What causes corneal opacity with pain after using contacts?

Question

Hello doctor,

I noticed a white cloudy area around the rim of my cornea a couple of days ago with no pain. After a couple of days, I used a rigid gas permeable contact wear. I have now woken up with pain in the same eye, and it is now bloodshot around that one side. I decided not to wear the contacts today, and I have worn the glasses only.

I visited my optometrist, and he has prescribed a steroid drop. I am looking for a second opinion. Of note, I have worn glasses for 25 years. I have used the RGP lenses for 12 years. Had a white patch on the edge of the cornea approximately five years back. This was attributed to contact irritation and healed after a few weeks of not wearing RGPs.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

This is a corneal ulcer. The probable cause is trauma due to lenses or an infected contact lens solution. Please do not use the steroid drop. You can have devastating consequences. The steroid drops will give you very mild relief, but they will stop healing and promote the growth of the ulcer.

Investigations to be done include cultures of lenses and their solution. You should refrain from wearing the contacts in the future. I suggest you use spectacles only.

I suggest you take the following:

Start Moxifloxacin eye drops six times a day.
Start Tobramycin eye drops four times a day.
Start Carboxymethylcellulose plus Naphazoline eye drops 10 to 12 times a day.
Start Homatropine eye drops twice daily. This will cause blurred vision but will give relief.
Start Gatifloxacin eye ointment at bedtime. Have this treatment until the ulcer heals completely.
Visit an ophthalmologist.
Follow up every week.

Consult your specialist doctor, discuss with him or her, and with their consent, take the following medicines.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.