Mistaken diagnosis of keratoconus because of corneal warpage induced by hydrogel lens wear.
OBJECTIVE
We report a case of corneal warpage secondary to hydrogel lens wear that was initially mistaken as a case of keratoconus.


METHODS
A 26-year-old Chinese female hydrogel lens wearer presented with an interest in refractive surgery. After topographies and pachymetries were performed, keratoconus was initially diagnosed for her right eye and suspect keratoconus diagnosed for her left eye. This conclusion was felt to be confirmed at a follow-up visit 1 week later, but keratoconus contact lens treatment was delayed because of the presence of superficial punctate keratitis.


RESULTS
After 8 weeks without lens wear, corneal maps were performed again. The maps now showed regular with-the-rule astigmatism, and none of the previous evidence of keratoconus. Central pachymetries were also normal.


CONCLUSIONS
Soft contact lens wear can induce corneal warpage mimicking keratoconus. Had the standard treatment for keratoconus been implemented before resolution of the warpage, it could have proven injurious to the patient, because the treatment itself could have provided an impetus for the protrusion to remain or perhaps even progress. Our case gives clinicians reason to pause when dealing with contact lens wearers presenting with corneal curvature irregularities such as keratoconus or ectasia, because of the possibility of lens-induced warpage.
Tseng
Santos Shan-Yu
SS
Department of Optometry, Chung Shan Medical University, Taichung, Taiwan. santos_tseng@hotmail.com
Hsiao
John Ching-Jen
JC
Chang
David Chao-Kai
DC
D000328:Adult; D001251:Astigmatism / Q000175:diagnosis; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D003315:Cornea / Q000473:pathology*; D019781:Corneal Topography; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D007640:Keratoconus / Q000175:diagnosis* / Q000209:etiology*; D012029:Refraction, Ocular; D014792:Visual Acuity
D020136:Hydrogel, Polyethylene Glycol Dimethacrylate