Ho Derek K-H, Mathews John P
Stanley Eye Unit, Abergele Hospital, Llanfair Road, Abergele, Conwy, North Wales, LL22 8DP, UK.
BMC Ophthalmol. 2017 Jul 4;17(1):116. doi: 10.1186/s12886-017-0505-4.
Bandage contact lenses are commonly used by ophthalmic practitioners to protect the patient's cornea. We report a case of folded bandage contact lens retained for six and a half years in the upper subtarsal space. To our knowledge, no other cases of retained bandage contact lens have previously been reported in the literature.
A patient was applied a pair of bandage contact lenses due to persistent ocular pain secondary to dry eye symptoms. At her subsequent visit, bandage contact lens was removed from her left eye, but none was found in the right eye. Documentation from further visit stated that the bandage contact lenses were no longer in situ. 6.5 years since the lens insertion, lid eversion revealed a 'foreign body' retained beneath her right upper eyelid, which was noted to be a folded, discoloured bandage contact lens.
The 'upper fornix trap', where the contact lens may be retained by the upper tarsal edge, presents an anatomical hazard for contact lens users. Moreover, soft contact lenses may be more likely to retain asymptomatically and to fold onto itself compared to hard lenses. Our case report highlights the importance of performing a thorough eye examination, which includes double eversion of the upper eyelids and sweeping of the fornices with cotton buds, and maintaining clinical suspicion of contact lens retention.
眼科医生常用绷带式隐形眼镜来保护患者的角膜。我们报告了一例折叠式绷带式隐形眼镜在上睑结膜下间隙留存六年半的病例。据我们所知,此前文献中尚未报道过其他绷带式隐形眼镜留存的病例。
一名患者因干眼症继发的持续性眼痛而佩戴了一副绷带式隐形眼镜。在她随后的就诊中,左眼的绷带式隐形眼镜被取出,但右眼未发现。进一步就诊的记录表明绷带式隐形眼镜已不在原位。在镜片植入6.5年后,翻转眼睑发现右上睑下方留存有一个“异物”,经确认是一片折叠、变色的绷带式隐形眼镜。
“上穹窿陷阱”(即隐形眼镜可能被上睑板边缘卡住的部位)对隐形眼镜使用者构成了解剖学上的风险。此外,与硬性镜片相比,软性隐形眼镜可能更易无症状留存并自行折叠。我们的病例报告强调了进行全面眼部检查的重要性,其中包括上睑双重翻转以及用棉签擦拭穹窿部,并始终保持对隐形眼镜留存情况的临床怀疑。