The osmotic component of swelling under extended wear soft contact lenses

Swelling of the cornea during sleep when wearing an extended wear contact lens has a osmotic and hypoxic component. The normal swelling of the cornea during sleep, caused by the change from hypertonic tears of the open eye to the isotonic tears of the closed eye, is about 3%. Under an extended-wear contact lens, there is an additional 6 to 8% swelling of the cornea in the closed eye because the cornea under the contact lens is at an oxygen tension substantially below that present in the palpebral conjunctiva. Data on human subjects wearing extended wear contact lenses are consistent with this allocation of the 8 to 12% total corneal swelling observed upon awakening.