Case Studies in Ophthalmology
Cases for the Ophthalmology Clerkship
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Case #41 Contact Lenses
History
A 27 year old woman comes to your office complaining of not being able to wear her contact lenses for more than three hours. She also states that her eyelids feel itchy.
She says that she used to be able to wear her lenses for 20 hours a day.
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Question #1
Should she continue to wear these lenses?
Question #2
What are some possible ocular complications of contact lens wear?
Question #3
What are the proposed etiologies for giant papillary conjunctivitis?
Question #4
Which zones of the palpebral conjunctiva are of particular importance in giant papillary conjunctivitis?
Question #5
Which type(s) of lenses are more likely to cause this problem?
Question #6
What are her options for future contact lens wear?
Question #7
What is the probable reason for her having corneal neovascularization beyond the corneal limbus?
References
Allansmith MR et al: Giant papillary conjunctivitis in contact lens wearers. Amer J Ophthalmol 1977; 83:697-708.
Allansmith MR et al: Giant papillary conjunctivitis induced by hard or soft contact lens wear: quantitative histology. Amer J Ophthalmol 1978; 85:766-778.
Meisler DM et al: Cromyln treatment of giant papillary conjunctivitis. Arch Ophthalmol 1982; 100:1608-1610.
Molinari JF: The clinical management of papillary conjunctivitis. Amer J Ophthalmol 1981; 58:886-891.