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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SICS diffuse
SICS annular

Video: SICS - Diffuse

SICS - Diffuse

Video: SICS - Annular

SICS - Annular

Video: SICS With/Without a Barrier Filter

SICS With/Without a Barrier Filter

SICS (solution induced corneal staining)

Solution induced corneal staining (diffuse and annular)

Symptoms

  • Frequently asymptomatic
  • Mild stinging or burning may be experienced on lens insertion and immediately following lens removal

Signs

  • Maximal staining often occurs after 2 hours of lens wear
  • Superficial punctate keratitis, often in an annular pattern
  • Superficial punctate keratitis may affect the entire corneal surface

Etiology

  • Research is ongoing with respect to the cause of SICS
  • The staining may be indicative of cellular compromise
  • Some theories suggest that SICS illustrates the binding of fluorescein to epithelial cells, with the contact lens preservative molecule acting as a binding agent

Prevalence

  • Common, particularly with FDA group II hydrogels (especially those containing NVP) and SiHy materials when used with preserved care systems
  • Negligible with hydrogen peroxide and not present with daily disposables

Differential Diagnosis

Management

  • Use solutions without added preservatives e.g. Hydrogen peroxide
  • Rinse lenses with saline prior to insertion; rubbing lenses with the preserved care product prior to storage may also reduce the level of SICS
  • Select SiHy and disinfection solution combinations known to cause less solution-related corneal staining
  • Switch to DD lenses
  • NOTE: If asymptomatic and mild, treatment may not be necessary.
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