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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Contact lens related acute red eye
Acute red eye

C.L.A.R.E.

Contact lens relate acute red eye, acute red eye, tight lens syndrome

Symptoms

  • Early morning, acute onset
  • Painful, red eye
  • Photophobia
  • Lacrimation

Signs

  • Acute, usually unilateral, bulbar hyperemia (> grade 2).
  • Small focal, diffuse peripheral infiltrates may be present.

Etiology

  • Inflammatory reaction of the cornea and conjunctiva usually following overnight lens wear.
  • Due to contamination of the lens with gram negative bacteria.
  • Often minimal or no corneal staining

Prevalence

  • Rare in DW, infrequent in EW.

Differential Diagnosis

Management

  • Cease wear immediately
  • Consider therapeutic treatment for large (>0.5mm) infiltrate(s), if diagnosis is uncertain or for significant discomfort.
  • Review within 24 hours and confirm diagnosis.
  • Wear may be resumed when infiltrates resolve. Hyperemia resolves rapidly, infiltrate resolution may take several weeks.
  • Reduce EW schedule after resolution, consider refit with looser lens or switch to DW. Discuss hygiene habits to prevent contamination of the lenses with bacteria.

Alcon Vision Care is uniquely poised to serve every contact lens wearer by addressing the full life cycle of their needs.