Intraepithelial corneal haemorrhage in a rigid contact lens wearer

Abstract

Intracorneal haemorrhage is a rare complication of modern contact lens wear. While a limited number of reports have described intracorneal haemorrhages (typically stromal) associated with the extended wear of soft contact lenses with limited oxygen permeability for the correction of aphakia, this case report documents the management and resolution of a significant intraepithelial corneal haemorrhage associated with long-term rigid contact lens wear for keratoconus and high myopia.

Case Report: Intracorneal Hemorrhages Seen with Scleral Contact Lens Wear and Netarsudil Therapy

“…There are case reports and series, albeit rare, of intracorneal hemorrhages in contact lens wearers of all modalities, including soft contact lenses, rigid gas-permeable lenses, and older-generation scleral contact lenses. [8][9][10][11][12][13] Intracorneal hemorrhages associated with contact lens use are hypothesized to be associated with hypoxia or mechanical etiologies. In one article, tight peripheral curves were implicated as a possible mechanism causing intracorneal hemorrhages.…”

“…Intracorneal hemorrhages associated with contact lens use are hypothesized to be associated with hypoxia or mechanical etiologies. In one article, tight peripheral curves were implicated as a possible mechanism causing intracorneal hemorrhages 8 . The Scleral Lenses in Current Ophthalmic Practice Evaluation study team surveyed 723 providers who fit an estimated 84,375 patients in scleral contact lenses; the providers cumulatively identified 49 cases of intracorneal hemorrhage seen in scleral lens wearers 14 .…”

“…In one article, tight peripheral curves were implicated as a possible mechanism causing intracorneal hemorrhages. 8 The Scleral Lenses in Current Ophthalmic Practice Evaluation study team surveyed 723 providers who fit an estimated 84,375 patients in scleral contact lenses; the providers cumulatively identified 49 cases of intracorneal hemorrhage seen in scleral lens wearers. 14 Schornack 14 postulated that recall bias may influence the total number of cases reported.…”

Treatment for Intracorneal Hematoma by Anterior Chamber Gas Tamponade Combined With Keratocentesis

“…Furthermore, a report was published on corneal lamellar transplantation for the treatment purpose. 7 However, the gas tamponade approach is considered the least invasive and has a better prognosis; therefore, it should be attempted first.…”

“…The main causes of intracorneal hematoma are associated with intraocular surgeries, such as canaloplasty, trabeculectomy, and cataract surgeries, [1][2][3][4][5] although these are rare cases. Other causes include ocular trauma, inflammatory corneal diseases with stromal vascularization, [6][7][8] and spontaneous or intracorneal hematoma. 9,10 A wide range of treatment options for intracorneal hematoma are available, including conservative natural absorption, 2,10 pharmacotherapy with treatments such as antibiotic drugs, 8 and tissue plasminogen activator.…”