Tabatabaei Seyed Ali, Soleimani Mohammad, Johari Mohammadkarim
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Oman J Ophthalmol. 2017 May-Aug;10(2):106-108. doi: 10.4103/0974-620X.209109.
To report a case of atypical sterile ring infiltrates during wearing soft silicone hydrogel contact lens due to poor lens care. A 29-year-old woman presented with complaints of pain, redness, and morning discharge. She was wearing soft silicone hydrogel contact lens previously; her current symptoms began 1 week before presentation. On examination, best-corrected visual acuity was 20/40 in that eye. Slit-lamp examination revealed dense, ring-shaped infiltrate involving both the superficial and deep stromal layers with lucid interval to the limbus, edema of the epithelium, epithelial defect, and vascularization of the superior limbus. Cornea-specific laser confocal microscopy (Heidelberg Retina Tomograph 2 Rostock Cornea Module, HRT 2-RCM, Heidelberg Engineering GmbH, Dossenheim, Germany) revealed Langerhans cells and no sign of Acanthamoeba or fungal features, using lid scraping and anti-inflammatory drops; her vision completely recovered. We reported an atypical case of a sterile corneal ring infiltrate associated with soft contact lens wearing; smear, culture, and confocal microscopy confirmed a sterile inflammatory reaction.
报告一例因软性硅水凝胶隐形眼镜护理不当导致的非典型无菌性环形浸润病例。一名29岁女性主诉疼痛、眼红及晨起分泌物增多。她之前佩戴软性硅水凝胶隐形眼镜;当前症状在就诊前1周开始出现。检查时,该眼最佳矫正视力为20/40。裂隙灯检查发现致密的环形浸润,累及浅层和深层基质层,与角膜缘有清晰间隔,上皮水肿、上皮缺损及上方角膜缘血管化。角膜特异性激光共聚焦显微镜检查(德国海德堡工程公司的海德堡视网膜断层扫描2型罗斯托克角膜模块,HRT 2-RCM)显示有朗格汉斯细胞,未发现棘阿米巴或真菌特征,通过睑缘刮片及使用抗炎滴眼液后,其视力完全恢复。我们报告了一例与软性隐形眼镜佩戴相关的非典型无菌性角膜环形浸润病例;涂片、培养及共聚焦显微镜检查证实为无菌性炎症反应。