title: Epithelial split associated with wear of a silicone hydrogel contact lens.
abstract: OBJECTIVE
  To describe the appearance and management of a superior epithelial arcuate lesion (SEAL) observed in association with the wear of a silicone hydrogel lens.
  
  
  METHODS
  We present a case of a 30-year-old male who presented with a SEAL after 4 months of wear of a silicone hydrogel lens on a 30-day extended wear schedule. Bacteriological examination of the lenses and ocular adnexa was conducted at the time of the event. The clinical presentation and management are presented and compared to a review of cases associated with hydrogel lenses.
  
  
  RESULTS
  The patient presented with symptoms of mild irritation. A linear splitwas noted in the superior peripheral cornea of the affected eye and was associated with limbal injection, stromal infiltrates, and fluorescein staining. Normal ocular biota was recovered from the lenses and eyelids of both eyes. Visual acuity remained unchanged and the lesion resolved following prophylactic treatment and discontinuation of lens wear for 8 days.
  
  
  CONCLUSIONS
  The diagnosis and management of this SEAL case in a silicone hydrogel lens wearer mirrored that of previous events associated with hydrogel lenses. The possible etiologies of SEAL in this case are discussed and include mechanical irritation and dehydration of the lens surface.
authors.affiliation: Cornea and Contact Lens Research Unit, School of Optometry and Cooperative Research Centre for Eye Research and Technology, The University of New South Wales, Sydney, Australia.
authors.forename: I
authors.initials: I
authors.lastname: Jalbert
authors.forename: D F
authors.initials: DF
authors.lastname: Sweeney
authors.forename: B A
authors.initials: BA
authors.lastname: Holden
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003262:Contact Lenses, Extended-Wear / Q000009:adverse effects*; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004847:Epithelial Cells / Q000473:pathology*; D006801:Humans; D008297:Male; D012826:Silicone Elastomers; D014792:Visual Acuity
chemical_list: D012826:Silicone Elastomers