Peripheral Corneal Infiltrate

Peripheral sterile corneal infiltrate associated with extended contact lens wear. 

Clinical features:

  • Symptoms include ocular discomfort, foreign body sensation, tearing, photophobia and conjunctival hyperemia.
  • Signs:
    • Single or multiple, 1-2 mm corneal infiltrates with minimal overlying epithelium disruption
    • Infiltrates are usually located superiorly and parallel to the limbus with an area of clear cornea between the infiltrate and the limbus.
    • May occur secondary to:
      • Contact lens wear as a consequence of corneal hypoxia
      • Immune response (hypersensitivity) to preservatives in contact lens care products

Management:

  • Treatment options include cessation of contact lens wear, topical antibiotics and/or topical corticosteroids.
  • Corneal scrapings for stains and cultures should be considered with larger infiltrates complicated with epithelial defect, anterior chamber inflammation and ocular pain.