COMPLICATIONS OF CONTACT LENS WEAR
A patient with contact lens is diagnosed to have overwear syndrome. He has symptoms of photophobia, redness, blurring of vision. Treatment should be:
| A |
Antibiotic +cycloplegic |
|
| B |
Avoid wearing of contact lens till the symptoms settle |
|
| C |
Removal of contact lens and wear new lens |
|
| D |
Send the lens for culture sensitivity |
A patient with contact lens is diagnosed to have overwear syndrome. He has symptoms of photophobia, redness, blurring of vision. Treatment should be:
| A |
Antibiotic +cycloplegic |
|
| B |
Avoid wearing of contact lens till the symptoms settle |
|
| C |
Removal of contact lens and wear new lens |
|
| D |
Send the lens for culture sensitivity |
A 20 year old college student comes to your clinic with complaints of pain, redness, photophobia, eyelid swelling and a foreign body sensation in his eyes. He gives a history of using contact lenses. Examination of eyes shows corneal ulceration, stromal ring and perineural infiltrates.
| A |
Both Assertion and Reason are true, and Reason is the correct explanation for Assertion |
|
| B |
Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion |
|
| C |
Assertion is true, but Reason is false |
|
| D |
Assertion is false, but Reason is true |
A 20 year old college student comes to your clinic with complaints of pain, redness, photophobia, eyelid swelling and a foreign body sensation in his eyes. He gives a history of using contact lenses. Examination of eyes shows corneal ulceration, stromal ring and perineural infiltrates.
| A |
Both Assertion and Reason are true, and Reason is the correct explanation for Assertion |
|
| B |
Both Assertion and Reason are true, and Reason is not the correct explanation for Assertion |
|
| C |
Assertion is true, but Reason is false |
|
| D |
Assertion is false, but Reason is true |
This patient is suffering from acanthamoeba keratitis caused by a free living protozoa acanthamoeba. Acanthamoeba is found in contaminated contact lens solutions, hot tubs, lakes and swimming pool. Signs of acanthamoeba keratitis are central stromal infiltrate, ring infiltrate or satellite infiltrate. Confocal microscopy of the infected cornea is the most accurate method for identifying the organism.
A soft contact lens users has corneal keratitis cause is
| A |
Acanthamoeba-ulcer |
|
| B |
Erosion of cornea |
|
| C |
Pseudomonas infection |
|
| D |
Herpes infection |
A soft contact lens users has corneal keratitis cause is
| A |
Acanthamoeba-ulcer |
|
| B |
Erosion of cornea |
|
| C |
Pseudomonas infection |
|
| D |
Herpes infection |
C i.e. Pseudomonas infection
Complications of soft contact lens are A/E:
| A |
Giant papillary conjunctivitis |
|
| B |
Folliculosis |
|
| C |
Corneal vascularization |
|
| D |
Corneal erosion |
Complications of soft contact lens are A/E:
| A |
Giant papillary conjunctivitis |
|
| B |
Folliculosis |
|
| C |
Corneal vascularization |
|
| D |
Corneal erosion |
B i.e. Folliculosis
Giant papillary conjunctivitis occurs as an allergic response to all except:
| A |
Contact lens |
|
| B |
Intraocular lens |
|
| C |
Prosthesis |
|
| D |
Nylon sutures |
Giant papillary conjunctivitis occurs as an allergic response to all except:
| A |
Contact lens |
|
| B |
Intraocular lens |
|
| C |
Prosthesis |
|
| D |
Nylon sutures |
Ans. Intraocular lens
Corneal complications of contact lens use ‑
| A |
Acanthamoeba keratitis |
|
| B |
Corneal infiltrate |
|
| C |
Corneal vascularization |
|
| D |
All of the above |
Corneal complications of contact lens use ‑
| A |
Acanthamoeba keratitis |
|
| B |
Corneal infiltrate |
|
| C |
Corneal vascularization |
|
| D |
All of the above |
Ans. is ‘d’ i.e., All of the above
Advantages of contact lens
- Contact lens has several advantages over spectacles :-
- Retain binocularity in Anisometropia owing to less magnification of size of retinal image.
