II. Management: Displaced Contact Lens

  1. Reassurance that lens will not travel retrobulbar
  2. Find the lens
    1. Have patient look up or down as lids are held
  3. Move off Cornea to Sclera
  4. Remove the lens with irrigation or with plunger
  5. Replace the lens on the Cornea
  6. Fluorescein will stain lens permanently but may ease finding it

III. Complications: Infection

  1. Risk Factors
    1. Overnight Contact Lens wear (20 fold increased risk)
    2. Tap water used to rinse Contact Lenses
    3. Water exposure while wearing Contact Lenses (swimming, showering, hot tub)
  2. Infectious Keratitis Causes
    1. Acanthamoeba
    2. Pseudomonas (esp. soft cosmetic contacts)
    3. Mixed Bacteria
    4. Fungal infections
    5. Herpes Simplex Virus
  3. Management
    1. Treat Contact Lens induced Bacterial Conjunctivitis or Keratitis with topical Fluoroquinolone or Aminoglycoside
  4. Resources
    1. CDC Contact Lens Risks for Infection
      1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6432a2.htm

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