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Egor Fedoseev
Egor Fedoseev

Contact Lens Complications ((NEW))



Contact lenses must therefore be designed with the ability to allow oxygen to permeate through the lens, in order to reach the cornea. If a problem arises that prevents this from occurring, serious complications can develop.




Contact Lens Complications


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Treatment generally involves changing the type of lens you wear and the solution you use, as well as eyelid hygiene. Your doctor may recommend taking a break from contact lenses altogether until your symptoms have subsided.


If your eyes are red and sore, you may be having an allergic reaction to your contact lens solution. Most people with allergic reactions to their solutions have a sensitivity to the preservatives found in the solution.


If your contact lens does not fit properly, it will not adhere to the surface of your eye and will move around easily. This can result in a corneal abrasion, or a scratch on the epithelium, the outermost protective layer of the cornea.


A corneal ulcer is a sore that develops on the cornea, generally from a bacterial, viral, or fungal infection. Contact lens wear increases the risk of corneal ulcers when improper hygiene enables germs to get lodged behind the lens.


Treatment generally involves discontinuation of contact lens wear for several weeks, or sometimes even permanently, hospitalization until the infection is under control, and corneal transplant surgery to recover normal vision. In very rare cases, patients with severe corneal ulcers lose an eye from the condition.


The cornea is the second most densely-packed innervated organ, after the brain. In many cases, after years of wearing contact lenses, the corneal nerves become desensitized to the contact lenses due to either mechanical trauma or metabolic changes. This can cause problems later on in life.


This condition occurs as a result of an immune response to your contact lenses and/or bacteria on your contact lenses. This condition can cause a more serious complication called microbial keratitis, and must therefore be closely monitored.


Microbial keratitis is a type of corneal ulcer that causes an infection of the cornea. This condition is a serious complication of contact lens wear that can cause vision loss. Though rare, it is most often associated with overnight lens wear and extended-wear, as well as poor hygiene or using inappropriate cleansing solutions.


While this is a rare condition, especially with newer contact lens designs that use oxygenated materials, it is important to follow up with your regular eye exams so your doctor can continue to check for this complication.


Contact lenses are one of the most regularly used medical devices. These are worn directly over the cornea. These are used to correct refractive errors and moderate-to-severe eye problems. Also, cosmetic contact lenses are becoming popular because of their aesthetic value. Several people using contact lenses are developing eye problems. Recent scientific studies have pointed out that regular contact lenses may cause pathologic changes in the human eyes, which can be very harmful.


A. Soft Contact Lenses: These are made up of soft, flexible plastic materials. These lenses help in the passage of oxygen. Silicone hydrogel is used to fabricate these lenses. Due to their flexibility, these lenses are very comfortable.


2. Hydroxyethyl Methacrylate (HEMA) Hydrogel: These materials are biocompatible and expensive. Their oxygen permeability is less, and protein deposition on the lens surface is one of their main drawbacks.


Soft contact lenses are used to correct myopia (a vision problem where near objects are visible but not far objects), hyperopia ( a vision problem where far objects are visible but near objects appear blurred), astigmatism (blurred vision), presbyopia ( gradual loss of ability to focus on nearby objects).


1) Hypoxia-Induced Changes: The avascular cornea gets oxygen and nutrients from the tear film. Excessive wear of polymethyl methacrylate and rigid contact lenses are responsible for such hypoxic changes because of the disruption of contact with the tear film. Corneal changes observed due to the hypoxic conditions are:


2) Superior Epithelial Arcuate Lesion (SEAL): This lesion occurs in the superior cornea, within about 2 mm (millimeter) of the superior limbus (border between cornea and sclera), between the limbus and the contact lens rim. Improper lens fit and lens design are responsible for this. This is characterized by the following:


3) Allergic and Toxic Reactions: Allergic reactions due to contact lens wear are serious complications. Several factors cause this. Irritation or allergic reaction caused by surfactants, lubricants, and buffer solution present on the lens solution. These chemicals cause solution-induced corneal staining (SICS), less commonly known as preservative-associated transient hyperfluorescence (PATH). An annular staining pattern in the peripheral corneal region characterizes this. Silicone hydrogel materials absorb the chemicals in the lens solution and release these materials into the ocular surface. Severe cases are manifested with features of:


