Mistaken Diagnosis of Keratoconus Because of Corneal Warpage Induced by Hydrogel Lens Wear

Abstract

Soft contact lens wear can induce corneal warpage mimicking keratoconus. Had the standard treatment for keratoconus been implemented before resolution of the warpage, it could have proven injurious to the patient, because the treatment itself could have provided an impetus for the protrusion to remain or perhaps even progress. Our case gives clinicians reason to pause when dealing with contact lens wearers presenting with corneal curvature irregularities such as keratoconus or ectasia, because of the possibility of lens-induced warpage.

The influence of soft contact lens wear and two weeks cessation of lens wear on corneal curvature

“…Our results found this steepening was only statistically significant for the Tangential radii measured at the inferior location on the cornea. This finding is in agreement with authors who reported increased irregularity of corneal curvature and corneal warpage or pseudo-keratoconic topography with SCL wear [6,11,12].Contact lens-induced corneal warpage is particularly evident with rigid CL wear but up to 27.5% of reported cases have been associated with SCL wear [3,[34][35][36][37].…”

Videokeratoscopic indices in relation to epidemiological exposure to keratoconus

“…Epithelial moulding arising from poorly fitted contact lenses might cause spurious inferior steep or SRAX patterns [28].…”

Photorefractive keratectomy in eyes with atypical topography

“…57 Contact lens warpage may take many months to resolve and may have an appearance on topography similar to that of keratoconus. 58,59 …”