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Giant Papillary Conjunctivitis is an inflammation of the conjunctiva, or the tissue that lines the underside of the eyelids. This inflammation is often linked to contact lens wear due to rubbing and contact with contact lenses onto this delicate tissue, which can cause friction and develop into GPC, but is not always directly related to contact lens wear. Patients who are suffering from GPC will present with small bumps, often likened to cobblestone, on the tissue on the underside of the eyelid. This can be viewed only by turning the lids inside out. Patients can expect to experience irritation, sensitivity to light, swelling, and itchy eyes from the bumps as they rest upon the eye. GPC can be treated by discontinuing contact lens wear while the condition is present and can be avoided in the future by ensuring that the lenses are replaced on their correct wearing schedules and are not over worn. Alternatively, patients can switch to daily disposable lenses to mitigate the chance of GPC occurring due to less possibility for protein to build up on the lenses during everyday wear. If not treated, GPC can lead to a complete intolerance for contact lenses and can become harder to treat the longer the condition persists. In the image, we can see an upper lid overturned and the cobblestone-like papillae present.

References: Insight Vision Center Optometry (2020, March 7). Giant Papillary Conjunctivitis. Retrieved from: https://www.insightvisionoc.com/eye-health/giant-papillary-conjunctivitis-2/

Image: Giant Papillary Conjunctivitis (GPC). Eye Care Center of Northern Colorado. Retrieved from: https://eyecaresite.com/eyecare/giant-papillary-conjunctivitis-gpc/

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CLARE ( Contact lens induced acute red eye) also known as just acute red eye. This image below gives us a visual presentation of this condition, which is caused by wearing your contact lenses overnight. It creates an inflammatory reaction to the cornea and conjunctiva as you can see. Symptoms can occur as eye pain, photophobia, epiphora or ocular irritation. Treatment can vary on the symptoms and stage of condition, but antibiotics would be the choice of treatment if it does not go away. It is important to have the patient understand not to "nap" with their CLs and prior to treatment to remove and stop using the contact lenses. After healing, patients may resume the usage of CLs but understanding the wearing schedule.

Contact Lens-associated Red Eye: Causes and Corrections. (n.d.). Retrieved October 05, 2020, from https://www.revieweducationgroup.com/ce/contact-lens-associated-red-eye

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CLARE ( Contact lens induced acute red eye) also known as just acute red eye. This image below gives us a visual presentation of this condition, which is caused by wearing your contact lenses overnight. It creates an inflammatory reaction to the cornea and conjunctiva as you can see. Symptoms can occur as eye pain, photophobia, epiphora or ocular irritation. Treatment can vary on the symptoms and stage of condition, but antibiotics would be the choice of treatment if it does not go away. It is important to have the patient understand not to "nap" with their CLs and prior to treatment to remove and stop using the contact lenses. After healing, patients may resume the usage of CLs but understanding the wearing schedule.

Contact Lens-associated Red Eye: Causes and Corrections. (n.d.). Retrieved October 05, 2020, from https://www.revieweducationgroup.com/ce/contact-lens-associated-red-eye

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Protein Deposit on Soft Contact lenses - Theresa Vu 

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Protein Deposit on Soft Contact lenses - Theresa Vu 

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Anyone who wear contact lenses on a daily basis can experience this complication. The lack of proper lens hygiene and wear schedule can cause protein deposits to form traces of small bumps on the contact lens. Protein deposit are formed by "denatured lysozymes, albumin, gamma globulin and sometimes calcium." Symptoms of protein deposit build up on the lenses are decrease in comfort, blurry vision, and redness of the eye. If build up persist and no immediate check up with your eyecare doctor, it can lead into an infection and severe visual problems.
To reduce protein deposits, one can consider changing lens solution to a solution that contains an enzymatic cleaner, along with the reminder of proper lens hygiene and wear schedule.

