Treatment of refractory vernal ulcers with large-diameter bandage contact lenses

To report two cases of refractory vernal ulcers in which the fitting of a large-diameter (22 mm) hydrogel (Contaflex T75) bandage contact lens (BCL) ameliorated the signs and symptoms of the condition.

Two patients with refractory vernal ulcers are described. Mechanisms of the effect of a large-diameter lens across the ocular surface are discussed in this condition.

The first patient is a 10-year-old boy who had been treated unsuccessfully for a left vernal corneal ulcer with topical prednisolone 0.5% and olopatadine. The vernal ulcer resolved 2 weeks after the fitting of a large-diameter BCL. The second patient is a 4-year-old boy who had been intolerant of all his previous topical medications partly because of his ocular discomfort in association with the right vernal ulcer. A large-diameter BCL was fitted in his right eye. The BCL was removed 2 weeks later with complete healing of the corneal vernal ulcer. Owing to his improved comfort, the patient was able to tolerate topical prednisolone 0.5% drops.

Large-diameter BCLs may be a useful treatment option in the management of refractory vernal ulcers.