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CONTACT LENSCONTACT LENS
COMPLICATIONCOMPLICATION
By:
NOOR MUNIRAH BINTI AWANG ABU BAKAR
P82498
INTRODUCTIONINTRODUCTION
The principle causes: COMPLIANCE &
COMPATIBILITY
◦ Inadequate lens-cornea relationship
◦ Insufficient O2 transmissibility
◦ Poorly maintained CL & CL case
◦ Incompatibility to material & solution
◦ Not comply to the dos and don’ts
STATISTICSTATISTIC
CBS news, Aug 20, 2015  CDC: Contact Lens
wearers are putting their eyes at risk.
Report from US Centers for Disease Control
and Prevention
◦ Risk of an eye infectionPercentage Activity with lens on
87% Sleep
85% Showered
61% Swimming
55% Top off lens solution in the lens case
99% Neglect CL hygiene at least once
30% Rinse with tap water
Research: 1000 contact lens wearer, age >18 years old
CL WEAR COMPLICATIONSCL WEAR COMPLICATIONS
Eyelids Tear film Conjunctiva
Corneal
epithelium
Limbus
Corneal stroma Corneal
TEAR FILMTEAR FILM
DRY EYE
•Why?
•Tear volume deficiency
•Excessive tear evaporation
•Complaints:
•burning, dryness, irritation,
blurry vision
•Associated with:
•MGD, reduced tear prism
•Diagnosis:
• TBUT, Schirmer, Phenol red
test, lissamine green
•Management:
•Rewetting drops, lid and lens
margin
EYELIDSEYELIDS
Meibomian gland dysfunction(MGD)
•What?
•An inflammation /blockage affect
meibomian gland
•37%-47% suffer
•Signs:
•Oily droplet along lid margin
•Greasy lens
•Symptoms:
•Smeary vision, dryness, itchiness,
irritation,
•Management:
•Lid hygiene, warm compression,
artificial tears, mechanical
expression
CONJUNCTIVACONJUNCTIVA
CL PAPILLARY CONJUNCTIVITIS
(CLPC)
•Signs:
•Papillary changes-cobblestone
formation
•Conjunctival redness
•Complaints:
•Itching, blur vision, discomfort
•Diff. Diagnosis:
• Follicles
•Management:
•Off lens wear, Alter lens type,
design or wearing modailty, alter
care system and ocular hygiene
CL PAPILLARY CONJUNCTIVITIS
(CLPC)
◦ Causes : varies individually
 Allergy to solution or lens material
 Mechanical Trauma
 Cl coating cause trauma to the conjunctiva-release
inflammatory mediator
 Individual suceptibility
LIMBUSLIMBUS
NEOVASCULARIZATION
•What?
•New growth of blood vessel
•18% in extended CL wear ; 11%
in daily wear soft cl
•Why?
•Hypoxia
•Complaints:
•VA lost if extreme
•Management:
•Discontinue CL wear, change
CL with high Dk/t, topical
corticosteroid
CORNEAL EPITHELIUMCORNEAL EPITHELIUM
CORNEAL STAINING
•What?
•Apperance of bright areas of
fluorescein in epithelium
•Type:
•3& 9 O’clock-RGP
• Dimple veiling-RGP
•Inferior Epi. Arcuate lesion (SMILE)
•Superior Epi Arcuate Lesion(SEAL)
•Symptoms:
•Asymptomatic (vision & comfort)
•Photophobia (severe cases)
•Signs:
•VA unaffected
CORNEAL EPITHELIUMCORNEAL EPITHELIUM cont.cont.
CORNEAL STAINING
•Diagnosis:
• fluorescein & cobalt blue filter to
check corneal integrity/tissue
disruption
•Management:
•Rewetting drops,
•lid hygiene
•lens hygiene
CORNEAL STROMACORNEAL STROMA
ACANTHAMOEBA KERATITIS
•Why?
•Replication of amoebae
•Extended CL wear
•Complaints:
•Pain, redness, photophobia
•Associated with:
•hypoxia
•Diagnosis:
• paracentral lesion or central
lesion
•AC with cell & flare
•Management:
•Stop cl wear, topical medication
CORNEAL ENDOTHELIUMCORNEAL ENDOTHELIUM
ENDOTHELIAL POLYMEGATHISM
•What?
•Varies in cell size
•With polymorphism(shape)
•Smptoms:
•Corneal exhaustion syndrome
(discomfort & reduce wearing time)
•Causes:
•Hypoxia
•Hypercapnia
•Management:
•Reduce wearing time
•Fit higher dk/t lens
CONCLUSIONCONCLUSION
Patients may have one or more
complications.
Some of complications related each
other, thus complete management should
be considered.
References:References:
1. Efron, N. Contact Lens Complication. 2nd
. Ed.
2004:Butterworth Heinemann.
