First contact diagnosis and management of contact lens-related complications

Abstract

To describe the spectrum of contact lens-related problems in cases presenting to a tertiary referral eye hospital. A retrospective case record analysis of 111 eyes of 97 consecutive patients was undertaken over a period of five months at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. Contact lens-related complications (CLRC) were classified into microbial keratitis, sterile corneal infiltrates, corneal epitheliopathy and contact lens-related red eye (CLARE). Main parameters examined were nature of the first contact, clinical diagnosis, and management pattern. Forty-two percent of the initial presentations were to health care practitioners (HCPs) other than ophthalmologists. Mean duration from the onset of symptoms to presentation was 6.3 ± 10.9 days. Forty-nine percent (n = 54) of patients had an associated risk factor, most commonly overnight use of contact lenses (n = 14, 13 %). Most common diagnosis at presentation was corneal epitheliopathy (68 %) followed by sterile infiltrates (10 %), CLARE (8 %) and microbial keratitis (6 %). No significant differences were found in the pattern of treatment modalities administered by ophthalmologists and other HCPs. HCPs other than ophthalmologists are the first contact for contact lens-related problems in a significant proportion of patients. These HCPs manage the majority of CLRC by direct treatment or immediate referral.

Influence of Tear Protein Deposition on the Oxygen Permeability of Soft Contact Lenses

“…The studies on factors affecting the Dk of SCL have been continuously conducted since the decrease in Dk negatively affects the physiology of the cornea [ 9 , 10 , 24 , 33 ]. Therefore, it is important to estimate the Dk during SCL wear because decreased Dk will cause side effects such as corneal edema, corneal striae, corneal folds, endothelial polymegethism, and corneal exhaustion syndrome [ 4 , 6 ]. In the present study, SCL were hydrated in artificial tears and proteins were deposited, and then the degree of change in their Dk was evaluated according to the protein deposition.…”

“…Soft contact lenses (SCL) used for visual correction and/or cosmetic reasons act as barriers against the oxygen transportation into the cornea, although the degree varies depending on the characteristic of lens materials, which ultimately affect the lens wearers' tear and corneal metabolism [ 1 – 3 ]. Thus, conventional hydrogel lenses with low oxygen permeability ( Dk ) may cause hypoxic condition of the cornea and can further lead to clinical issues such as corneal edema, corneal neovascularization, corneal acidosis, epithelial keratitis, and endothelial polymegethism [ 4 ]. Particularly, the change of corneal epithelium induced by contact lens wear is known to be found more often in Asian wearers than non-Asians [ 5 ].…”

Moderne Hightech-Kontaktlinsen 2018 – mehr als nur ein Refraktionsausgleich

“…ein Abstrich vom Auge und von der Flüssigkeit aus dem Linsenbehälter. Bei Verdacht auf bakterielle Infektion ist sofort mit einer Therapie zu beginnen [18].…”

Enhancement of Contact Lens Disinfection by Combining Disinfectant with Visible Light Irradiation

“…With approximately 125 to 140 million contact lens wearers worldwide [1][2][3] (numbers from 2004 and 2010) the prevention of lens-related infection is a serious healthcare issue. Several ocular diseases are associated with contact lens wear, such as contact lens acute red eye (CLARE), contact lens peripheral ulcer (CLPU) and infiltrative keratitis [4][5][6][7]. Due to the high numbers of contact lens users, even complications with a rare occurrence will concern a considerable number of patients.…”