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    Contact Lens Aftercare & Management

    Resources for monitoring, recording and taking appropriate action during the care of contact lens wearers.

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    Slit Lamp Examination of the Eye

    A reference guide for the correct set-up and use of the slit lamp in contact lens aftercare management.

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    Inferior Epithelial Arcuate Lesions (Smile Stain)

    Example of SMILE stain

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    Foreign Body Staining (Mechanical)

    Foreign body track staining

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    3 and 9 O’clock Staining

    Associated bulbar conjunctival hyperemia along the horizontal meridian

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    Solution Induced Corneal Staining (SICs)

    Example of SICs donut staining pattern

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    Superior Epithelial Arcuate Lesions (SEALs)

    Superior epithelial arcuate lesion (SEAL) viewed with fluorescein

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    Mucin Balls

    Mucin balls visible with medium-high magnification and diffuse white light

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    Dimple Veil

    Dimple veil visible with diffuse white light view

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    Epithelial Microcysts

    Microcysts, reversed illumination

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    Striae

    Striae, visible in optic section

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    Reduced Lens Wettability

    Lens surface drying between blinks

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    Visible Deposition of Tear Film Components

    Calculi (Jelly bumps)

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    Visible Lens Spoilation From External Sources

    Low magnification view of make up on lens

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    Lens Damage

    Torn soft lens edge

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    Tear Film Quality

    Fluorescein tear film break up

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    Tear Film Quantity

    Tear meniscus height measurement on Oculus K5

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    Pterygium

    Nasal pterygia viewed under higher magnification

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    Bulbar Conjunctival Staining (General)

    Punctate staining of conjunctiva viewed under blue light and Wratten filter

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    Bulbar Conjunctival Staining (CL Related)

    Temporal lens edge lissamine green stain viewed under white light

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    Bulbar Conjunctival Edema (Chemosis)

    Acute allergic conjunctivitis with chemosis

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    Bulbar Conjunctival Hyperemia

    Magnified view of conjunctival hyperemia

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    Pingueculae

    Prominent temporal pingueculae

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    Folds

    Corneal folds

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    Scarring

    Marked radial keratotomy (RK) refractive surgery scars

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    Asymptomatic Infiltrative Keratitis (AIK)

    Asymptomatic infiltrative keratitis staining with fluorescein

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    Infiltrative Keratitis (IK)

    Infiltrative keratitis

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    Contact Lens Peripheral Ulcer (CLPU)

    Active CLPU staining with fluorescein

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    Contact Lens Associated Red Eye (CLARE)

    Contact lens associated red eye (CLARE)

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    Microbial Keratitis (MK)

    Microbial keratitis with associated limbal hyperemia

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    Endothelial Changes — Polymegathism

    Corneal endothelial cells viewed in specular reflection

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    Lens Binding (Rigid Lenses)

    Rigid corneal lens bound to cornea

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    Corneal Distortion (Warpage)

    Corneal distortion illustrated by distorted placido disc reflection

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    Limbal Staining

    Low magnification view of circum-limbal lissamine green staining

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    Limbal Edema

    Limbal edema viewed with fluorescein and blue light

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    Limbal Bearing

    Example of limbal bearing with a scleral lens in a very hyperemic eye

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    Superior Limbic Keratoconjunctivitis (SLK)

    Higher magnification view of superior limbic keratoconjunctivitis

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    Neovascularisation

    Extensive corneal vascularization visible under a scleral lens

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    Limbal Hyperemia

    Higher magnification view of limbal hyperemia

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    Contact Lens Associated Papillary Conjunctivitis (CLAPC)

    Marked giant papillae and hyperemia

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    Lid Wiper Epitheliopathy (LWE) / Upper Lid Margin Staining (ULMS)

    Lower lid wiper epitheliopathy with lissamine green

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    Meibomian Gland Dysfunction (MGD)

    Example of frothy tears

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    Blepharitis

    Primarily Staphylococcal Blepharitis, with evidence of some Demodex collarettes too

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    Lid Parallel Conjunctival Folds (LIPCOF)

    Higher magnification example of LIPCOF

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    Corneal Staining

    Confluent central corneal stain