The human eye and tear provide essential physiological information for the detection of ocular dysfunctions and therapy monitoring. The measurements of biomarkers in tear composition are critical for disease diagnosis and early interventions. Hence, significant efforts are dedicated to the development of functional contact lenses that can quantify tear analytes and ocular physiological condition. The combination of microfluidics and contact lens technologies offer real-time monitoring of ocular physiology and timely detection of eye disorders through wireless components. This review discusses the fundamentals of microfluidic contact lenses and their diverse applications in ophthalmic diagnostics and drug delivery. It also elucidates the strategies for the commercialization of microfluidic contact lenses to create clinical and point-of-care products.