This document discusses Contact Lens-Induced Acute Red Eye (CLARE), a sterile inflammatory reaction that causes redness, irritation, mild pain, and photophobia in one eye. It is characterized by redness at the limbus and sterile infiltrative keratitis without anterior chamber involvement or fluorescein staining. Potential causes include bacterial contamination, hypoxia, tight lens fit, or deposits on the lens. The document outlines symptoms, signs, etiology, examination techniques, differential diagnosis, prognosis, and management of CLARE.

1. in the name of god
Boyuk tanrimin adila
Contact Lens-Induced Acute Red Eye(CLARE)
Ehsan Shir Ali Vand(MS Opt)
16th congress of optometry
Tehran- Iran
August 2013www.optazar.blogfa.com

2. Definition
- inflammatory eye reaction
- Usually unilateral
- Redness of limbus
- Sterile infiltrative keratitis

3. Symptoms:
- Redness
- Irritation
- Mild pain
- Photophobia
- Watering

4. sign
- Infiltration
- Anterior chamber involvement (-)
- Fluorescein staining (-)

5. Etiology
- Bacterial contamination
- Hypoxia
- Tight lens
- Deposit

6. Deposit
- Denatured protein ,calcium ,lipid and…
- Mechanical trauma

7. Bacterial contamination
- Gram negative
- Gram positive

8. Corneal Hypoxia

9. Examination
- Slit lamp eye examination:
- Low mag. Diffuse illumination
- High mag. Direct and indirect illumination
- Fluorescein staining method

10. infiltrations
-sterile infiltration
-infectious infiltration

12. Sterile infiltration
- Contact lens induced peripheral ulcer(CLPU)
- Contact lens induced acute red eye(CLARE)
- Infiltrative keratitis(IK)

13. Differential diagnosis
-sterile infiltrations:
- CLARE
- CLPUC
- Infiltrative keratitis(IK)
- microbial keratitis(MK)

14. CLPU
- Unilateral inflammatory reaction
- Noticed in morning
- Epithelial loss
- Anterior chamber involvement
- Corneal staining
- Watering ,limbal redness ,mild to severe pain ,foreign
body sensation .

15. Infiltrative keratitis
- Sub epithelial infiltration
- Daily occurrence
- Burning ,mild pain ,redness
- Unilateral inflammatory reaction

17. Microbial keratitis
- Corneal staining more than 2mm in diameter
- Focal infiltration more than 1.5mm in diameter
- Severe ocular pain that persist or worsens after lens removal
- Extensive anterior chamber flare
- Significant vision loss

19. prognosis
- Discomfort
- Photophobia
- Infiltration
- Vision loss

20. Management
- Cease lens usage
- Improve hygiene
- Fit frequent replacement lens
- Fit low water content lens
- Avoid tight lens fit

21. Thank you for your attention