Infiltrative Keratitis

The #1 reason for a contact lens-wearing patient to have a red, painful, light-sensitive eye is not "pink eye", not "corneal ulcer", and not "corneal abrasion". It's infiltrative keratitis, or an INFLAMMATORY event (not infectious, which is why some practitioners choose to call this a "sterile ulcer"...I don't like that term b/c I think the word "ulcer" implies microbial keratitis) that causes a collection of white blood cells in the cornea, or a visible white spot. It causes pain, blur, light sensitivity and redness, most often after SLEEPING in contacts, even contacts that are FDA approved for extended wear. If you sleep in your contacts and you wake up with a painful, red eye, it's probably infiltrative keratitis. I always think it's funny that patients and doctors both will diagnose these as "corneal abrasion". How did it get abraded!!?? You can't "scratch" an eye that has a contact lens on it. Infiltrative keratitis is not dangerous. It's only painful and annoying. Most of them go away on their own in a few days if the lens is removed, still need to come in for an exam. Why? Because unfortunately the symptoms of infiltrative keratitis (redess, pain, light sensitivity, blur) ARE THE EXACT SAME SYMPTOMS AS A MUCH, MUCH MORE SERIOUS CONDITION: microbial keratitis. Only by LOOKING at your cornea will I be able to tell if you have the "no big deal" infiltrative keratitis or the "VERY BIG DEAL" microbial keratitis. No amount of describing your symptoms to me over the phone will allow me to differentiate. So if you sleep in contacts, even if I told you that was ok, and you wake up with a painful, red have to come in. If you have IK I'm just going to Rx you a steroid-antibiotic combo and you'll be over it soon. Maybe this would be a good time to switch to dailies like Alcon's DT1? In 13 years of practice I have yet to have a dailies wearer who had a significant problem...


Popular Posts