Download Severe diffused dry spots in a short

Severe diffused dry spots in a short-term silicone hydrogel contact lens
wearer: A case report
Lung, Chun-Yee Jenny, BSc (Hons.) Optom., Ng, Hou-Yan Larry, OD, FAAO, FBCLA
Purpose: To report an unusual case of severe diffused corneal dry spots in a short-term
silicone hydrogel contact lens wearer.
Case History: A 46-year-old woman, YW, who used to wear conventional hydrogel contact
lens material (Polymacon) asymptomatically for more than 20 years, was made to switch into a
monthly disposable silicone hydrogel (SH) contact lens because of the concern for better
corneal health. After using the new lenses for about three months, the patient complained of
mild ocular irritation, even after the instillation of lubricant eye drops. Biomicroscopy revealed
severe diffused dry spots all over the corneal surfaces in both eyes. However, negative corneal
staining had been noted in both corneas. The patient was thus instructed to cease contact lens
wear immediately. Lubricant eye drops (daytime) and eye gel (nighttime) were prescribed.
After discontinuation of contact lens wear for one week, all the dry spots on both corneas
disappeared. The patient was then made to wear regular daily disposable hydrogel contact lens.
Both subjective feeling and corneal health were found to be optimal during the subsequent
aftercare consultations.
Discussion: The etiology, precaution, clinical management, as well as differential diagnosis of
unusual corneal desiccation during SH lens wear will be thoroughly discussed.
Conclusion: The literature shows no previous case reports that describe severe diffused dry
spots during SH lens wear. Silicone hydrogel material can provide higher oxygen permeability
and lower water content, which may prevent corneal desiccation in some patients with dry eye.
However, the author advises that clinicians and patients should be aware of significant corneal
desiccation signs, which may occur on a cornea with SH lens as compared to a conventional
hydrogel lens. Controlled studies are thus recommended in order to investigate more
thoroughly the cause of significant corneal desiccation during SH lens wear.