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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Mucin balls slit lamp

Video: Mucin Balls - White Light

Mucin Balls - White Light
Mucin balls lissamine green

Video: Mucin Balls - Sodium Fluorescein Imprints

Mucin Balls - Sodium Fluorescein Imprints

Mucin Balls

Symptoms

  • Generally none
  • Vision may be affected in extreme cases

Signs

Etiology

  • Focal accumulation of components of the tear film (e.g. mucus, lipids) under the lens that cause an indentation in the epithelium
  • Seen most often with higher modulus materials. Most common in EW of SiHy lenses, but not exclusive to these lenses
  • May occur as a result of aqueous-depleted post-lens tear film following overnight wear

Prevalence

  • Rare, although more common in SiHy EW

Differential Diagnosis

  • Microcysts – mucin balls may be similar in size or larger.
    The majority of mucin balls disappear on lens removal, whereas microcysts remain for weeks
  • Dimple-veil – will pool fluorescein, as will mucin-ball indentations

Management

  • Monitor
  • Topical lubricants
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