Contact lens complication

contact lens complications by nurul akimi

1. CONTACT LENS COMPLICATIONS NURUL AKIMI ABDULLAH P82506

2. INTRODUCTION CL is an alternative to correct refractive error, improve visual acuity & for cosmetic purpose Improper handling of CL leads to various complications

3. DRY EYE Most common problem Disorder of tear film Chronic lack of sufficient lubrication & moisture on the eye surface Range from subtle irritation to inflammation of the anterior tissue Symptoms Scratchiness, red eyes, burning sensation, tearing

4. PAPILLARY CONJUNCTIVITIS Appearance of localized swelling/papillae (tarsal conjunctiva) Advanced cases, papillae > 1mm, conj. oedema , mild ptosis S oft lens wear papillae are more numerous Apex (more rounded form) Rigid lens wear Papillae flatter

5. PAPILLARY CONJUNCTIVITIS Early stage of CLPC Tarsal conjunctiva looks almost similar to normal Advanced CLPC (>grade 2) Papillae exceed 1mm More readily appreciated with fluorescein Slightly depressed apex Presence of a tuft of capillary vessels at the apex CLPC (> grade 3) Conjunctival edema, mild ptosis

6. CORNEAL ABRASION Scratch or staining on the surface of cornea Tissue disruption Caused by poorly-fitted CL, lens deposit, overwear Patterns include arcuate , linear/dimpled, superior, inferior, temporal, nasal, deep or superficial

7. CORNEAL ABRASION Low level staining(<grade 2) Transient Not necessarily require action Severe staining (> grade 2) Conjunctival redness, chemosis , lacrimation

8. CORNEAL HYPOXIA/EDEMA One of the most common complication Wear lenses beyond replacement schedule Sleeping in lenses Oxygen deprivation of the eye tissue Symptoms include very red painful eye normally upon awakening No signs of infection

9. CORNEAL HYPOXIA/EDEMA Management Select material with higher oxygen permeability Reduce CL wearing time Ensure optimal contact lens fit

10. NEOVASCULARIZATION New vessel growth at the limbus Resulted from chronic hypoxia To supply oxygen & nutrients to the tissue Vision loss is rare Formation & extension of vascular capillaries into previously avascular region of cornea

11. NEOVASCULARIZATION Chronic hypoxia-stromal edema-soften the stroma Tissue more susceptible to vascular penetration

12. KERATITIS Infection of the cornea Poor compliance with contact lens wear Microorganism invade the cornea causing surface erosion Significantly uncomfortable & photophobia Sterile keratitis Sterile infiltrate, usually benign Can be due to solution toxicity, trauma, hypoxia

13. KERATITIS Microbial keratitis One of the most serious potential complication Infectious (bacteria, virus, fungus, amoeba ) gives positive culture result Symptoms Foreign body sensation, pain, redness, swollen lids, lacrimation, photophobia, discharge, vision loss Bacterial has rapid & devastating time course Acathamoeba is not as rapid

14. CORNEAL ULCER The most severe complication of CL wear An infection of the deeper layers of cornea Full thickness epithelial erosion Due to overwear , lens/solution contamination Can lead to corneal scarring Symptoms Pain,tearing,vision loss, photophobia, watery/purulent discharge

15. THANK YOU