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Corneal pathophysiology with contact lens wear
1Department of Optometry, University of Melbourne, Parkville, Australia.
Survey of Ophthalmology
|July 1, 1990
Summary
Contact lens wear causes corneal changes, primarily reduced epithelial metabolic activity due to hypoxia. Understanding these physiological modifications is key for contact lens clinicians to differentiate normal adaptation from pathological issues.
Area of Science:
- Ophthalmology
- Corneal Physiology
- Contact Lens Science
Background:
- Contact lens wear significantly impacts corneal appearance and function.
- Key alterations include hypoxia-induced reduction in corneal epithelial metabolic activity.
- Other factors like antigens, toxins, mechanical forces, and CO2 retention also affect corneal health.
Purpose of the Study:
- To review corneal changes associated with contact lens wear.
- To categorize these changes based on causative agents and time scales.
- To provide a foundation for understanding the etiology and management of contact lens-induced corneal effects.
Main Methods:
- Review of existing literature on contact lens-induced corneal alterations.
- Analysis of physical and chemical processes underlying observed signs and symptoms.
- Categorization of corneal changes by etiology and temporal progression.
Main Results:
- Hypoxia is a primary driver of reduced corneal epithelial metabolism during lens wear.
- Contact lenses can induce diverse corneal changes through various stimuli (antigenic, toxic, mechanical).
- Distinguishing physiological adaptation from pathological hypofunction is a critical clinical challenge.
Conclusions:
- A systematic understanding of contact lens-induced corneal changes is essential for effective clinical management.
- Identifying causative agents and understanding physiological processes aids in diagnosis and treatment.
- This review provides a framework for managing the spectrum of corneal adaptations and complications from contact lens use.