A Guide to Clinical Contact Lens Management

Signs, Symptoms, Diagnosis and Management

Academy for Eyecare Excellence™
IN COOPERATION WITH
Centre for Contact Lens Research
Home
Cornea
Limbus
Conjunctiva
Lid
Contact Lens
 
Signs
Symptoms
Contact Us

Visual Disturbance

Characteristic Type Consistency Mode of Onset Severity
Alternatives
  • Reduced VA
  • Flare
  • Glare
  • Non-specific
  • Constant
  • Intermittent
  • Night
  • Near
  • Distance
  • Without lens
  • Sudden
  • Gradual
  • Fluctuating
  • Mild
  • Moderate
  • Severe

Symptoms

  • Reduced or fluctuating vision; glare

Signs

  • Acuity reduced from previous best acuity or acuity fluctuating with blink
  • Keratometry mires on lens front surface may show breakup and distortion < 5 seconds after blinking
  • Low contrast VA affected more than high contrast VA when increased intra-ocular light scattering is present
  • Effect of refractive error exacerbated by large pupils

Etiology

  • Discomfort may be attributed to the lens(es), maintenance solutions or ocular factors

Prevalence

  • Common

Differential Diagnosis

  • Symptoms will frequently allow identification of cause; ensure ocular pathology is ruled out as cause of reduced vision

Management

  • Depends upon source of visual loss
  • May require mydriatic examination, central Amsler grid assessment and/or full visual field testing to rule out more serious pathology
  • Management options include changing the CL prescription, changing to a toric lens if uncorrected astigmatism, changing to a rigid lens in the case of corneal distortion (e.g. keratoconus) or trauma, changing CL material or using rewetting drops (all depending on the underlying cause of the reduced vision)
Consider refit to toric lens Consider GP lenses Counsel patient on lens care Review

Alcon Vision Care is uniquely poised to serve every contact lens wearer by addressing the full life cycle of their needs.