Case Report:
PK, a 34 year-old, Indian female, first presented to the Cornea and Contact Lens Department of the University Eye Care Center on October 18, 2016 with a chief complaint of dry eyes and blurred vision through her current glasses most prominent in the evening. Patient PK is a financial analyst that spends eight to ten hours on the computer each day. During her free time she enjoys going out with friends and running. PK reported a history of occasional soft contact lens wear with Dailies Aquacomfort Plus on the weekends. She was interested in increasing her soft contact lens wear to a daily basis for cosmesis. PK’s medical history was remarkable for seasonal and environmental allergies. Her ocular history was significant for unilateral …show more content…
Biomicroscopy examination also revealed bilateral papillae leading to the diagnosis of allergic conjunctivitis. Vision and fit were not evaluated at this visit because PK forgot to wear her lenses into the follow-up examination. At this point, PK was given instructions to purchase a Bruder’s Mask to treat the hordeolum and express the meibomian glands, which contributed to her dry eye symptoms. She was also prescribed Zaditor two times daily to manage the allergic conjunctivitis, and instructed to return in one week to assess the fit, health and vision with the Dailies Aqucomfort Plus lenses. At the second follow-up, PK presented with a chief complaint of blurred vision in the evening. She reported an average wear time of five hours per day and felt that the Dailies Aquacomfort Plus lenses provided satisfactory vision and comfort. Upon assessment, the fit revealed poor fitting lenses that had minimal to no movement on blink. The minimal movement viewed with biomicroscopy deemed the Dailies Aquacomfort Plus a suboptimal fit. For this reason, PK was re-fit into Acuvue Oasys with Hydralux (14.3/9.0) lenses. The rationale behind fitting the Acuvue Oasys lens was the flatter base curve (BC) would lead to …show more content…
Resolution of SEAL can take between one to seven days (19, 20). An important change to consider is to switch the patient from extended wear or continuous wear to daily wear. Furthermore, if the lens wear schedule does not resolve the issue, the next step is to re-fit the patient into a different lens material, design, or modulus with close monitoring at follow-up visits (21). If multiple soft contact lens re-fits are unable to resolve the issue, a RGP may be indicated (19,20). The rate of reoccurrence was found in one study to be 63%, however, these patients were not re-fit into a different lens after their initial diagnosis. The same study showed that there was a 16% reduction of reoccurrence when the patient was re-fit into a new lens after the initial lesion
PK, a 34 year-old, Indian female, first presented to the Cornea and Contact Lens Department of the University Eye Care Center on October 18, 2016 with a chief complaint of dry eyes and blurred vision through her current glasses most prominent in the evening. Patient PK is a financial analyst that spends eight to ten hours on the computer each day. During her free time she enjoys going out with friends and running. PK reported a history of occasional soft contact lens wear with Dailies Aquacomfort Plus on the weekends. She was interested in increasing her soft contact lens wear to a daily basis for cosmesis. PK’s medical history was remarkable for seasonal and environmental allergies. Her ocular history was significant for unilateral …show more content…
Biomicroscopy examination also revealed bilateral papillae leading to the diagnosis of allergic conjunctivitis. Vision and fit were not evaluated at this visit because PK forgot to wear her lenses into the follow-up examination. At this point, PK was given instructions to purchase a Bruder’s Mask to treat the hordeolum and express the meibomian glands, which contributed to her dry eye symptoms. She was also prescribed Zaditor two times daily to manage the allergic conjunctivitis, and instructed to return in one week to assess the fit, health and vision with the Dailies Aqucomfort Plus lenses. At the second follow-up, PK presented with a chief complaint of blurred vision in the evening. She reported an average wear time of five hours per day and felt that the Dailies Aquacomfort Plus lenses provided satisfactory vision and comfort. Upon assessment, the fit revealed poor fitting lenses that had minimal to no movement on blink. The minimal movement viewed with biomicroscopy deemed the Dailies Aquacomfort Plus a suboptimal fit. For this reason, PK was re-fit into Acuvue Oasys with Hydralux (14.3/9.0) lenses. The rationale behind fitting the Acuvue Oasys lens was the flatter base curve (BC) would lead to …show more content…
Resolution of SEAL can take between one to seven days (19, 20). An important change to consider is to switch the patient from extended wear or continuous wear to daily wear. Furthermore, if the lens wear schedule does not resolve the issue, the next step is to re-fit the patient into a different lens material, design, or modulus with close monitoring at follow-up visits (21). If multiple soft contact lens re-fits are unable to resolve the issue, a RGP may be indicated (19,20). The rate of reoccurrence was found in one study to be 63%, however, these patients were not re-fit into a different lens after their initial diagnosis. The same study showed that there was a 16% reduction of reoccurrence when the patient was re-fit into a new lens after the initial lesion