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Emergency: requires immediate attention
Contact lens solution toxicity - External and Internal Eye
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Contact lens solution toxicity - External and Internal Eye

Contributors: Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
Other Resources UpToDate PubMed

Synopsis

As the name implies, contact lens solution toxicity occurs only in patients who wear contact lenses. This toxicity is very often associated with improper contact lens wear or poor contact lens hygiene. The more common form of contact lens toxicity is caused by contact lens overwear (often sleeping in contact lenses) leading to corneal hypoxia. This will lead to rapid decline in vision associated with ocular pain, redness, and light sensitivity. Chronic hypoxia will cause corneal scarring and vascularization. The second type of contact lens toxicity was classically associated with the preservative thimerosal but can be seen with any contact lens solution. With this type of toxicity, patients will complain of ocular discomfort and foreign body sensation. Patients may notice reduced vision, especially when trying to use their glasses and will typically present with severe pain, light sensitivity, and often reduced vision.

Codes

ICD10CM:
H18.829 – Corneal disorder due to contact lens, unspecified eye

SNOMEDCT:
397561005 – Contact lens overwear syndrome

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Keratoconjunctivitis sicca syndrome
  • Herpes simplex virus keratitis
  • Keratoconjunctivitis (eg, Viral conjunctivitis, Vernal keratoconjunctivitis, Atopic dermatitis, Keratoconjunctivitis sicca syndrome)
  • Blepharitis / Meibomitis
  • Giant papillary conjunctivitis
  • Limbal stem cell deficiency
  • Viral keratitis

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated:08/17/2021
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Emergency: requires immediate attention
Patient Information for Contact lens solution toxicity - External and Internal Eye
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Emergency: requires immediate attention
Contact lens solution toxicity - External and Internal Eye
A medical illustration showing key findings of Contact lens solution toxicity : Eye pain, Photophobia, Contact lens wearer, Conjunctival injection
Clinical image of Contact lens solution toxicity - imageId=3144398. Click to open in gallery.
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