If a patient experiences discomfort and burning with soft contact lenses, what could be the likely issue?

When a patient experiences discomfort and burning with soft contact lenses, one likely issue is that the lens may be too tight. A contact lens that is too tight can exert excess pressure on the cornea, leading to irritation and discomfort. This can cause symptoms like burning, sensitivity, or even redness in the eyes. Proper fitting of contact lenses is crucial, as a lens that does not allow sufficient movement or fluid exchange can deprive the corneal tissue of necessary nutrients and hydration, leading to discomfort.

In contrast, while a lens that is too small may not fit properly and could potentially cause discomfort, burning sensations are more typically associated with pressure or irritation from a tight fit. A contaminated lens could lead to discomfort, but the symptoms would usually be more pronounced, such as discharge or infection signs, rather than just burning. An old lens could cause reduced comfort due to material degradation or accumulation of deposits, but discomfort is more often linked to fit issues than to age alone. Therefore, the notion that the lens is too tight aligns most closely with the symptoms described.