The upper tarsal conjunctiva is in constant friction with the surface of the contact lens. The conjunctival surfaces of 80 soft and gas-permeable contact lens wearers (40 each) and 20 controls were studied using biomicroscopy and impression cytology. A filter dissolution technique was used to process the conjunctival imprints. Biomicroscopic and cytologic grading of the conjunctivae was performed using four-tier grading systems. Impression cytology is a non-invasive, painless procedure. The altered technique of processing yielded better cellularity and excellent cellular detail. On biomicroscopy and cytology, all controls showed Grade 1 appearances. Soft lens wearers who were symptomatic were found to have a significant increase in both biomicroscopic and cytologic grades, when compared with their asymptomatic counterparts. No correlation was found between duration of lens use and biomicroscopic or cytologic grades. All changes were found to be more severe in soft lens wearers.

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