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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Confluent corneal staining
Confluent corneal staining

Staining - Confluent

Symptoms

  • Discomfort, which may persist for some time following lens removal

Signs

  • Large area of disruption of the corneal epithelium
  • Corneal fluorescein staining over a substantial area
  • Configurations vary

Etiology

  • Indicates moderate to severe disruption of the epithelium
  • May result from abrasions, foreign body under the lens, major toxic response or severe metabolic insult. May also result from a bound rigid/orthokeratology lens (after overnight wear)

Prevalence

  • Occasional

Differential Diagnosis

Management

  • Cease lens wear until epithelial disruption is repaired
  • Isolate cause of condition and take remedial action
  • Prophylactic antibiotics (ensure pseudomonas coverage) may be advisable and rewetting drops are recommended
  • May consider a topical analgesic or SCL bandage lens if discomfort is severe
  • Monitor in 24-48 hours until epithelium is healed
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