Two presentations of upper lid migration of rigid gas-permeable contact lenses

To report two differing forms of upper lid migration of rigid gas-permeable contact lens and review the literature on embedded contact lenses.

Two case reports and review of the literature.

Case 1 was a 36-year-old woman, who presented with a 1-year history of a left upper lid mass. Eversion of the upper lid revealed a tarsoconjunctival mass with an overlying scar. Excision revealed a migrated contact lens within a cyst of conjunctival epithelium. She recalled she had lost the lens 1 year before noticing the mass. Case 2 was a 42-year-old woman, who had a 10-month history of mucopurulent discharge from the right eye. Double eversion of the upper lid revealed an embedded contact lens with pus. Excision demonstrated a lens surrounded by inflamed granulation tissue. She recalled having lost the lens after sleeping overnight with the lens in place approximately 1 year before the development of the mucopurulent discharge.

These cases highlight the importance of acquiring a detailed history of contact lens loss in patients presenting with upper eyelid masses. Furthermore, the history of lens loss may be remote from commencement of symptoms, which may vary significantly between patients.