CONTACT LENS CONJUNCTIVITIS

Conjunctivitis is caused by virus, bacteria, allergens like smoke and dust particles, or foreign bodies in the eye - typically contacts.

What are the types of conjunctivitis in contact lenses?

There are four types of contact lens induced conjunctivitis.

Allergic conjunctivitis

Atopic conjunctivitis

Toxic conjunctivitis

Vernal conjunctivitis

Allergic conjunctivitis: Allergic conjunctivitis is the most common type. In people without allergy, contacts induce allergy against preservatives in lens solutions. In people with allergy contact lenses aggravate the conditions. Allergic conjunctivitis can be seasonal caused by seasonal allergens like pollens or perennial caused by perennial allergens like smoke, dust or animal dander.

The symptoms are:

Redness

Swelling

Tearing

Itching

Occasional discharge

Sometimes it is difficult to diagnose allergic conjunctivitis because other disorders like dry eyes have similar symptoms. In such cases patient history and deeper eye examination helps. In allergic conjunctivitis, itching is the most severe symptom.

As in other contact lens related disorders the ideal solution would be removal of the offending lens and the solution preservative till the disorder subsides. Later they may be replaced by new lenses and a lens care regime free of preservatives. If the disorder persists gas permeable lenses may be used.

Where lens removal is not possible, artificial tears, cool compressors and ocular irrigation can provide relief. Topical non-steroid and anti-inflammatory agents may be used. Steroids are used, if at all, in more severe cases.

In pre-existing allergy cases the condition should be properly controlled before resuming lens wear.

Atopic conjunctivitis: Atopic conjunctivitis is the most severe form of allergy. People with eczema are more prone to it. It is a chronic condition and the prognosis is guarded. Atopic conjunctivitis is caused by airborne allergens and certain foods.

The symptoms are:

Itching

Dry eyes

Photophobia

Blurred vision

Atopic conjunctivitis left untreated may lead to corneal swelling and conjunctival scarring. In some rare cases, lack of early treatment has led to blindness. Atopic conjunctivitis is rare and is seen mainly in older people.

Topical steroids, mast cell stabilizers and topical antihistamines are the common medications. In severe cases oral steroids may be used for a short time.

Considering the severity of the disorder patients should be dissuaded from wearing contacts.

Toxic conjunctivitis: Toxic conjunctivitis is an allergy often caused by preservatives present in lens cleaning solutions. These preservatives are