Corneal Ulcers
 

This is the most serious of all contact lens complications as it can seriously effect your vision and even cause blindness. Soft lens wearers have a greater risk then Gas permeable wearers. Sleeping with your extended wear soft lenses exposes you to the greatest risk and is therefore not recommended. Micro-organisms enters the cornea causing the infection. Many ulcers are caused by unhygienic handling of your contact lenses. Your contact lens case should be kept clean and changed every 3 months. Your lenses should be cleaned daily and disinfected according to the instructions of the solution manufacturers. If your practitioner provides you with an alternative instruction, follow this carefully. Discard old lenses and damaged lenses.

The development of a corneal ulcer (an infection of the cornea) unfortunately is a common complication of contact lens use. Soft contact lenses have a higher risk of corneal ulcer than rigid lenses, but all lenses have some risk. Disposable contact lenses worn extended wear were found to have a much higher risk of corneal ulcer than any other type of lens, for reasons that are not fully understood. A corneal ulcer starts when a bacteria (or rarely a fungus or parasite) infects an area of breakdown in the corneal surface. The surface may break down, forming a small corneal abrasion, due to routine lens use. Overwear of lenses, improper cleaning of lenses, extended wear use of lenses, and overly tight lenses may increase the risk of developing this surface breakdown. Normally, a corneal abrasion, even if tiny, is uncomfortable. However, a contact lens can act as a bandage on the eye masking symptoms, and some contact users develop a lack of sensitivity of the cornea.

Once an infection begins, most people experience severe symptoms. The eye typically becomes red and painful. There may be tearing or discharge and sensitivity to light. The vision may be variably blurred. There are other disorders which can cause these symptoms, but the risk of corneal ulcer in contact lens users is such that the most important thing to do initially is to remove the contact lens. An appointment should be arranged immediately with an ophthalmologist to determine if an infection is present. A corneal ulcer needs to be treated intensively with antibiotic eyedrops, and often a culture of the infected cornea, or of the lens or lens case is performed. Frequent follow-up appointments will help the ophthalmologist determine if the infection is being adequately treated with the antibiotics. Usually a week or two of antibiotic eyedrops is needed, and contact lenses cannot be worn during this time.

A successfully treated corneal ulcer may still leave a scar which could affect the vision. It is important to avoid situations which can lead to corneal ulcer, such as overwear of lenses, poor disinfection techniques, swimming with contact lenses in, and ignoring symptoms of pain or redness.