Is atopy a risk factor for the use of contact lenses?

We studied the tolerance of soft contact lenses (CL) in 24 atopic (16 with hay fever) and 52 non-atopic subjects with a mean age of 20 years. They were examined when they first came to an ophthalmologist to have CL and re-examined after an average of 1.7 years. All subjects were allowed to use CL throughout the year, including the pollen season. Of the 76 subjects, 31 (41%) reported some kind of eye symptoms during the use of CL. Six subjects (8%) had stopped using CL because of symptoms. Altogether, in 29/76 subjects (38%) some objective sign was detected in the examination, confirming the subjective symptoms (conjunctivitis 16, keratoconjunctivitis 8, increased limbal blood vessels 4, and eczema palpebrae 1). Fourteen of the 24 atopics (58%) had experienced symptoms compared with 17 of the 52 non-atopics (33%) (p = 0.034). Eleven atopics had seasonal eye symptoms, and eight of them (73%) had problems with CL use. Eosinophils and neutrophils found in the conjunctival scrapings at the first examination appeared to predict poor CL tolerance when the occurrence of symptoms in different groups was first compared by bivariate analysis. The risk factors that could predict poor CL tolerance were also evaluated, with logistic regression analysis controlling potential confounders. History of an atopic condition increased 5-fold the risk of experiencing various external eye symptoms during the use of CL. We conclude that seasonal atopic allergy is a especially risk factor for wearing soft contact lenses, and their use should be restricted during the season.