If a lens shows edge lift or decentration during wear, what is the most likely clinical action?

If a lens shows edge lift or decentration during wear, what is the most likely clinical action?

• A. Stop using lenses permanently
• B. Reassess and adjust the lens fit parameters.
• C. Switch to a different brand without assessment
• D. Keep the same parameters if discomfort occurs

Answer: (B)

Edge lift or decentration shows the lens isn’t fitting the eye properly. When the edge lifts or the lens sits off the visual axis, tear exchange and lid interaction can be disrupted, leading to blurry vision, discomfort, or corneal staining. The best action is to reassess the lens fit and adjust the parameters to restore stable, centered alignment. Practically, this means rechecking the corneal shape with keratometry or topography, evaluating how a trial lens moves with a blink and how the edge sits using fluorescein, and then tweaking fit parameters. If the lens is too flat and the edge lifts, try a steeper base curve or a different diameter to improve centration; if the lens is too steep, a flatter base curve or a different diameter may reduce bearing and also help. In some situations, trying a different lens design or brand that better matches the eye is appropriate after re-fitting and assessment. The goal is centration, comfortable edge interaction, and proper tear exchange, not continuing with a misfit.