4) Contact Lens-Induced Papillary Conjunctivitis: Conjunctival inflammation is caused by silicone hydrogel lenses. The inflammation can be of two types; local and generalized. While local inflammation is asymptomatic, the generalized reaction is caused by an immunologic reaction caused by the denaturation of tear film coating on the lens surface. The hydrophobic nature of these lenses is responsible for depositing lipid substances on the lens surface. This is manifested by:


.5) Microbial Keratitis: This corneal infection is caused by bacteria and fungi. Hypoxic conditions and microtrauma induced by the lens lead to the accumulation of microorganisms. Gram-negative bacteria, such as Pseudomonas aeruginosa, Haemophilus influenzae, and gram-positive species, such as Streptococcus pneumoniae, are responsible for bacterial-induced keratitis. Contact lens-induced acute red eye response is a common condition associated with it. This is manifested by:


Contact lens-associated peripheral ulcer (CLPU) is associated with sterile circular epithelial lesions at the periphery, and anterior stromal infiltrates. A grayish-white infiltration characterizes fungal keratitis with feathery borders with satellite lesions.


Contact lenses are one of the most regularly used ophthalmic devices. Several eye problems can be treated with contact lenses. Selection of proper lenses and maintaining lens hygiene are very important to reduce complications caused by contact lenses. Moreover, proper diagnosis is required to treat lens-related complications.


Contact lenses, while safe and effective for the vast majority of people, can cause a variety eye problems. Some are not too dangerous, such as giant papillary conjunctivitis, while others are more serious, such as corneal abrasions, inflammation or infection. When these complications are diagnosed and treated promptly, the results are typically quite good. However, corneal ulceration and scarring can occur and cause temporary or permanent poor vision. Rarely, contact lens wearers can develop a parasitic infection called acanthamoeba, which can be devastating.


Contact lenses, while safe and effective for the vast majority of people, can cause numerous eye problems such as giant papillary conjunctivitis, new blood vessels in the cornea, corneal abrasions, corneal swelling or infection.


Symptoms depend on the specific problem from none to mild foreign body sensation, itching, redness, decreased contact lens tolerance, mild to severe pain, light sensitivity, mild or severe decreased vision.


Depends on the specific diagnosis. Most require cessation of contact lens wear, at least temporarily. Problems from contact lens overwear or giant papillary conjunctivitis often improve with a contact lens holiday. Some patients may be able to resume contact lens wear, at which point we usually recommend daily disposable lenses. Corneal infections are treated with appropriate antibiotic, anti-fungal or anti-acanthamoeba medications.


Appropriate contact lens wear, including no sleeping, showering, or swimming in contact lenses. Remove contact lenses whenever the eye is red or irritated and seek urgent ophthalmic care if the symptoms persist.


Soft contact lens wear causes the conjunctiva to respond in various ways. The association between conjunctival changes and symptomotology is important to consider, as it can play a role in the outcome of a fitting. However, it is not always entirely clear whether these physiological changes are the underlying cause of contact lens discomfort. This article describes several conjunctival findings that are important to consider in soft contact lens wearers.


This is a non-infectious inflammatory response of the superior tarsal palpebral conjunctiva due to mechanical irritation from chronic eyelid movement over a foreign object. Most commonly, GPC is associated with contact lens wear; however, similar reactions have been noted with exposed ocular sutures, filtering blebs, ocular prosthesis, scleral buckles and elevated corneal scars.2


The polymer of a contact lens can also influence GPC development. The type of polymer can impact the amount of deposits that form on the surface of a lens. For example, polymers that have higher water content and ionic properties attract larger amounts of protein deposits compared with lenses with lower water content.5,6 The push toward increased oxygen permeability with silicone hydrogel contact lenses unfortunately makes the lenses more susceptible to protein deposits. In addition, the higher modulus of silicone hydrogel lenses makes them stiffer, which can cause even more mechanical trauma.7


Pathophysiology. While the true cause of chalasis is not yet known, it is hypothesized that the etiology is multifactorial.13 It may result from local trauma, age-related connective tissue degradation, inflammation or delayed tear clearance.13,14 The dominant theory was derived from the thought that chalasis is the result of an age-related degradation of conjunctival elastic fibers from repeated mechanical insult of the eyelids on the conjunctiva.15 This may escalate with contact lens use, seeing how contact lens wearers, especially gas permeable users, are more likely to have conjunctivochalasis.16 This risk increases with years of wear, as mechanical insult causes the elastic fibers to degrade over time and creates redundant tissue.15,16 041b061a72


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