The document discusses contact lens acute red eye (CLARE), an inflammatory reaction that can occur in contact lens wearers. It presents the etiology as being due to hypoxia, contamination, or an ill-fitting lens. The symptoms include a painful, red eye with watering, irritation, and photophobia. Signs involve acute redness around the limbus and infiltrates on the epithelium. Risk factors include extended wear and poor hygiene. Management involves discontinuing lens wear, antimicrobial therapy if infected, and prescribing new lenses with a higher DK/t value after inflammation subsides. Prevention methods consist of avoiding extended wear, steep fittings, practicing good hygiene, and frequent lens replacement.

1. KAUSTAV GOGOI
B.Optom 3rd year
RCOJ

2. Layout
Introduction
Etiology
Symptoms
Signs
Risk factors
Examination
Differential diagnosis
Management
Prevention
References

3. Introduction
Contact lens acute red eye is a serious inflammatory response
reaction reported frequently with extended wear lenses
It is an inflammation of the outer surface of the eye that occurs
only in patients wearing contact lenses

4. Etiology
Due to inflammatory response that can be from hypoxia to
contamination to an ill-fitting lens
Tight lens
Due to contamination of the lens with gram negative
bacteria
Protein deposits

5. Symptoms
Typically seen in extended wear patients who wake up
with painful red eye in the morning
Watering
Irritation
Photophobia
Vision is affected if it is severe

6. Signs
Acute 360 degrees red eye
Redness which tends to be worse near the limbus
Diffuse conjunctiva and limbal hyperemia
Multiple epithelial and subepithelial infiltrates
Profuse watery discharge
 Usually unilateral and is not contagious

7. Examination
 Slit-lamp examination:
Low magnification diffuse illumination
High magnification direct and indirect illumination
Fluorescein staining method

8. Risk factors
Soft contact lens extended wearer
Poor hygiene
Low DK/t
Tight lens

9. Differential diagnosis
CLPUC
Infective keratitis
Microbial keratitis

10. Management
Discontinue of lens wear
Refer for medical intervention- antimicrobial therapy if
due to infection
Antibiotic drop may be prescribe if there is a disruption of
the corneal epithelium
New contact lenses should be prescribed after the
inflammation subsides
The new lenses should have higher DK/t value than the
previous lens

11. Prevention
Avoid extended wear
Avoid steep fitting
Proper hygiene
Frequent replacement

12. References
Monica chaudhry, contact lens primer, contact lens
complications, page no. 255
http://www.mastereyeassociates.com/contact-lens-acute-
red-eye-inflammation
www.reviewofcontactlenses.com/article/bringing-clarity-
to-clare
http://www.aocle.org/livingL/clare.html