Objective: The purpose of this manuscript was to review the evidence concerning the role of an allergic reaction to silicone as the basis for the reported increase in contact lens–associated infiltrates in wearers of silicone hydrogel contact lenses.
Methods: A literature review was undertaken to investigate the antigenic properties of silicone and the causes of contact lens–associated inflammatory reactions.
Results: Immune cells cannot interact with silicone directly but can interact with antigens on these lenses. These antigens could be due to tear film deposits, microbial contamination, or components of care systems used with these lenses.
Conclusions: Inflammatory reactions associated with silicone hydrogel contact lens wear are not caused by an allergic reaction to silicone alone.