Contact Lense Overwear

Definition:  A patient that has severe pain a short time after removing a contact lens  

Signs/Symptoms:  

• Blurred vision from corneal edema

• Injection

• Severe pain

Differential Diagnosis:

• Dry eye syndrome

• Corneal abrasion

• Foreign body

Causes: usually involves sleeping in daily wear or hard contact lenses. 

Evaluation:

• Visual acuity

• Remove the contact lens if not already removed

• Fluorscein stain of the cornea

• Observe for foreign body and abrasion

Treatment:

• Rewetting of a dry contact lens should be the first line of management while lens is still in place in the eye. 

• If initial therapy is ineffective the contact lens should be removed.

• If fluorescein stain is positive for corneal epithelial defects the antibiotic therapy should be instituted 

  • Ciprofloxacin 4 times a day should be used until corneal defects have resolved.

• Reevaluate daily until resolved. 

• Contacts should not be replaced into the eye until total resolution takes place

Prognosis:

Generally good

Patients may need one day for recovery

This does not warrant medvac, but observation for corneal ulcer should be done daily.

This section provided by CAPT Robert B. North, Jr., MC, USN

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