Dry eye has long been identified as the most common reason for contact lens failure.  As reviewed in a recent article, many of the deficiencies of a particular eye can be better addressed by proper contact lens selection.  Unfortunately along with the explosion of disposable contact lens usage there has been a certain perception created that contact lenses are all interchangeable.  Nothing could be further from truth.  Health and comfort of the eye's surface is affected by the water content, ionicity, oxygen permeability, along with lens surface properties such as protein, lipid, and mucin deposition, protein adsorption, and wettability.  These are just some of the variables that will have impact on a contact lens' performance.  Almost equally important to the contact lens selection are the contact lens solutions used since compatibility of the solution with the specific contact lens, action, cytotoxicity, and biocompatibility will also play a significant role in overall lens performance for the contact lens wearer.  Careful selection of the contact lens and associated contact lens solutions as well as appropriate management of the underlying causes of the dry eye can bring contact lens success to the dry eye patient.