contact lens corneal edema

Corneal Edema Caused by Contact Lens Wear

Corneal edema, also known as corneal swelling, is a condition characterized by the buildup of fluid in the cornea, the clear dome-shaped surface that covers the front of the eye. This can be caused by various factors, including contact lens wear.

Causes and Effects

When contact lenses are worn for extended periods, they can impede the flow of oxygen to the cornea, leading to fluid retention and swelling. This is because contact lenses can create a barrier that prevents oxygen from reaching the cornea, causing it to swell (1). Prolonged use of bandage contact lenses can also lead to increased risk of infection and should be treated with broad-spectrum antibiotics (2).

Symptoms and Treatment

Corneal edema caused by contact lens wear may result in mild symptoms such as blurred vision or discomfort. In some cases, it can lead to more severe complications like corneal distortion or even loss of vision (10). To treat this condition, it is essential to select a lens material with higher oxygen permeability and ensure an optimal contact lens fit (10).

Prevention and Management

To prevent corneal edema caused by contact lens wear, it's crucial to follow proper hygiene practices, such as cleaning and disinfecting the lenses regularly. Additionally, taking regular breaks from wearing contact lenses can help maintain healthy corneas (11). If you experience any symptoms of corneal edema, consult an eye care professional for proper diagnosis and treatment.

References

• [1] Although constant contact lens usage can cause mild corneal edema, bandage contact lenses are best tolerated, as they allow greater oxygen transmissibility.
• [2] Corneal edema is the medical name for corneal swelling. Causes include inflammation, infection and injury or eye surgery.
• [10] To treat this condition one should select a lens material with higher oxygen permeability, decrease contact lens wearing time, and ensure an optimal contact lens fit.
• [11] Mild corneal edema may go away on its own if it isn’t too severe. It’s common in postoperative patients who’ve undergone eye surgeries and in people 50 and older.

Common Signs and Symptoms of Contact Lens Corneal Edema

Corneal edema, also known as corneal swelling, is a condition that can occur when wearing contact lenses for an extended period. The symptoms can vary from person to person, but here are some common signs and symptoms associated with contact lens corneal edema:

• Blurry Vision: One of the most noticeable symptoms of corneal edema is blurry vision or hazy eyesight [1].
• Halos around Lights: People with corneal edema may experience halos or rings around light sources, which can be a sign of fluid buildup in the cornea [4].
• Sensitivity to Light: Corneal edema can cause increased sensitivity to light, making it uncomfortable for individuals to look at bright lights or even during the day [12].
• Pain and Discomfort: Some people may experience mild to severe pain or discomfort in their eyes due to corneal edema [7].
• Foreign Body Sensation: A few individuals might feel a foreign body sensation, itching, or redness in their eyes as a result of corneal edema [7].

Other Possible Symptoms

In addition to the above symptoms, some people may experience:

• Rings or Halos around Light Sources
• Pain in the Eye
• The Feeling of Something Stuck in the Eye

It's essential to note that these symptoms can be caused by various factors, including contact lens overuse, infections, and certain eye conditions. If you're experiencing any of these symptoms, it's crucial to consult with an eye doctor for proper diagnosis and treatment.

References:

[1] - Corneal edema may include blurry vision [1]. [4] - Halos around lights are a sign of fluid buildup in the cornea [4]. [7] - Pain and discomfort can be symptoms of corneal edema [7]. [12] - Increased sensitivity to light is a symptom of corneal edema [12].

To diagnose contact lens-related corneal edema, several diagnostic tests can be employed.

• A comprehensive eye examination by an eye care professional is the first step in diagnosing corneal edema. This examination assesses your medical history and inquires about any symptoms you may be experiencing.
• Slit-Lamp Examination: This is often the first step in diagnosing corneal edema. It allows the eye doctor to closely inspect the cornea for signs of swelling, cell loss, and other abnormalities.
• Corneal Scrapings for Smears: In some cases, your doctor may take a sample from the affected area to examine under a microscope for any signs of infection or inflammation.
• Pachymetry: This test measures the thickness of your cornea using a device called a pachymeter. It's essential in detecting subtle changes in corneal thickness caused by edema.
• Anterior Segment Optical Coherence Tomography (AS-OCT): This imaging technique provides detailed images of the front part of your eye, including the cornea. It helps identify subtle changes in corneal thickness and detect any signs of edema.

These diagnostic tests help determine the presence and extent of contact lens-related corneal edema, as well as identify the underlying cause. Proper diagnosis is crucial for effective treatment and management of this condition.