Image source:
https://www.bausch.com/ecp/clinical-resources/clinical-eye-photos/soft-contact-lenses#.X3pfUmhKjIU
Information source: https://www.reviewofophthalmology.com/article/handling-contact-lens-complications

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Acanthamoeba Kerititis by Stephanie Sheffer 

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Acanthamoeba Kerititis by Stephanie Sheffer 

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Acanthamoeba keratitis is a parasitic infection of the eye caused by the microscopic ameba Acanthamoeba. This parasitic infection can lead to severe pain and blindness if not treated properly. The cornea is the area of the eye that is most affected. Symptoms of this contact lens complication include eye pain, excessive tearing, foreign body sensation, sensitivity to light, eye redness, and eye sensitivity.  The ameba that causes this corneal infection is found in the soil, air, and natural bodies or water like lakes or oceans. Contacts lens wearer are most at risk for this infection. They can reduce their chances of infection by not swimming or use hot tubs in their contact lenses, not wearing contact lenses while showering, properly disinfecting lenses daily, maintain proper handling,  and avoiding contaminated water overall.
Sources
Image - https://www.reviewofcontactlenses.com/article/daily-disposables-prescribing-trends-and-pipeline-lenses
Content- https://www.cdc.gov/parasites/acanthamoeba/gen_info/acanthamoeba_keratitis.html

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The Bullous Keratopathy is a type of corneal disorder.  It’s a cloudy cornea that is swollen with blisters on the surface.  The swelling leads to a formation of fluid filled blisters afterwards.  By using the slit lamp, fluorescein  is used to determine the damage parts of the cornea.  It also determines what type of treatment could be used determining if it’s serious or not.  This disorder usually will use soft contact lenses are used but only for a short period of time.  The reason is if they are on for long, discomfort by the soft contact lenses, acting as a bandage that aids the cornea.  This picture helps me understand more about management of contact lenses because the contact lenses protect the disorder from spreading/ getting worse.  Contact lens is like a shield and will give the support the cornea so that the Bullous Keratopathy can stop being a threat. The arrow in the picture is a blister.  In order for it to heal, the contact lens needs to play a role to decrease the blister and calm down swelling.
•        (Image) EVO. (n.d.). BULLOUS KERATOPATHY. https://www.doctor-hill.com/NEW2/mesa-eye-doctors/specialists/cornea/bullous-keratopathy/

(Website) Roat, M. (2020, May). Bullous Keratopathy. https://www.merckmanuals.com/home/eye-disorders/corneal-disorders/bullous-keratopathy

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Renee Scott        CLARE: Contact lens acute-induced red eye. This is an inflammatory reaction of the anterior portion of the eye. This condition occurs when patients wear their contact lenses while sleeping.  It is mostly associated with hydrogel lenses but can occur with other types of lenses as well.  The risk for Clare is increased with the use of extended wear contact lenses and is most common during the first 3 months of use.  This condition is usually acute but has a sudden onset in which patients may wake up in serious pain out of nowhere. Patients are generally very light sensitive when suffering from Clare. In cases of Clare, patients are to immediately remove contact lenses and seek medical attention.  In most cases, the condition will resolve itself but some cases require antibiotics.   

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Renee Scott        CLARE: Contact lens acute-induced red eye. This is an inflammatory reaction of the anterior portion of the eye. This condition occurs when patients wear their contact lenses while sleeping.  It is mostly associated with hydrogel lenses but can occur with other types of lenses as well.  The risk for Clare is increased with the use of extended wear contact lenses and is most common during the first 3 months of use.  This condition is usually acute but has a sudden onset in which patients may wake up in serious pain out of nowhere. Patients are generally very light sensitive when suffering from Clare. In cases of Clare, patients are to immediately remove contact lenses and seek medical attention.  In most cases, the condition will resolve itself but some cases require antibiotics.   

