Purpose Lid-parallel conjunctival folds (LIPCOF) are related to dry eye symptoms and appear to be related to mechanical forces in blinks. The primary aim of this longitudinal, parallel group study was to investigate impact of contact lens wear (CLW) on LIPCOF and secondly the impact of contact lens wear on lid-wiper epitheliopathy (LWE) and dry eye symptoms. Methods After a 2-week wash-out phase with a hydrogen peroxide care regimen, 30 experienced contact lens wearers (female: 25, male: 5; median age: 34.5 years) with at least LIPCOF Sum grade 1 (nasal + temporal LIPCOF, either eye) were randomised into three groups: one which discontinued CLW (SPEC), one which were refitted with senofilcon A two-weekly replacement daily wear silicone hydrogel (OAS) and one which continued to wear their habitual lenses (HCL). LIPCOF Sum and LWE were evaluated at the enrolment visit and over a period of 12 weeks. LIPCOF were classified by fold number using a four-grade scale. LWE was classified using a five-point scale after staining with lissamine green and fluorescein. Symptoms were evaluated with the Ocular Surface Disease Index (OSDI). Results On enrolment, there were no differences between groups for LIPCOF Sum (median 2.0), LWE (1.0) and OSDI scores (12.5) (Kruskal-Wallis, p > 0.718). Median changes at 12-weeks follow-up compared to the enrolment visit were (HCL-group: 0.5, 0.0, 0.0; OAS-group: −1.0, −0.5, −10.42; SPEC-group: −0.5, −0.5, −5.21; LIPCOF, LWE and OSDI, respectively). LIPCOF (Friedman-Test, p = 0.178), LWE (p = 0.791) and OSDI (p = 0.874) were unaltered over the period of observation in the HCL group. LWE (p = 0.120) was unaltered in OAS group but LIPCOF (p = 0.001) and OSDI (p = 0.003) significantly improved. In the SPEC group LIPCOF (p = 0.031), LWE (p = 0.002) and OSDI (ANOVA repeated measurements, p = 0.034) changed significantly. Conclusions Refitting experienced CLW with senofilcon A daily wear, 2-week reusable contact lenses, or ceasing lens wear, improved LIPCOF, LWE and dryness symptoms.