Superior limbic keratoconjunctivitis in contact lens wearers

Area of Science:

• Ophthalmology
• Toxicology

Background:

• Cosmetic contact lens (CL) wear is common.
• Superior limbic keratoconjunctivitis (SLK) is an ocular surface disease.
• Thimerosal is a preservative used in some contact lens solutions.

Purpose of the Study:

• To investigate the link between thimerosal exposure and contact lens-induced superior limbic keratoconjunctivitis (CL-SLK).

Main Methods:

• Studied 40 patients with daily wear cosmetic CLs presenting with SLK-like symptoms.
• Documented exposure to thimerosal-preserved solutions.
• Performed skin and ocular sensitivity testing for thimerosal.
• Examined conjunctival biopsies using light and transmission electron microscopy.

Main Results:

• All patients exposed to thimerosal-preserved solutions developed CL-SLK.
• Symptoms resolved upon discontinuation of lens wear.
• One-third of tested patients showed positive thimerosal sensitivity.
• Microscopy revealed epithelial edema, hyperplasia, inflammation, and reduced goblet cells.

Conclusions:

• Thimerosal exposure is implicated in the etiology of contact lens-related superior limbic keratoconjunctivitis (CL-SLK).
• Discontinuation of thimerosal-containing solutions is crucial for managing CL-SLK.