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Source: http://www.contactlensart.org/contact-lens-complications/

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Corneal ulcers arise from infections that form and are contained within the cornea.  A person can experience visual impairment, redness in the eye, pain, and discharge which can be mild to severe.  People who wear contact lenses are prone to getting corneal ulcers.  Bacterial infections tend to be the most common reason as to why corneal ulcers form.  Bacterial infections will usually happen as a result of trauma or damage to the eye.  It is important to reduce the chances of ulcers from forming.  The key component is properly washing hands prior to insertion and removal of lenses.  In addition to cleaning and disinfecting the lenses as well.  If an ulcer is left untreated, "it increases in size and grows deep, it can cause perforation (hole)" (Stein, pg. 290, 2018).  A person can also lose the eye that is affected.
Sources:
Garg, P., & Rao, G. N. (1999). Corneal ulcer: diagnosis and management. Community eye health, 12(30), 21–23

Stein H. A., Stein R. M., Freeman M. I. (2018). The OPHTHALMIC ASSISTANT (10th ed). New York, NY: Elsevier
https://www.allaboutvision.com/conditions/corneal-ulcer.htm

Image:
https://www.eyecenters.com/cornea-and-conjunctiva-louisville/corneal-ulcer/cornealulcer_1/

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Protein and Lipid deposit By Alexandro Dorce 

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Protein and Lipid deposit By Alexandro Dorce 

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Many soft and gas permeable contact users for extended wear have at least once experienced what's known as Protein or lipid deposits attached to their contact lens. These common deposits characteristics consist of an opaque film on the contact lenses' located either interior or exterior surface of the lenses. Protein and lipid deposits start with the lysozyme in the tear film that binds to the lens surface and undergoes structural changes that impair the contact lens function. The factors that play a role in why these complications occur happen because of the lens substrate, PH of the tear film, and temperature. Professionals have claimed that the protein and lipid deposits do no harm to patients' cornea surface but could still bring harm to those who happen to wear contacts for daily and extended wear. The problem starts with the deposits blocking the contact lens's outer edges where the tear film would usually have access. Due to the tear film's blockage, the cornea can't receive enough oxygen and decrease comfort and promote impaired vision. Other complications can occur like Giant papillary conjunctivitis or neovascularization. Medical professionals diagnose the problem using the biomicroscope, an instrument used to determine a contact lens's fit. To prevent patients from experiencing these risk factors, health professionals must educate their patients. Health professionals need to teach their patients the importance of practicing good hygiene, providing a better wear schedule, and telling patients to replace their contact lenses when their expiration date comes up. A contact lens follows up could also help with the situation.
Resources:
Contact Lens Society of America. (2016). Advanced contact lens manual (Vol. 1)

https://www.reviewofophthalmology.com/article/handling-contact-lens-complications

https://www.reviewofcontactlenses.com/article/the-how-and-why-of-contact-lens-deposits
Image

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GIANT PAPILLARY CONJUNCTIVITIS -Andrea Hernandez 

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GIANT PAPILLARY CONJUNCTIVITIS -Andrea Hernandez 

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When using the Efron Grading Scale for contact lenses complications in relation to severity of this GPC - I was left astonished. It's beyond severe according to the scale. People that wear contact lenses have a greater chance of getting GPC. You know you have GPC  when the inside of your eyelid gets: red, swollen, and irritated. At first the inside of the eyelid is rough ,red, and swollen but later you see these bumps called papillae that can grow to the size of a pimple if not larger as the case in the image shown below. Other symptoms include: something is stuck in our eye, swollen or droopy eyelids, excess mucus in the eye making vision blurry. If not treated right away if can cause serious damage to the eyelid and cornea. Therefore affecting the patients visual acuity. It is also important to keep in mind and consider exchanging the contact lenses for one with a different edge and polymer modulus.- RGP. lenses, this may help combat the mechanical aspects of GPC. Symptoms usually decrease quickly after these adjustments, but it will take longer for the papillae to return to normal.Once a patient is diagnosed with GPC they should be eased back into contact lens wear, and should follow a daily wear schedule with daily disposables or frequently replaced lenses to keep up with the healing.

