Chronic Morbidity of Corneal Infiltrative Events Associated With Contact Lens Wear

Abstract

In general, contact lens-associated CIEs do not compromise the long-term integrity of the cornea. Changes in lens-related behaviors of patients who have suffered from a CIE seem to be aimed at reducing the risk of a further occurrence. Anecdotally, more severe CIEs may be associated with chronic tissue morbidity.

Corneal infiltrative events

“…Putting this question of terminology aside, 92% and 44% of cases of severe and nonsevere keratitis, respectively, were associated with generalized conjunctival redness in the Manchester Keratitis Study. [4][5][6][7][8][9][10] Thus, the association of CIEs and generalized eye redness cannot be considered to be a reliable indicator of a discrete condition such as 'CLPU'. Since the term 'infiltrative keratitis' implies the presence of infiltrates in the cornea, all CIEs can be considered as being a form of IK.…”

“…The details of this work -collectively referred to as 'The Manchester Keratitis Study' -have been published previously [4][5][6][7][8][9][10] and will be referred to extensively throughout this chapter. The design of this experiment is represented schematically in Figure 24.5.…”

“…Fluffy white infiltrates and other associated signs and pachometry. 8 Snellen visual acuity was recorded in both eyes. A questionnaire was administered to ascertain the type and extent of changes in contact lens wear and care since suffering from the CIE. Slit lamp biomicroscopy revealed the presence of a circular scar, approximately 1.5 mm in diameter, in the central cornea of the right eye of the patient who had suffered the most clinically severe CIE; no residual scar, or any other abnormality, was detected in any of the other 12 patients.…”

Endothelial cell redistribution

“…Efron et al 24 failed to find evidence of a change in endothelial cell density in a group of patients who had recently suffered from a contact lens associated 12 corneal infiltra tive event.…”

Characterizing Contact Lens–Related Corneal Infiltrates

“…6,7 They can often resolve without impact on the corneal tissue or visual acuity. 4,8,9 However, they present with a range of severity, and in serious cases, they may lead to scarring and temporary or permanent reduction in visual acuity. 1,4,8–10 Scar development from CIEs is poorly understood, and the course of infiltrate resolution has not been documented.…”