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Friday, June 14, 2013

SCAR FROM CONTACT LENS RELATED CORNEAL ULCER

Here is the scar from a resolved corneal ulcer.  This occurred in a patient who overwore their Acuvue Oasys
contact lenses.  It is common to overwear these lenses because they are very comfortable.

The majority of these cases are in patients in their 20's.  One reason may be that individuals in their 20's have less money generally and so they wear their contact lenses longer, they often don't have a good pair of glasses, and they extend the life of the lens until the lenses start to bother them.  The problem with this is that once the lenses bother the eyes, damage has already occurred to the corneal epithelium.


The scary thing about these corneal ulcers is that most of the time they don't give any warning.  All of a sudden the eyes hurt and the patient is very light sensitive and intolerant of the contact lenses.  It's interesting to me how patients sometimes still try to wear their lenses until they can tolerate it no longer.  


This particular patient is VERY lucky.  This scar is just off the visual axis.  It is close enough so that the patient will have streaks of light and haloes during night driving, but far enough that they can still get 20/20 vision.  But if the ulcer had been more in the visual axis, vision would have been PERMANENTLY decreased.  There may be some slight fading of the scar over decades, but he gets to keep this scar for life. 


Bottom line:  Don't over wear your contact lenses unless you wear the Air Optix Night and Day lenses.  Those are the only lenses I feel comfortable having patients wear more than 12 hours a day because they breath enough oxygen. 

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