References:
Boyd, K. (2020, March 25). Giant Papillary Conjunctivitis. Retrieved October 01, 2020, from https://www.aao.org/eye-health/diseases/what-is-giant-papillary-conjunctivitis

Image:
Lai, Y., Sundar, G., & Ray, M. (2017, September 17). Surgical treatment outcome of medically refractory huge giant papillary conjunctivitis. Retrieved October 1, 2020, from https://www.sciencedirect.com/science/article/pii/S2451993617300464

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Waleska Reyes
Acanthamoeba Keratitis is a rare sight-threatening parasitic infection that can have serious effects like blindness. Acanthamoeba is a microscopic ameba, which is a single celled living organism that then causes Acanthamoeba Keratitis when it infects the corneas transparent outer covering. Acanthamoeba Keratitis is mostly seen in people who wears contact lenses who are not storing or handling the lenses properly. AK, can be found in tap water, swimming pools, hot tubs even having home made solutions to clean the lenses. Some signs of Acanthamoeba Keratitis are: eye pain, eye redness, sensitivity to light, blurred vision, excessive tearing, or a feeling of something in the eye. AK can be treated with medications and can be avoided by washing hands, storing the lenses before any activity involving water, most importantly following your eye care providers care plan.
Source:  “Acanthamoeba Keratitis FAQs.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 Nov. 2010, www.cdc.gov/parasites/acanthamoeba/gen_info/acanthamoeba_keratitis.html.
Image: Vislisel, Jesse. “Acanthamoeba Keratitis.” Acanthamoeba Keratitis, 11 Sept. 2015, eyerounds.org/atlas/pages/acanthamoeba/index.htm.

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Nasal and Temporal Epithelial Disruption by Chris Hunt

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Nasal and Temporal Epithelial Disruption by Chris Hunt

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Commonly referred as 3 o’clock and 9 o’clock staining. Insufficient tear exchange under the GP lens at the nasal and temporal cornea. The tear film over that portion is not steadily replenished and resulting in epithelial desiccation. This could be due to a laterally displaced lens, incomplete blink, or excessive edge clearance. To correct this issue change to a soft lens if capable or change the GP to a larger diameter. Redesigning the GP peripheral curves or changing to a sclera lens will also work, as well the patient needs to blink more to produce more exchange of the tear film.

References

Contemporary CL complications. (2018, December 1). Retrieved from https://www.clspectrum.com/issues/2018/december-2018/contemporary-cl-complications

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Epithelial Microcysts

Joy McElhaney

Epithelial microcysts are caused by chronic metabolic stress. “They appear as minute scattered gray opaque dots with focal illumination and as transparent refractile inclusions with indirect retroillumination” (Prasannakumary, C. & Jyothy, P.T., 2017). The patient’s vision is normally unaffected. These microcysts are usually identified from wearers of extended wear soft contact lenses. A small number of microcysts are not dangerous, however, a large quantity could signify epithelial metabolic distress. Treatment includes decreasing overnight wear of contact lenses, change of wear habits to daily wear only or increasing the frequency of lens replacement.

Source:

Prasannakumary, C. & Jyothy, P.T. (2017) Complications of contact lens. Kerala Journal of Ophthalmology. Retrieved on September 29, 2020 from http://www.kjophthal.com/article.asp?issn=0976-6677;year=2017;volume=29;issue=2;spage=68;epage=71;aulast=Prasannakumary

Photo Credit: Google Image Search

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I choose microial keratitis for my topic. This is a pathologic condition. It is a corneal infection from wearing contact lenses although this is not always the case.. It can be bacterial, viral, or fungal. The patient would most likely experience pain, redness, photophobia, discharge, blurred vision and awareness of spots on the cornea. This is usually treated with antibiotic eyedrops.

Retrieved from Google images: Bronner, A., OD November 15, 2017 Manging Microbial Keratitis
Dictionary of Eye Terminology, 6th edition, Cassin, B., Rubin, M., MD 2012

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I chose giant papillary conjunctivitis.  GPC is painful and may take weeks to heal properly.  There are many reasons on why a patient may develop GPC.  Some of those reasons consist of poor eye health, improper care of contact lenses, or over wearing contact lenses.  According to Doctor Castle, “ GPC does not cause problems instantly”(2017).  Therefore, many patients do not even know they have GPC until it worsens and they are having eye that are burning and perhaps leaking some discharge.  It is important for patients to understand that contact lenses are not bad but they do have possible risk factors that they need to be informed about incase they have any similar symptoms they will know to discontinue wear and call the doctor immediately.

