Clinical characterization of corneal infiltrative events observed with soft contact lens wear.
OBJECTIVE
Corneal infiltrates are commonly observed during adverse reactions associated with contact lens wear. Broad ranges of presentations are encountered, and there is no well-established classification system. The aim of this paper is to categorize corneal infiltrates associated with soft lens wear and present the typical clinical characteristics associated with each type of event.


METHODS
All events of corneal infiltrates occurring in soft contact lens clinical trials over 10 years (9 years retrospective and 1 year prospective) and conducted at two contact lens research centers were reviewed by a panel of experts comprising ophthalmologists, optometrists, and other biologic scientists. Classification of each event was based on assessment of a range of signs and symptoms by the review panel.


RESULTS
A classification scheme was devised to distinguish infiltrative events that were serious and symptomatic (microbial keratitis), clinically significant and symptomatic (contact lens-induced peripheral ulcer, contact lens-induced acute red eye, infiltrative keratitis), and clinically nonsignificant and asymptomatic (asymptomatic infiltrative keratitis and asymptomatic infiltrates).


CONCLUSIONS
Corneal infiltrates can be classified into six distinct categories. This classification scheme, based on clinical characteristics, should aid diagnosis, management, and treatment of corneal infiltrates as well as assisting investigations into the etiology of each of these conditions.
Sweeney
Deborah F
DF
Cornea and Contact Lens Research Unit, School of Optometry and Vision Science, and The Cooperative Research Center for Eye Research and Technology, The University of New South Wales, Sydney, Australia. D.Sweeney@crcert.unsw.edu.au
Jalbert
Isabelle
I
Covey
Michael
M
Sankaridurg
Padmaja R
PR
Vajdic
Claire
C
Holden
Brien A
BA
Sharma
Savitri
S
Ramachandran
Lakshmi
L
Willcox
Mark D P
MD
Rao
Gullapalli N
GN
D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D003316:Corneal Diseases / Q000209:etiology*; D003320:Corneal Ulcer / Q000209:etiology; D003937:Diagnosis, Differential; D005128:Eye Diseases / Q000209:etiology; D006801:Humans; D006940:Hyperemia / Q000209:etiology; D007239:Infections; D007634:Keratitis / Q000175:diagnosis / Q000382:microbiology; D011446:Prospective Studies; D012189:Retrospective Studies