Factors contributing to contact lenses complication

1. CONTACT LENS
COMPLICATION
MOHD ZHARIF BIN MOHD NOR
P82505

2. LEARNING OUTCOME
•Can classify the type of contact lens related
complication
•Can explain factors that contribute to contact lens
related complication

3. TYPE OF CONTACT LENS COMPLICATION
• Infectious complication
• Keratitis
• Corneal perforation
• Pseudomonas corneal ulcer

4. • Non-infectious complication
• Dryness
• Hypoxic reaction
• Giant papillary conjunctivitis
• Corneal epithelial problems
• Endothelial complication
• Neovascularization
TYPE OF CONTACT LENS COMPLICATION

5. FACTORS CONTRIBUTE TO CONTACT LENS
COMPLICATION
•Contact lens material / type
•Contact lens solution / care system
•Contact lens modality / mode or wear
•Contact lens fitting
•Physiological changes

6. •Lens surface accumulate substance
•Tear film
•Eyelids
•Potentially immunogenic, toxic, and become source of
infection
•Lens also occlusive
•Reducing corneal oxygenation
•Trapping waste product of metabolism ( other
potential irritant)

7. •Improvement of lens care system and material have
been directed at reducing the impact of these
compromising condition
•Lens material and care system work hand in hand

8. •Mode of wear and modality have been perceived as a
risk factor of CL complication
•There has been a move to more frequent
replacement lens
• Conventional lens
• Monthly disposable
• Bi-weekly disposable
• Daily disposable

9. •Studies show:
• Daily wear rigid lens – safest type
• Extended wear soft CL – least safe
• Extended wear SCL twice the risk of complication
compare to daily wear rigid lens
• Continuous wear of extended wear SCL resulted in 15
times higher risk of suppurative keratitis than daily wear
RGP
• Extended wear SCL appeared to carry 21 times greater
risk of microbial keratitis compared to daily wear of RGP
•Extended wear lens – suppuration was incrementally
related to number of over night wear

10. •In particular, oxygen performance is not the only
factor involved in infection risk
•The gas permeability of lens decline as their surface
deposited
•Extended wear should therefore still be approached
with extreme caution

11. •All lens wearer ultimately show reduce corneal
sensitivity
• RGP > SCL
• Adaptation to mechanical stimulation
• Reduced oxygen tension at the corneal surface
•Reversible on discontinuation of lens wear
•Reduced corneal sensitivity makes the CL wearer less
aware of corneal abrasion caused by the lens or by
debris trapped beneath it
•Asymptomatic minor epithelial damage

12. •Meibomian gland dysfunction and blepharitis increase
the risk of contact lens complication
•MGD – dryness
•Blepharitis – inflammation of lid margin, discharge
that will attract more deposits and microbial organism

13. References:
• http://www.optometry.co.uk/uploads/articles/586d7b2b81d5c23cb892cbef0
• Suchecki JK, Donshik P, Ehlers WH. Contact Lens Complications.
Ophthalmol Clin North AM. 2003 Sep; 16(3)):471-84