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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Furrow staining
Furrow staining

Video: Contact Lens Peripheral Ulcer (CLPU) - White Light

Contact Lens Peripheral Ulcer (CLPU) - White Light

Video: Old CLPU Scars - Central Cornea

Old CLPU Scars - Central Cornea

Contact Lens Peripheral Ulcer (CLPU)

Contact lens peripheral ulcer, culture negative peripheral ulcer, sterile corneal ulcer, sterile infiltrate

Symptoms

  • Moderate foreign body sensation. None in some cases
  • Redness
  • Mild photophobia
  • Symptoms reduce on lens removal

Signs

  • Distinctive, circular infiltrate towards periphery of the cornea
  • Infiltrate has clearly defined margins, size 0.2 to 1.0mm
  • Overlying epithelial staining occurs early in the condition
  • Generally leaves a small scar which fades over time

Etiology

  • Non-infectious, infiltrative response to gram positive bacterial exotoxins

Prevalence

  • Rare in DW, infrequent in EW

Differential Diagnosis

Management

  • Cease lens wear immediately
  • If doubt as to whether infectious or sterile, treat as infectious. Start topical antibiotic
  • Ocular lubricants, steroid/antibiotic combination topical treatment
  • Review within 24 hours
  • Recurrence is likely, limit EW to 6N
  • Consider DD, and lid hygiene
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