A Guide to Clinical Contact Lens Management

Signs, Symptoms, Diagnosis and Management

Academy for Eyecare Excellence™
IN COOPERATION WITH
Centre for Contact Lens Research
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3 and 9 o’clock corneal staining
3 and 9 o’clock corneal staining

Staining – 3 & 9 O’Clock

Symptoms

  • May be associated with lens intolerance, reduced wear time, dryness

Signs

  • Fluorescein, rose Bengal and/or lissamine green staining in the nasal and temporal corneal margins adjacent to the lens edge
  • Conjunctival hyperemia along horizontal meridian

Etiology

  • Disruption of the epithelial surface due to tear film breakdown, incomplete blinking, or desiccation

Prevalence

  • Common in rigid lens wearers

Differential Diagnosis

Management

  • Aim to improve the centration of the GP lens
  • Blinking exercises
  • Refit with larger diameter lens and thinner edge design
  • Refit with a GP toric lens if the cornea is >2D toric
  • Refit with SiHys if GP lens fitting cannot be improved
  • Ocular lubricants and/or blinking exercises
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