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in the name of godBoyuk tanrimin adila
Contact Lens-Induced Acute Red Eye(CLARE)
Ehsan Shir Ali Vand(MS Opt)
16th congress of optometryTehran- Iran
August 2013www.optazar.blogfa.com
Definition
- inflammatory eye reaction- Usually unilateral - Redness of limbus- Sterile infiltrative keratitis
Symptoms:
- Redness - Irritation - Mild pain- Photophobia- Watering
sign- Infiltration
- Anterior chamber involvement (-)
- Fluorescein staining (-)
Etiology
- Bacterial contamination- Hypoxia - Tight lens- Deposit
Deposit
- Denatured protein ,calcium ,lipid and…- Mechanical trauma
Bacterial contamination
- Gram negative- Gram positive
Corneal Hypoxia
Examination
- Slit lamp eye examination:- Low mag. Diffuse illumination- High mag. Direct and indirect illumination- Fluorescein staining method
infiltrations
-sterile infiltration
-infectious infiltration
Sterile infiltration
- Contact lens induced peripheral ulcer(CLPU)- Contact lens induced acute red eye(CLARE)- Infiltrative keratitis(IK)
Differential diagnosis
-sterile infiltrations:- CLARE- CLPUC- Infiltrative keratitis(IK)- microbial keratitis(MK)
CLPU
- Unilateral inflammatory reaction- Noticed in morning- Epithelial loss- Anterior chamber involvement- Corneal staining- Watering ,limbal redness ,mild to severe pain ,foreign
body sensation .
Infiltrative keratitis
- Sub epithelial infiltration- Daily occurrence - Burning ,mild pain ,redness- Unilateral inflammatory reaction
Microbial keratitis- Corneal staining more than 2mm in diameter- Focal infiltration more than 1.5mm in diameter- Severe ocular pain that persist or worsens after lens removal- Extensive anterior chamber flare- Significant vision loss
prognosis
- Discomfort- Photophobia- Infiltration- Vision loss
Management
- Cease lens usage - Improve hygiene- Fit frequent replacement lens- Fit low water content lens- Avoid tight lens fit
Thank you for your attention