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