A patient reports sudden sharp pain upon inserting a soft daily wear lens. What should be suspected?

When a patient experiences sudden sharp pain upon inserting a soft daily wear contact lens, the most common consideration is the possibility of a damaged lens. A damaged lens can have a rough edge, tear, or a distortion in its shape, all of which can cause discomfort or sharp pain upon insertion. This situation prompts the need for a careful examination of the lens to ensure that it is intact and not defective.

The other factors, while they may lead to discomfort in certain situations, do not typically manifest as acute sharp pain during lens insertion like a damaged lens would. Improper blinking generally results in discomfort due to dryness or lack of movement but does not typically occur at the moment of lens insertion. A tight lens, which can lead to discomfort, usually presents after prolonged wear rather than during insertion. Edema, or swelling of the cornea, may result in a stinging sensation over time but is not likely to be the cause of immediate sharp pain at the moment the lens is placed on the eye. Therefore, the suspicion of a damaged lens is the most logical and immediate assessment in this scenario.