BestAdmin. (2017, June 04). Giant Papillary Conjunctivitis - Treatment, Pictures, Symptoms, Cure. Retrieved June 9, 2019, from https://doctorcastle.com/giant-papillary-conjunctivitis

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Bacterial Keratitis aka microbal - Kate Hamlin

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Bacterial Keratitis aka microbal - Kate Hamlin

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This is an infection that causes a dome shaped covering over the color part of the eye. The two commonly known bacterial keratitis are, Pseudomonas aeruginosa and staphlyococcus aureus. The main causes for this occurring are overnight wear, improper care of the contact lenses, eye disease, injuries to the eye, and problems with the eyelids. It is very important that you follow a regular cleaning schedule and be aware of the symptoms to avoid this infection to become potentially blinding.
Signs to look out for: Eye pain, redness, blurred vision, sensitivity to light, excessive tearing and eye discharge. If any of these signs occur see an eye care physician right away!

Source: Center for Disease Control and Prevention
Healthy Contact Lens Wear and Care, April 7, 2014
https://www.cdc.gov/contactlenses/bacterial-keratitis.html

Photo taken from:
https://www.foresteyesurgery.com.au/blog/?post=microbial-keratitis-corneal-abscess

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When reviewing the different images for contact lens complications I found Fungal Keratitis to be one of the most sight-threatening infections of the cornea. The whiteish clear dome almost covering the entire pupil is caused by fungus, which generally include fungi – Fusarium, Aspergillus, and Candida. Microbiological tests are used to diagnose the severity of it. Fungal Keratitis in countries such as India and Nepal are the majority of microbial keratitis. (2017) Commonly caused by yeast-like fungi, poorly cared and extended wear of hydrogels lenses. In 2006 the solution ReNuMoitureLoc had a major outbreak of fungal keratitis, which decreased after summoning back the product. (2017) Other factors that can increase the chance of developing this infection are vegetative trauma, topical steroids, and underlying systemic diseases.

Alipour, F., Khaheshi, S., Soleimanzadeh, M., Heidarzadeh, S., & Heydarzadeh, S. (2017). Contact Lens-related Complications: A Review. Retrieved June 09, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423374/

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The contact lens complication I choose is corneal neovascularization. Corneal neovascularization is when new blood vessels begin to grow into the cornea. Some of the symptoms for this condition are redness, pain, light sensitivity, tearing, and blurring or a visual decrease when using contact lenses. If the corneal neovascularization is not treated once the blood vessels reach 2mm past the cornea margin, permanent vision, or the inability to wear contact lenses will occur. This condition is a result of over-wearing contact lenses resulting in the supply of oxygen for the cornea being cutoff. Other causes for this condition are tight-fitting lenses, trauma, infection, contamination from the lenses or solution, lens deposit buildup, or chemical burn. Due to the broad ways of the cause of this condition, anyone can be inflicted with this condition. Treatment for corneal neovascularization depends on the cause and how severe the condition is. Some of the options are laser photocoagulation surgery, a limited or altogether discontinue the wearing contact lenses.

Corneal Neovascularization in Philadelphia, PA. (2019). Retrieved from https://www.oppdoctors.com/corneal-neovascularization-philadelphia/

Image: Corneal neovascularization. (2019). Retrieved from http://www.eagleeyeuk.com/corneal-neovascularization/

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I chose Acanthamoeba Keratitis because it is a disease that is very common in people who wear contact lens.  Although anyone can contract this disease it is mostly found in those that wear contacts. It is a rare disease but can result in permanent visual impairment and blindness. This infection is caused by microscopic, free living ameba. It affects the outer transparent layer of the eye called the cornea.  This disease can be contracted by disinfecting the lenses improperly, storing and handling the lens improperly, coming in contact with contaminated water, swimming, using hot tub, wearing them while showering and previous cornea trauma. This disease can be treated  with prescription medication by the doctor.  To decrease the chances of you contracting this disease make sure you follow up with your doctor on routine visits, have proper hygiene, avoid wearing your contacts while in the shower and large bodies of water.

