Contact lens wearers with dry eye symptoms are twice as likely to display LWE as asymptomatic wearers, although there does not appear to be a link between LWE and clinical tear film tests (tear break-up time, Schirmer's). In non-contact lens wearing dry eye patients 88 per cent have LWE (66 per cent at grade 2 and above) as opposed to only 16 per cent (14 per cent grade 1, 2 per cent grade 2) of those without dry eye. LWE is correlated with an increased number of lid parallel conjunctival folds (LIPCOF). The condition is revealed by lissamine green staining. It is more common in RGP and silicone hydrogel lens wearers. LWE explains contact lens intolerance in wearers that show no other signs.
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