|Year : 2022 | Volume
| Issue : 4 | Page : 984-985
Bandage contact lens – The master masquerader
Amrita Joshi, Sanjay K Mishra, Alok Sati, Pradeep Kumar
Department of Ophthalmology, Army Hospital Research and Referral, New Delhi, India
|Date of Submission||21-Jan-2022|
|Date of Acceptance||25-Jul-2022|
|Date of Web Publication||11-Oct-2022|
Dr. Alok Sati
Professor (Cornea and Anterior Segment Surgeon), Army Hospital Research and Referral, New Delhi - 110 010
Source of Support: None, Conflict of Interest: None
Keywords: Bandage Contact Lens, corneal deposition, corneal dystrophy
|How to cite this article:|
Joshi A, Mishra SK, Sati A, Kumar P. Bandage contact lens – The master masquerader. Indian J Ophthalmol Case Rep 2022;2:984-5
A 60-year-old gentleman presented to our cornea clinic with a complaint of diminution of vision. On examination, the following were observed: the distance visual acuity (DVA) right eye (RE)- 6/9, left eye (LE)- hand movement close to face (HMCF), intraocular pressure (IOP) by applanation tonometry RE- 18 mmHg, LE- not recorded; slit-lamp examination RE was normal and LE revealed mild ciliary congestion with a bandage contact lens (BCL) in situ and multiple opaque protein deposits in the center, giving the corneal surface a mulberry-like appearance [Figure 1]. On removal of the lens, the cornea was found to be healthy [Figure 2] with a normal posterior segment. DVA left eye was 6/9 with an IOP of 16 mmHg.
|Figure 1: Image showing protein deposits accumulated over the central part of the bandage contact lens|
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|Figure 2: Image of clear, healthy cornea after removal of the bandage contact lens|
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| Discussion|| |
This patient was seen by various general ophthalmologists in the periphery and was pigeonholed as a corneal dystrophy. As apprised by the patient, a BCL was placed in his left eye in 2019 following some corneal infection. The world was subsequently struck by the coronavirus disease 2019 (COVID-19) pandemic and he was lost to follow-up. He confessed to being oblivious with regard to this BCL in his eye and approached an ophthalmologist only on experiencing diminution of vision. Scrupulous slit-lamp examination divulged a potential space between the posterior surface of the lens and the anterior surface of cornea, distinctly validating it to be a retained BCL enshrouding a healthy cornea [Figure 3].
|Figure 3: Image of the bandage contact lens being held by a forcep, after removal from the eye|
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Lens deposition commences within minutes of wear and is governed by multifarious factors, including patient compliance, individual tear chemistry, and environment. Protein deposits, however, occur as lysozyme binds to the lens surface and alters its morphology.
We did an extensive PubMed search and encountered reports of lost BCL in the fornix masquerading as a mass or chalazion, but could not find a single report misjudging BCL with protein deposits as a corneal dystrophy.
To the best of our knowledge, we are reporting such a case for the first time with an aim to share this interesting image with our fellows and trainees to encourage a thorough slit-lamp evaluation to promptly detect such masqueraders.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Mann A, Tighe B. Contact lens interactions with the tear film. Exp Eye Res 2013;117:88-98.
Ho DKH Mathews JP. Folded bandage contact lens retention in a patient with bilateral dry eye symptoms: A case report. BMC Ophthalmol 2017;17:116.
[Figure 1], [Figure 2], [Figure 3]