This paper outlines changes to the ocular surface caused by contact lenses and their degree of clinical significance. Substantial research and development to improve oxygen permeability of rigid and soft contact lenses has meant that in many countries the issues caused by hypoxia to the ocular surface have largely been negated. The ability of contact lenses to change the axial growth characteristics of the globe is being utilised to help reduce the myopia pandemic and several studies and meta-analyses have shown that wearing orthokeratology lenses or soft multifocal contact lenses can reduce axial length growth (and hence myopia).

However, effects on blinking, ptosis, the function of Meibomian glands, fluorescein and lissamine green staining of the conjunctiva and cornea, production of lid-parallel conjunctival folds and lid wiper epitheliopathy have received less research attention. Contact lens wear produces a subclinical inflammatory response manifested by increases in the number of dendritiform cells in the conjunctiva, cornea and limbus. Papillary conjunctivitis is also a complication of all types of contact lenses. Changes to wear schedule (daily disposable from overnight wear) or lens materials (hydrogel from SiHy) can reduce papillary conjunctivitis, but the effect of such changes on dendritic cell migration needs further study. These changes may be associated with decreased comfort but confirmatory studies are needed. Contact lenses can affect the sensitivity of the ocular surface to mechanical stimulation, but whether these changes affect comfort requires further investigation.

In conclusion, there have been changes to lens materials, design and wear schedules over the past 20+ years that have improved their safety and seen the development of lenses that can reduce the myopia development. However, several changes to the ocular surface still occur and warrant further research effort in order to optimise the lens wearing experience.

本文概述了隐形眼镜引起的眼表变化及其临床意义程度。大量研究和开发改善硬性和软性隐形眼镜的透氧性意味着在许多国家，由眼表缺氧引起的问题在很大程度上已被否定。隐形眼镜改变眼球轴向生长特征的能力正被用来帮助减少近视的流行，几项研究和荟萃分析表明，佩戴角膜塑形镜或柔软的多焦点隐形眼镜可以减少轴向长度的增长（从而减少近视）。

然而，对眨眼、上睑下垂、睑板腺功能、结膜和角膜的荧光素和丽丝胺绿染色、眼睑平行结膜皱襞的产生和眼睑擦拭器上皮病变的影响较少受到研究关注。佩戴隐形眼镜会产生亚临床炎症反应，表现为结膜、角膜和角膜缘中树突状细胞数量的增加。乳头状结膜炎也是所有类型隐形眼镜的并发症。改变佩戴时间表（从隔夜佩戴开始每天一次性）或镜片材料（来自 SiHy 的水凝胶）可以减少乳头状结膜炎，但这些变化对树突状细胞迁移的影响需要进一步研究。这些变化可能与舒适度降低有关，但需要进行验证性研究。

总之，在过去 20 多年里，镜片材料、设计和佩戴时间表发生了变化，提高了它们的安全性，并见证了可以减少近视发展的镜片的发展。然而，眼表仍会发生一些变化，需要进一步研究以优化镜片佩戴体验。