Corneal conjunctivalisation in long-standing contact lens wearers

Background: There are many contact lens-related ocular surface disorders. Some can damage the limbal region where stem cells are thought to be located in its basal cell layer. This damage can result in destruction and a deficiency of corneal stem cells. One important sign of this complication is corneal conjunctivalisation. The purpose of this study is to describe clinical characteristics of a series of long-standing contact lens (CL) wearers with corneal conjunctivalisation (CC). Methods: In a one-year (March 2004 to March 2005) retrospective unmasked study, 591 CL clinical histories (195 new patients and 396 review patients) were analysed. Results: There were 24 eyes of 14 myopic patients (93 per cent women) with CC without a specific disease entity known to cause limbal stem cell deficiency (LSCD). Conjunctivalisation occurred in the inferior limbus of three eyes (12 per cent). Only four patients (28.6 per cent) reported previous ocular symptoms. All were myopic with a mean spherical equivalent of -8.80 +/- 5.00 (SD) dioptres (range from -1.75 to -21.50 D) and mean visual acuity 0.9 +/- 0.2 (range from 0.4 to 1.2). The mean years of CL wear was 17.6 +/- 8.5 (CI 95% 13.2 to 22; range six to 30). All were daily-wear patients with a mean daily wear time of 12.5 +/- 1.8 hours per day (CI 95% 11.6 to 13.4). Conclusion: Corneal conjunctivalisation is a contact lens-related complication in asymptomatic patients. Optometrists can play an important role in early diagnosis, education and management of these patients.