cornneal infiltration in response to contact lenses

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Peripheral Corneal Infiltrates

Peripheral corneal infiltrates are corneal infiltrates associated with contact lens use. This condition can also be known as CLACI or contact lens associated corneal infiltrates. Inflammatory cells enter the cornea as a response to toxins or other eye irritants.

CLACI is primarily limited to the edges of the cornea because it is a secondary infection spread from an infected sclera or conjunctiva. There has been a correlation found with bacterial presence in CLACI. Also hypoxia related to contact lens use may be a factor. Tight lens syndrome is thought to be a factor also as it prevents proper tearing which is essential for clearing away debris from the eye. As always, patient compliance with replacement schedules and proper cleaning play an important part in prevention of CLACI. Peripheral corneal infiltrates can be extremely uncomfortable.

Infiltrates can be sterile or infectious. Peripheral corneal infiltrates area usually sterile but can be infectious. Peripheral infiltrates are classified as contact lens associated red eye (CLARE) or contact lens peripheral ulcers (CLPU).

As CLARE is typically associated with extended wear lenses, the patient is often woken up by symptoms of pain, itching, tearing, photophobia, and redness. CLPU is also most common with extended wear users. Symptoms include redness, pain and tearing. Typically, there is no epithelial involvement in either classification.

Initial treatment of all peripheral corneal infiltrates, must identify and treat the cause of the infiltrates. Following that, 24-48 hours of topical antibiotics is recommended. When necessary, topical steroids are used. Eyelids can be cleaned with baby shampoo or lid cleansers.

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