Centers for Disease Control and Prevention CD/C 24/7:Saving Lives, Protecting People
https://www.cdc.gov/parasites/acanthamoeba/gen_info/acanthamoeba_keratitis.html
Image: Google/Wikipedia/ancathamoeba

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Meibomian Gland Dysfunction by Christie Agee

Contact lens usage requires a healthy tear film.  The tear film consists of three layers (liquid, aqueous, and mucous) all aimed at creating a healthy and moisturized environment for the eye. A healthy tear film also is an optimal surface for the contact lens to adhere to. In the mucous layer, Meibomian glands located in the eyelids, secrete meibum. Meibum is crucial to providing comfort and optimal vision (Townsend, 2010). One of the primary roles of the tear film is to slow down the evaporation process in the eyes, thus retaining moisture. Though Meibomian Gland complications can occur without contact lens usage, there has been a correlation between contact lens usage and Meibomian gland complications. According to the article “When the Problem is not Infection” by William Townsend, the longer a contact lens is used, the more evaporation of crucial eye moisture occurs. Disfunction of Meibomian glands can lead to blockages (as seen in picture), dry eye, and blepharitis (Hellem, Heiting, 2019). Contact lens usage can also cause Meibomian glands to shorten.

Hellem, A., & Heiting, G. (2019).Meibomian Gland Dysfuntion (MGD): The cause for dry eyes?Retrieved from

https://www.allaboutvision.com/conditions/meibomian-gland.htm

Premium Vison. (2019).Meibomian Gland Probing and Expression [Google+ post]. Retrieved from

http://www.premiumvisionsc.com/meibomian-gland-probing-and-expression-mgpe/ (image)

Townsend, W. (2010). When the problem is not infections: Recognize the signs and symptoms of contact-lens

related complications. Retrieved from https://www.reviewofcontactlenses.com/article/when-the-

problem-is-not-infectious

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(GPC) Giant papillary conjunctivitis- Bianca

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(GPC) Giant papillary conjunctivitis- Bianca

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First off their are 2 forms of GPC Primary and secondary, which I was unaware of. Primary GPC can be cause my seasonal allergies and people with asthma. Secondary GPC Is usually found in people who use soft contact lens. Reason being "allergens are more likely to stick to soft contact lenses than hard lenses." (Allansmith, M.R. , 1987).
Patients with poorly fit soft contact lenses are also susceptible to secondary GPC. With the irritation from a poorly fit lens design you will notice the under the upper lid to form enlarged bumps called papillae. These bumps can be very uncomfortable symptoms include pain, inflammation, blurred vision, increased mucous and decreased lens   tolerance. Treatment will include discontinued use of contact lenses for 2 to 4 weeks and in which afterward patient being refitted maybe with a RGP lens.                                                                 Sources: CLSA VOLUME 2( p.g. 237)
https://www.ncbi.nlm.nih.gov/
Image  http://orphanophthalmics.com/_Media/6e32ea6d_7369_4570_9c86_4-2.jpeg

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I choose corneal edema because it is a common complication with contact lenses but I have not seen many images of it. It is important to be able to recognize the appearance and presentation of it to prevent additional complications from following and the reduce risk of permanent damage.

Edema is typically caused by a lens not having a high enough DK or the lens being too tight and not allowing adequate tear film exchange under the lens. It can occur with GP or soft lenses but is much more common with GP/ scleral lens.

The three main characteristics noticed by practitioners are micro cysts/ bullae ( a bullae is similar to a micro cyst but larger) and a haze in the cornea under slit lamp exam, both of which are not permanent and will preface the third. The third sign is polymegethism which is a permanent disformation of the endothelial cells. If any of these signs are noted, discontinue contact lens use and refer to their PECP (primary eye care physician).

Zimmerman,A (2018). Contemporary CL Complications.Contact Lens Spectrum. https://www.clspectrum.com/issues/2018/december-2018/contemporary-cl-complications

Irina Kezik (Jun 26,2009). Contact Lenses

https://www.slideshare.net/optometristiem.lv/contact-lenses (images)

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I selected microbial keratitis as my main focus. This is inflammation of the cornea caused by infection. Your eyes have a sort of built in defense mechanism with the lids constantly casting off debris and the regenerated layers of the epithelium (aided by the tear film). If a patient in non compliant and over wearing contact lenses, infections and bacteria essentially bask in all their glory on and under the lens. Patient's may report reduced vision, pain, photophobia, watery eyes or excessive discharge. It's important to treat this as quickly as possible to avoid permanent damage/ scarring it's important that a patient see their eye doctor immediately. Causes of this include over wear of contact lenses, contaminated eye care products (cases, expired solutions or drops), dry eye syndrome and reduced immunity function. Communicating with patients proper routines and wear schedules is key to keeping them from becoming a statistic.

