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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