This document discusses several common complications that can arise from contact lens wear, including dry eye, papillary conjunctivitis, corneal abrasion, corneal hypoxia/edema, neovascularization, keratitis, and corneal ulcer. Dry eye is the most common problem and results from a lack of sufficient lubrication and moisture on the eye surface. Papillary conjunctivitis appears as localized swelling or papillae on the tarsal conjunctiva. Corneal abrasion is a scratch or staining on the cornea surface caused by a poorly fitted lens or lens deposits. Prolonged lens wear can lead to corneal hypoxia/edema from oxygen deprivation. Neovascularization is the growth of new blood

1. NURUL AKIMI ABDULLAH
P82506

2. INTRODUCTION
• CL is an alternative to correct refractive
error, improve visual acuity & for
cosmetic purpose
• Improper handling of CL leads to various
complications

3. DRY EYE
• Most common problem
• Disorder of tear film
• Chronic lack of sufficient lubrication &
moisture on the eye surface
• Range from subtle irritation to inflammation
of the anterior tissue
• Symptoms
– Scratchiness, red eyes, burning sensation, tearing

4. PAPILLARY CONJUNCTIVITIS
• Appearance of localized swelling/papillae
(tarsal conjunctiva)
• Advanced cases, papillae > 1mm, conj.
oedema, mild ptosis
• Soft lens wear
– papillae are more numerous
– Apex (more rounded form)
• Rigid lens wear
– Papillae flatter

5. PAPILLARY CONJUNCTIVITIS
• Early stage of CLPC
– Tarsal conjunctiva looks almost similar to normal
• Advanced CLPC (>grade 2)
– Papillae exceed 1mm
– More readily appreciated with fluorescein
– Slightly depressed apex
– Presence of a tuft of capillary vessels at the apex
• CLPC (> grade 3)
– Conjunctival edema, mild ptosis

6. CORNEAL ABRASION
• Scratch or staining on the surface of cornea
• Tissue disruption
• Caused by poorly-fitted CL, lens deposit,
overwear
• Patterns include arcuate, linear/dimpled,
superior, inferior, temporal, nasal, deep or
superficial

7. CORNEAL ABRASION
• Low level staining(<grade 2)
– Transient
– Not necessarily require action
• Severe staining (> grade 2)
– Conjunctival redness, chemosis, lacrimation

8. CORNEAL HYPOXIA/EDEMA
• One of the most common complication
• Wear lenses beyond replacement schedule
• Sleeping in lenses
• Oxygen deprivation of the eye tissue
• Symptoms include very red painful eye
normally upon awakening
• No signs of infection

9. CORNEAL HYPOXIA/EDEMA
• Management
– Select material with higher oxygen permeability
– Reduce CL wearing time
– Ensure optimal contact lens fit

10. NEOVASCULARIZATION
• New vessel growth at the limbus
• Resulted from chronic hypoxia
• To supply oxygen & nutrients to the tissue
• Vision loss is rare
• Formation & extension of vascular capillaries
into previously avascular region of cornea

11. NEOVASCULARIZATION
• Chronic hypoxia-stromal edema-soften the
stroma
• Tissue more susceptible to vascular
penetration

12. KERATITIS
• Infection of the cornea
• Poor compliance with contact lens wear
• Microorganism invade the cornea causing
surface erosion
• Significantly uncomfortable & photophobia
• Sterile keratitis
– Sterile infiltrate, usually benign
– Can be due to solution toxicity, trauma, hypoxia

13. KERATITIS
• Microbial keratitis
– One of the most serious potential complication
– Infectious (bacteria, virus, fungus, amoeba) gives
positive culture result
– Symptoms
• Foreign body sensation, pain, redness, swollen lids,
lacrimation, photophobia, discharge, vision loss
– Bacterial has rapid & devastating time course
– Acathamoeba is not as rapid

14. CORNEAL ULCER
• The most severe complication of CL wear
• An infection of the deeper layers of cornea
• Full thickness epithelial erosion
• Due to overwear, lens/solution contamination
• Can lead to corneal scarring
• Symptoms
– Pain,tearing,vision loss, photophobia,
watery/purulent discharge

15. THANK YOU