Cornea and External Diseases

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.