Circinate corneal scarring

A 56-year-old man presented with symptoms of monocular diplopia and reduced vision in his left eye. Visual acuities were R6/6, L6/12. At his previous visit left visual acuity was 6/6. An irregular area of anterior corneal stromal scarring was evident, encroaching on the visual axis of the left eye. Rigid lens fitting improved left visual acuity to 6/6, however, lens wear caused a corneal abrasion over the lesion after one to two hours of wear. Several other contact lens and surgical strategies were employed to successfully address the visual requirements of the patient.