Bacterial Keratitis. (n.d.). Retrieved from http://www.improveeyesighthq.com/bacterial-keratitis.html

Gurwood, A. S. O. D., & Helvick, D. ,. B. S. (2011). The Path of Least Resistance. Retrieved from https://www.optometricmanagement.com/issues/2011/may-2011/the-path-of-least-resistance

I'm not a fan of padlet.... why is this stuff EVERYWHERE!

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I chose the topic of lid disfigurement, specifically entropion and ectropion. Normal lids are crucial for contact lens wear. With normal lids, blinking is used to "spread the tear film across the ocular surface to allow for normal lubrication" (CSLA, 17). If there is any compromise to normal lids, the patient's ocular surface can suffer, making contact lens wear  not ideal. In entropion, a patients lids turn inward and can cause irritation to the ocular surface from the lashes rubbing up against it. In this case, bandage contact lenses can actually improve discomfort. Ectropion occurs when the lower lid turns outwards or away from the eye. This causes a problem for the lacrimal lake to properly support tears and can lead to other complicated problems such as "exposure keratits, corneal scarring, corneal neovascularization, corneal ulceration, and possible perforation" if left untreated (CLSA, 4).

Eyelid Malpostion (Ectropion or Entropion “Turning out or turning in”). (n.d.). Retrieved from https://austinoculoplastics.com/eyelid-malpostion-ectropion-or-entropion-turning-out-or-turning-in/

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I chose to depict one of the more serious complications; corneal ulcers. As you can see in the picture there is also subconjunctival hemorrhaging as well as hazing on the cornea we well. Corneal ulcers tend to form where the cornea is ‘damaged’ or ‘compromised’ (Abelson MD, Pietrantonio OD, & Mertz, 2004). Corneal ulcers happen more frequently in contact lens wears, especially those who have poor hygiene habits, do not follow the proper wearing schedule or ignore signs of irritation. Corneal ulcers are very painful, dangerous, and are typically treated with antibiotics.

Source: Abelson MD, M. B., Pietrantonio OD, J. , & Mertz, P. (2004, September 15). Handling Contact Lens Complications. Retrieved from Review of Ophthalmology: https://www.reviewofophthalmology.com/article/handling-contact-lens-complications

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Corneal Neovascularization                       Genesis Perez

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Corneal Neovascularization                       Genesis Perez

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Corneal Neovascularization is a common condition that occurs with contact lens wear. It is often due to hypoxia, meaning lack of oxygen. There can be several reason why new vessels might disturb the non vascularized ( which is what causes hypoxia to start.) The most common reason this condition can happen is by having a tight-fitting lens. There could be different types of neovascularization depending on the case it can lead to other diagnoses, cases including; deep stromal growth or peripheral neovascularization which can be more risky if the vessels reach the corneal too deep. Other factors to be aware of are to see if the patient is sensitive to certain cleaning solutions, proper care to avoid too much lens deposits, consideration of the wear time, and possibly checking the Dk value to make sure oxygen to the cornea is not an issue. Overall, being an eye care professional includes being able to fit a proper lens to the eye in order to avoid a tight lens as well as making sure to explain thoroughly to the patient the importance of at home care as well as to pay attention to any discomfort or issue in order for the eye care professional to be aware of what is going on so these common conditions can be avoided.

Sources:
Image and infornation from;
[Corneal Vascularization]. (n.d.). Retrieved June 10, 2018, from https://www.stmichaelseye.com/corneal-neovascularization
Abelson, M. B. (2004, September 15). Handling Contact Lens Complications. Retrieved from https://www.reviewofophthalmology.com/article/handling-contact-lens-complications