Corneal scarring associated with daily soft contact lens wear

Three young people developed scarring of the corneas in both eyes with loss of visual acuity while wearing cosmetic daily wear soft contact lenses. The condition was bilateral in all cases. The scarring began superiorly, spreading inferiorly, and was associated with signs of external inflammation, that is, conjunctival injection and corneal staining, when the patient first presented. The conjunctival injection resolved quickly on cessation of lens wear. However, the corneal staining and scarring were much slower to resolve. Two cases did eventually resolve completely. However, the other case was left with a permanent decrease in visual acuity, associated with a fairly marked induced astigmatism, secondary to the corneal changes. Possible etiologies of this condition are discussed, including allergies to chemicals and lens deposits or a hypoxic phenomenon. Induced astigmatism, secondary to soft contact lens wear, has previously been documented, apparently related to prolonged wearing time. These cases may be demonstrating the same phenomenon developed to a more advanced and serious stage.