References:

• [1] (Context 2) Contact lenses can cause various eye problems, including new blood vessels in the cornea, corneal abrasions, corneal swelling or infection.
• [3] (Context 3) Pachymetry is used to estimate corneal thickness, but it may not accurately record corneal thickness in cases of edema.
• [4] (Context 4) If your doctor thinks you might have corneal edema, they'll likely measure the thickness of your cornea using a pachymeter and use ultrasound to get a better look at your eye.
• [5] (Context 5) Diagnostic tests for corneal swelling are completed in an outpatient setting, and your ophthalmologist will talk with you about your medical history and symptoms.
• [10] (Context 10) Diagnosing corneal swelling typically involves a comprehensive eye examination conducted by an eye care professional.
• [11] (Context 11) Proper diagnosis of corneal edema involves a thorough examination by an eye care professional, including a slit-lamp examination to closely inspect the cornea for signs of swelling, cell loss, and other abnormalities.
• [12] (Context 12) Diagnostic methods may include a slit-lamp examination, pachymetry, AS-OCT, and others to confirm the presence and extent of edema and identify the underlying cause.
• [13] (Context 13) Corneal distortion can result from acute or chronic hypoxic corneal conditions, contact lens materials, and contact lenses that are inadequately fitted.
• [14] (Context 14) Oedema causes corneal swelling, necessitating the use of a pachometer or AS-OCT to identify subtle changes in corneal thickness.
• [15] (Context 15) Measurement of central corneal thickness is an objective and surrogate assessment for the evaluation of corneal oedema.

Treatment Options for Contact Lens-Induced Corneal Edema

Corneal edema, also known as corneal swelling, can occur due to various reasons, including the use of contact lenses. In such cases, drug treatment is often recommended to alleviate symptoms and promote healing.

• Hypertonic solutions: These are commonly used to treat mild corneal edema caused by contact lens wear. Hypertonic saline drops or ointment can help reduce swelling by drawing water out of the cornea [2].
• Antibiotics: If an infection is suspected, antibiotics such as Polytrim or moxifloxacin may be prescribed to prevent further complications [9]. Broad-spectrum antibiotics are often used in conjunction with cycloplegics to manage symptoms.
• Corticosteroids: These medications can help reduce inflammation and swelling associated with corneal edema. However, their use should be carefully managed due to potential side effects [1].
• Alpha 2-adrenergic agonists and Beta-adrenergic blockers: These medications may also be used in the treatment of corneal edema, particularly in cases where other treatments have failed [6].

It's essential to note that non-surgical treatment options are often preferred for contact lens-induced corneal edema. However, surgical interventions such as corneal transplant or endothelial keratoplasty may be necessary in severe cases.

References:

[1] Your provider may recommend topical items (applied directly to your eye) or other forms of medications, like pills or shots, including: Corticosteroids for inflammation. [Context 1]

[2] Hypertonic solutions, typically 5% sodium chloride ophthalmic preparation or 5% ointment, can improve mild corneal edema by enhancing surface dehydration, as these agents act by creating a hypertonic tear film, thereby drawing water out of the cornea. [Context 2]

[6] Jan 18, 2023 — Postoperative Corneal Edema Medication: Ophthalmics, Other, Antibiotics, Corticosteroids, Alpha 2-adrenergic agonists, Beta-adrenergic blockers. [Context 6]

[9] Jan 18, 2023 — Patients for whom a bandage lens is prescribed should be treated with a broad-spectrum antibiotic (eg, Polytrim, moxifloxacin) 2-4 times a day. [Context 9]

Corneal Edema Caused by Contact Lens Wear: Differential Diagnoses

Contact lens-related corneal edema can be a serious condition that requires prompt attention from an eye care professional. When diagnosing this condition, it's essential to consider various differential diagnoses to ensure accurate treatment.

• Interstitial keratitis: This is a rare but potentially sight-threatening condition characterized by inflammation of the cornea.
• Corneal scar: A scar on the cornea can cause edema and vision problems.
• Salzmann’s nodular degeneration: This is a rare, benign condition that affects the cornea and can cause edema.
• Crocodile shagreen: A rare condition characterized by small, white or yellowish spots on the cornea.
• Band keratopathy: A calcification of the Bowman's layer in the cornea, which can cause edema.
• Anterior basement membrane dystrophy: A genetic disorder that affects the cornea and can cause edema.
• Meesman dystrophy: Another genetic disorder affecting the cornea.

These conditions should be considered as potential causes of contact lens-related corneal edema. It's crucial to rule out these differential diagnoses before proceeding with treatment.

References:

• [3] Corneal edema results if the contact lens fits so tightly against the cornea that the surface epithelium cannot breathe or become oxygenated.
• [4] The Differential Diagnosis. Causes of corneal edema include endothelial disorders, inflammatory processes, ocular surgery, trauma and toxins.
• [9] As discussed earlier, corneal edema consists of the swelling of the midsection of the cornea (stroma) as it is stressed, either from an inadequate oxygen supply ...
• [11] Here’s what’s on the differential for unilateral corneal edema in a white and quiet eye. ... The patient denied any contact lens wear, prior ophthalmic surgery or ocular trauma.

Please note that this list of differential diagnoses is not exhaustive, and other conditions may also be considered depending on individual circumstances.