Complications and Poor Compliance in Soft Contact Lens Wear: An Analysis of Fitting Inadequacies and Hygiene Practices

Abstract

Aim: The present study evaluates the role of clinical examination in optimizing the fitting of soft contact lenses and to highlight the main complications associated with their use. Study Design: Retrospective, descriptive study. Place and Duration of Study: Ophthalmology Department, University Hospital of Kasserine, Tunisia, over a six-month period (January-June 2023). Methodology: Thirty-four young adult females (aged 18-30 years) wearing soft contact lenses were assessed through standardized questionnaires, detailed ocular examinations, and evaluation of lens parameters and hygiene practices. Results: Among the 34 patients assessed, most were permanent wearers with non-medicalized fittings (88%) and poor hygiene habits. Lens fitting inadequacies were frequent (non-optimal base curve in 71%, inappropriate diameter in 80%). The majority developed hypoxic and inflammatory complications, particularly corneal neovascularization (88% prevalence), superficial punctate keratitis (68%), dry eye (94%), and protein deposits (88%). Subjective discomfort was reported by 65% of patients. No infectious complications were noted. Conclusion: The high prevalence of complications was directly associated with inadequate lens fitting and poor compliance with hygiene practices. Clinical examination prior to fitting, professional supervision, patient education, and regular follow-up are essential to reduce risks and ensure safe, comfortable, and effective visual correction.