- Irregular astigmatism can be corrected.
- No peripheral distoration as it moves with eye and there is normal field of vision.
- Not subjected to moistening.
- Several varieties of contact lens can aid in treatment of dry eye. Hard contact lens may stimulate reflex tearing and also prevent evaporation of tear .
- Cosmatically superior.
- Tinted contact lenses relieve photophobia in albinism.
Disadvantages of contact lens
- Complications of contact lens wearing are : ‑
- Intolerance : – Some people find wearing contact lenses intolerable.
- Corneal complications : – Corneal abrasion, Corneal edema, Corneal vascularization, Microbial keratitis (Pseudomonas, acanthamoeba), Sterile corneal infiltrate.
- Giant papillary conjunctivitis.
- Hypoxia : – Cornea is deprived of oxygen from the tear film by the presence of the contact lens. The cornea becomes edematous and new vessels may develop in the timbal area.
- Sensitivity : – This may develop in response to the preservative (thiomersal) in the cleaning and soaking solution. This results in allergic conjunctivitis.
Most common infection in contact lens users is‑
| A |
Streptococcus |
|
| B |
Pseudomonas |
|
| C |
Staphylococcus |
|
| D |
Neisseria |
Most common infection in contact lens users is‑
| A |
Streptococcus |
|
| B |
Pseudomonas |
|
| C |
Staphylococcus |
|
| D |
Neisseria |
Ans. is ‘b’ i.e., Pseudomonas
Complications of contact lens wear
- Complications of contact lens wearing are : ‑
- Intolerance :- Some people find wearing contact lenses intolerable.
- Corneal complications :- Corneal abrasion, Corneal edema, Corneal vascularization, Microbial keratitis (Pseudomonas, acanthamoeba), Sterile corneal infiltrate.
- Giant papillary conjunctivitis
- Hypoxia :- Cornea is deprived of oxygen from the tear film by the presence of the contact lens. The cornea becomes edematous and new vessels may develop in the limbal area.
- Sensitivity :- This may develop in response to the preservative (thiomersal) in the cleaning and soaking solution. This results in allergic conjunctivitis.
Keratitis in contact lens wearer is caused by all except ‑
| A |
Pseudomonas |
|
| B |
Pneumococcus |
|
| C |
Aspergillu |
|
| D |
Chlamydia |
Keratitis in contact lens wearer is caused by all except ‑
| A |
Pseudomonas |
|
| B |
Pneumococcus |
|
| C |
Aspergillu |
|
| D |
Chlamydia |
Ans. is ‘d’ i.e., Wilson’s disease
Ectopia lentis
- o Ectopia lentis is defined as displacement or malposition of the crystalline lens of the eye. The lens is considered dislocated (luxated) when it lies completely outside the lens patellar fossa. The lens is described as subluxated when it is partially displaced but contained within the lens space. Causes are
i) Homocystinuria
ii) Marfan syndrome
iii) Weil – Marchesani sydrome
iv) Ehler Dan los syndrome
v) Hyperlysinemia
vi) Sulphite oxidase deficiency
vii) Stickler syndrome
viii) Trauma
ix) Consecutive / spontaneous (Hypermature cataract, buphthalmos, high myopia)
A soft contact lens wearer developed pain & itching of the eye & showed a reticular pattern on the corneal epithelium the cause could be:
| A |
Corneal dystrophy |
|
| B |
Acanthamoeba |
|
| C |
Pseudomonas |
|
| D |
Recurrent |
A soft contact lens wearer developed pain & itching of the eye & showed a reticular pattern on the corneal epithelium the cause could be:
| A |
Corneal dystrophy |
|
| B |
Acanthamoeba |
|
| C |
Pseudomonas |
|
| D |
Recurrent |
- Typical reticular pattern due to radial keratoneuritis (Radial perineuritis).
- Due to this, the pain is very severe (neurological due to perineuritis) which is out of proportion to the degree of inflammation.
- Later, reticular superficial keratitis advanced to ring-shaped lesion in central or paracentral region.
