether the lens is being used in an off-label fashion. The advances in contact lens technology have opened new options for use of therapeutic contact lenses. With a new generation of high-Dk lenses whose makers promise fewer limiting problems of vascularization and infection, the utility of the older, traditional therapeutic lenses can be enhanced and the more selective application of individual lenses can be permitted. By considering the healing objectives of the particular treatment plan for a specific patient, greater control of the endpoint and timeframe of therapy is now possible.