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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folds, striae slit lamp

Corneal Folds and Striae

Symptoms

  • May be asymptomatic
  • Glare sensitivity in some cases

Signs

  • Folds appear as long straight dark lines in the posterior stroma, as observed in the specular reflex
  • Striae appear as fine white vertical lines, which tend not to branch, in the posterior stroma
  • Observed in early morning with EW lenses or high plus DW hydrogel lenses

Etiology

  • Increased hydration in posterior stroma results in separation of the ordered collagen structure
  • Folds occur with edema of >8%.
  • Striae occur if stromal edema is > 5%, with the number of striae related to the degree of corneal swelling

Prevalence

  • Occasional. Rare with modern lenses

Differential Diagnosis

Management

  • Improve lens Dk/t or Change to DW
  • Manage same as for stromal edema

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