Contact Lens Complication

1. NAME: ANG KAI LI
ID NO: P82502
COURSE:NNV6214
LECTURER: PROF MADYA DR HALIZA BINTI ABDUL
MUTALIB

2.  Tight/ loose lens fitting
 Lens material properties (type, water
content, ionic/non-ionic, modulus, Dk)
 Lens replacement schedule (DW/EW/CW)
 Lens modality

3.  Failure in hand washing before handling
lenses
 Replacement lenses on schedule
 Replacement of solution/contact lens casing
 Contact with water
 Follow-up

4.  Thimerosol
 Polyquaternium-1 (Alcon)
 Polyhexamethylene biguanide (B&L)
 Benzalkonium chloride (Allergan)

5. Mucin ball
Vacuoles
Microcysts

6. Aetiology
 Allergic, mechanical, or combination
reaction of superior conjunctival tarsal plate
Signs
 Raised-cobblestone like
 Stringy mucus in tear film and conjunctival
surfaces
 Papillae, >1 mm diameter in GPC
 Hyperemia of the palpebral conjunctiva
 Protein deposits on lens surface

7. Symptoms
 Increased lens movement
 Lens intolerance
 Decreasing comfort; itching
 Decreased or fluctuating vision
Management
 Discontinue lens wear until resolve
 Refit
 Drug therapy-Topical combined anti-histamine
& mast cell stabilizer, NSAID, corticosteroid

8. Aetiology
 Inflammatory of cornea and conjunctiva-
overnight lens wear.
 Gram negative bacteria
 Sensitivity to lens care products
Signs
 Acute, usually unilateral, bulbar hyperemia
(> grade 2).
 Small focal, diffuse peripheral infiltrates may
present

9. Symptoms
 Early morning, acute onset
 Painful, red eye
 Photophobia
 Lacrimation
Management
 Temporary discontinuation of contact lens
wear-monitor
 Palliative therapy
 Regular lens replacement

10. Aetiology
 Low-riding RGP → resulting in inadequate lid
closure and localized corneal desiccation
Signs
 Punctate/diffuse staining at 3&9 o’clock
limbal

11. Symptoms
 Asymptomatic(mild)
 Decreased wearing time
 Discomfort
 Dryness
Management
 Temporary discontinuation
 Refit (SiHy/ larger diameter lens/thinner
edge design)
 Improved blinking
 Tear supplements

12. RINSING
CLEANING
DISINFECTING
-Heat
-Chemical
EXTRA STEPS
-Protein removal/enzymatic
cleaners
-Lubricating/Rewetting
CARE OF LENS
CASING

14. 22 y/o Caucasian man wearing Acuvue lenses
on a DW basis using Renu MultiPlus (B&L),
but showed signs of limbal hyperemia.
Refitted into PureVision (B&L) lenses and
wished to wear on a CW basis
After 7-8 days, pt c/o of burning sensation
and mild crusting on lashes. Comfort & vision
was reduced
Lens appeared to be greasy. Presence of
plugged meibomian glands with translucent
secretions

15.  Diagnosis: MGD
 Remove lenses every 5 days, rub and rinse
them with his ReNu Multiplus, soak them
overnight, insert them the next day for up to
another 5 to 6 nights.
 Artificial lubricants, lid scrubs and warm
compress
 Successfully wears the lenses on EW basis
with no complaints