Unexpected cause for eyelid swelling and ptosis: rigid gas permeable contact lens migration following a 28-year-old trauma

Abstract

A patient presented with left upper eyelid swelling and ptosis. The MRI reported a cyst with proteinaceous content. On surgical excision of the cyst, a rigid gas permeable (RGP) contact lens was found. The RGP lens was encapsulated within the upper eyelid soft tissue. It was later revealed that the patient experienced childhood trauma while wearing RGP contact lenses 28 years previously. The patient assumed that the RGP lens fell out and was lost; however, it can be inferred that the lens migrated into the eyelid and resided there asymptomatically for 28 years.

A rigid gas permeable contact lens discovered embedded in the upper eyelid 7 years after trauma: A case report

“…A literature search revealed five reported cases of an RGP contact lens becoming embedded in the eyelid following trauma [3] , [4] , [5] , [6] , [7] . Only one of the five reports described formation of granulation tissue and a capsule around the contact lens [3] . In the other reports, the contact lens did not cause a foreign-body reaction.…”

“…MRI revealed multiple nodular lesions with a high-intensity signal on T2-weighted images. MRI performed at the time of migration of an RGP contact lens detects proteinaceous cysts around the lens [11] and shows swelling of the surrounding tissues [3] instead of the lens itself. This probably explains why multiple hyperintense lesions were detected.…”

“…The reported sites of migration include the upper fornix, tarsus, preseptal space, and orbit [2] . Although most cases remain asymptomatic, migrated contact lenses are sometimes discovered after the onset of symptoms such as discomfort, eye discharge, eyelid swelling, and ptosis [2] , [3] .…”