Peripheral ulcerative keratitis due to a ‘long lost’ hard contact lens
Article first published online: 27 AUG 2007
Clinical & Experimental Ophthalmology
Volume 35, Issue 6, pages 550–552, August 2007
How to Cite
Bhatt, P. R., Lam, F. C., Roberts, F. and Ramaesh, K. (2007), Peripheral ulcerative keratitis due to a ‘long lost’ hard contact lens. Clinical & Experimental Ophthalmology, 35: 550–552. doi: 10.1111/j.1442-9071.2007.01557.x
- Issue published online: 27 AUG 2007
- Article first published online: 27 AUG 2007
- Received 21 November 2006; accepted 9 May 2007.
- bacterial lipopolysaccharide;
- contact lens;
- matrix metalloproteinases;
- peripheral ulcerative keratitis.
Peripheral ulcerative keratitis (PUK) is a disorder consisting of a crescent-shaped destructive inflammation of the perilimbal corneal stroma. PUK can occur in a variety of ocular and systemic conditions including infections, lid abnormalities, dermatological disorders and connective tissue disorders. We present a case of PUK associated with a hard contact lens (CL) retained in the superior fornix for over 16 years. After removal of the embedded CL, a superior forniceal conjunctival pedicle graft was performed to prevent corneal perforation. The patient was managed postoperatively with a combination of topical steroids and antibiotics. The use of systemic immunosuppressive therapy was not necessary. Micro-trauma and micro-keratitis may have occurred as a result of the mechanical effect of the CL but if this was the sole mechanism, one would expect presentation at a much earlier date. We discuss the pathogenetic mechanisms which may have contributed to the development of this ulceration. This report highlights the importance of lid eversion when examining patients with anterior segment pathology.