Deep corneal stromal opacities associated with long term contact lens wear

Background - One male and three female long term contact lens wearers (mean age 30.3 years; range 26-33) demonstrated unusual deep corneal stromal opacities which were predominantly just anterior to Descemets membrane. None had any history of corneal dystrophy. These opacities were more common centrally, but were also identified in the corneal periphery. Methods - All patients underwent routine ophthalmic examinations and, where appropriate, slit-lamp photography and specular microscopy. Results - Mean lens wear in years and hours per day was 14.3 (range 10-17) and 14.3 (range 12-16) respectively. Specular microscopy disclosed cell densities within normal limits (mean 3041.5 cells per mm(2)) and coefficient of variation of mean cell area; COV = 0.31. Refractive errors ranged from -12.25 D to +6.25 best vision sphere and all four subjects attained at least 6/9 Snellen visual acuity. The subjects' contact lens wearing history included low water content hydroxymethylmethacrylate (HEMA) contact lenses and high water content HEMA contact lenses. Stromal opacity density was observed to diminish over a period of months on cessation of contact lens wear in two cases. Conclusion - The possible causes of these cases. rarely reported opacities are discussed.