Superior Limbic Keratoconjunctivitis Associated With Cosmetic Soft Contact Lens Wear

Contact Lens-induced Limbal Stem Cell Deficiency

“…11,13–15,22 Although the mean duration of CL use associated with LSCD is 14.2–17.6 years and 12.5–16.25 hours per day, patients have been reported to develop LSCD after as little as 6–12 months of CL use. 11,13,14,16,24 One retrospective review on CL-induced LSCD identified a mean age at diagnosis of 42 years, with 50% of cases presenting with bilateral findings and 58% with previously diagnosed ocular disorders. 11 Disease in CL wearers is frequently bilateral yet asymmetric, commonly because of subclinical disease in the fellow eye.…”

“…27 Thus, as expected, women represent the majority (67–93%) of patients with CL-induced LSCD. 11,13,14,24 The explanation for this slight female overrepresentation beyond their proportionate representation of CL users is unclear but may be related to the increased prevalence of dry eyes in females secondary to hormonal regulatory factors. 11,14 Other underlying discrepancies in gender susceptibility are in need of further elucidation.…”

“…11,13,14,16,24 Patients are usually asymptomatic initially, as were 71.4% of patients in a recent chart review of CL-induced LSCD with corneal conjunctivalization. 13 When symptomatic, patients often describe nonspecific symptoms such as pain, photophobia, decreased vision, tearing, dryness, blepharospasm, redness and irritation.…”

“…11,13,14 Patients wearing CLs, particularly soft CLs, should be annually examined with a high degree of suspicion, 14 with particular attention to the superior cornea and its staining pattern. 7–9,13,14,16–20,22,24,26,28 CL-induced LSCD can be reversible by medical treatment if recognized early. 7,14,19,24 …”

Superior limbic keratoconjunctivitis

“…2 There have been reports of patients who have recovered from CLSLK but have suffered a recurrence when lens wear has been resumed in the absence of thimerosal. 8 Such reports are inconclusive because in many cases the same lens was reused. Despite thorough cleaning, not all of the offending antigen may have been completely purged from the lens.…”