Contact Lens-Induced Peripheral Ulcer Treatment

Bacterial infections of the cornea can lead to contact lens-induced peripheral ulcers (CLPUs). The most common cause of CLPUs is prolonged usage of unwashed contact lenses, particularly prominent among wearers who leave their lenses in during sleep.

Bacterial Colonization

Corneal ulcers, a common eye disease, are linked to an infection known as bacterial keratitis. CLPU is one variant, specific to contact lens wearers, occurring when gram-positive bacterial strains, Staphylococcus aureus and Staphylococcus epidermidis, begin colonizing one or both of the contact lenses.

CLPU

The bacteria described above eat at the epithelial surface of the cornea, creating an ulcer. The results may produce slight discomfort or severe pain, accompanied by tearing and redness. Also, the formation of a cloudy, grey substance will be observed in the periphery of the eye; essentially, this is puss--a toxic discharge released as white blood cells fight the bacterial infection.

Severity of Bacterial Keratitis

Most eye clinicians agree that microbial keratitis, specifically bacterial keratitis, poses serious danger to the average contact lens wearer. Microbial keratitis is the focal point of modern ophthalmology "due to its potentially devastating effects on the eye, including severe vision loss," as the pathologist Eileen Burd warned back in1994, in an article for The Cornea.

Treatment of CLPU

Fortunately, contact lens-induced peripheral ulcers easily are treatable with antibiotics. Opthomologist Justin Bazan wrote in his blog on CLPU that, "Symptoms rapidly decrease, and the epithelium resurfaces over the lesion, leaving a well-demarcated grayish scar. This scar often assumes a 'bulls-eye' appearance and gradually fades after six months."

Recurrence of CLPU

These corneal ulcers can recur, for various reasons. The foremost reason for this recurrence is patient noncompliance; in other words, the patient's behavior does not change. Patients who've had CLPU must change their contact lenses and apply saline eyewashes as directed by their physicians or risk permanent damage.

References

• Burd EM, Ogawa GSH, Hyndiuk RA. Bacterial Keratitis and Conjunctivitis. In: Smolin G, Thoft RA, editors. The Cornea. Scientific Foundations and Clinical Practice. 3rd ed. Boston: Little, Brown, & Co, 1994. p 115--67.
• Justin Bazan, Contact Lens-Induced Peripheral Ulcer (CLPU)