2. Cohen, P. CDC: Contact Lens wearers are putting
their eyes at risk. Aug 20, 2015. CBS News..

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Contact lens complication

  • 1. CONTACT LENSCONTACT LENS COMPLICATIONCOMPLICATION By: NOOR MUNIRAH BINTI AWANG ABU BAKAR P82498
  • 2. INTRODUCTIONINTRODUCTION The principle causes: COMPLIANCE & COMPATIBILITY ◦ Inadequate lens-cornea relationship ◦ Insufficient O2 transmissibility ◦ Poorly maintained CL & CL case ◦ Incompatibility to material & solution ◦ Not comply to the dos and don’ts
  • 3. STATISTICSTATISTIC CBS news, Aug 20, 2015  CDC: Contact Lens wearers are putting their eyes at risk. Report from US Centers for Disease Control and Prevention ◦ Risk of an eye infectionPercentage Activity with lens on 87% Sleep 85% Showered 61% Swimming 55% Top off lens solution in the lens case 99% Neglect CL hygiene at least once 30% Rinse with tap water Research: 1000 contact lens wearer, age >18 years old
  • 4. CL WEAR COMPLICATIONSCL WEAR COMPLICATIONS Eyelids Tear film Conjunctiva Corneal epithelium Limbus Corneal stroma Corneal
  • 5. TEAR FILMTEAR FILM DRY EYE •Why? •Tear volume deficiency •Excessive tear evaporation •Complaints: •burning, dryness, irritation, blurry vision •Associated with: •MGD, reduced tear prism •Diagnosis: • TBUT, Schirmer, Phenol red test, lissamine green •Management: •Rewetting drops, lid and lens margin
  • 6. EYELIDSEYELIDS Meibomian gland dysfunction(MGD) •What? •An inflammation /blockage affect meibomian gland •37%-47% suffer •Signs: •Oily droplet along lid margin •Greasy lens •Symptoms: •Smeary vision, dryness, itchiness, irritation, •Management: •Lid hygiene, warm compression, artificial tears, mechanical expression
  • 7. CONJUNCTIVACONJUNCTIVA CL PAPILLARY CONJUNCTIVITIS (CLPC) •Signs: •Papillary changes-cobblestone formation •Conjunctival redness •Complaints: •Itching, blur vision, discomfort •Diff. Diagnosis: • Follicles •Management: •Off lens wear, Alter lens type, design or wearing modailty, alter care system and ocular hygiene
  • 8. CL PAPILLARY CONJUNCTIVITIS (CLPC) ◦ Causes : varies individually  Allergy to solution or lens material  Mechanical Trauma  Cl coating cause trauma to the conjunctiva-release inflammatory mediator  Individual suceptibility
  • 9. LIMBUSLIMBUS NEOVASCULARIZATION •What? •New growth of blood vessel •18% in extended CL wear ; 11% in daily wear soft cl •Why? •Hypoxia •Complaints: •VA lost if extreme •Management: •Discontinue CL wear, change CL with high Dk/t, topical corticosteroid
  • 10. CORNEAL EPITHELIUMCORNEAL EPITHELIUM CORNEAL STAINING •What? •Apperance of bright areas of fluorescein in epithelium •Type: •3& 9 O’clock-RGP • Dimple veiling-RGP •Inferior Epi. Arcuate lesion (SMILE) •Superior Epi Arcuate Lesion(SEAL) •Symptoms: •Asymptomatic (vision & comfort) •Photophobia (severe cases) •Signs: •VA unaffected
  • 11. CORNEAL EPITHELIUMCORNEAL EPITHELIUM cont.cont. CORNEAL STAINING •Diagnosis: • fluorescein & cobalt blue filter to check corneal integrity/tissue disruption •Management: •Rewetting drops, •lid hygiene •lens hygiene
  • 12. CORNEAL STROMACORNEAL STROMA ACANTHAMOEBA KERATITIS •Why? •Replication of amoebae •Extended CL wear •Complaints: •Pain, redness, photophobia •Associated with: •hypoxia •Diagnosis: • paracentral lesion or central lesion •AC with cell & flare •Management: •Stop cl wear, topical medication
  • 13. CORNEAL ENDOTHELIUMCORNEAL ENDOTHELIUM ENDOTHELIAL POLYMEGATHISM •What? •Varies in cell size •With polymorphism(shape) •Smptoms: •Corneal exhaustion syndrome (discomfort & reduce wearing time) •Causes: •Hypoxia •Hypercapnia •Management: •Reduce wearing time •Fit higher dk/t lens
  • 14. CONCLUSIONCONCLUSION Patients may have one or more complications. Some of complications related each other, thus complete management should be considered.
  • 15. References:References: 1. Efron, N. Contact Lens Complication. 2nd . Ed. 2004:Butterworth Heinemann. 2. Cohen, P. CDC: Contact Lens wearers are putting their eyes at risk. Aug 20, 2015. CBS News..