A clinicopathologic study of contact-lens-related keratoconus.

A patient, initially examined at the age of 16 years and monitored for almost two decades, had corneal warpage and keratoconus associated with contact lens wear. Although the patient was advised repeatedly of the risk of continued contact lens use, she persisted. Contact-lens corrected visual acuity continued to deteriorate in the left eye (from 20/20 to 20/200) and keratometric readings continued to increase (from 43.50/44.12 to 56/59). The patient eventually required a corneal transplant in the left eye because of advanced keratoconus. The host button was subjected to light and electron microscopy, which disclosed keratoconus of the round cone type. Spectacle-corrected visual acuity was 20/20 18 months postoperatively.