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| PHOTO ESSAY |
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| Year : 2023 | Volume
: 3
| Issue : 2 | Page : 541-542 |
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Fungal invasion of cosmetic contact lens mimicking a corneal ulcer
Gaurav Mahajan, Pawan Prasher
Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| Date of Submission | 15-Nov-2022 |
| Date of Acceptance | 04-Jan-2023 |
| Date of Web Publication | 28-Apr-2023 |
Correspondence Address:
Pawan Prasher
Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah, Amritsar, Punjab
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/IJO.IJO_3015_22
Keywords: Corneal tattooing, cosmetic contact lens, fungal infiltration, penetrating kertoplasty
How to cite this article:
Mahajan G, Prasher P. Fungal invasion of cosmetic contact lens mimicking a corneal ulcer. Indian J Ophthalmol Case Rep 2023;3:541-2 |
Cosmetic contact lenses (CCLs) are a type of extended wear soft contact lenses with high Dk coefficient and high water content.[1] Their use in the treatment of noninfective corneal pathologies is indicated for cosmesis as well as for pain relief, promotion of corneal epithelial healing, mechanical support, and protection. Contact lens contamination often occurs as a result of accumulation of significant cellular debris with their extended use and not following the recommended standard care procedures.[2]
A 27-year-old male presented for evaluation of a gradually increasing white spot in the left eye. He had undergone therapeutic penetrating keratoplasty 5 years back in that eye, but the graft had failed with no perception of light. The slit-lamp evaluation showed a central 3 mm × 2.5 mm grayish-white lesion having a striking resemblance to a corneal ulcer on the brown-colored CCL he was wearing [Figure 1]a. He revealed that he had been using CCL for several years after his graft turned opaque, but due to the coronavirus disease (COVID) situation, he had not been able to get it cleaned for the last few months. On removing the CCL, an opaque graft with extensive superficial vascularization was seen [Figure 1]b. There was no epithelial defect or underlying infiltration. Scrapings of the material from the CCL surface revealed broad, sparsely septate fungal hyphae on a 10% KOH smear [Figure 1]c. The culture of CCL could not be carried out due to logistic issues. He was prescribed topical antifungals initially, which were discontinued after ensuring that there was no infiltration of the cornea at 2 weeks follow-up. Considering the possibility of a lack of compliance with CCL hygiene, the patient was offered corneal tattooing for cosmetic rehabilitation, which gave a good outcome postoperatively [Figure 1]d. | Figure 1: Slit-lamp evaluation showed the following: a central 3 mm × 2.5 mm grayish-white lesion on the brown-colored CCL (a); an opaque graft with extensive superficial vascularization (b); scrapings of the material from the CCL surface showing broad, sparsely septate fungal hyphae on a 10% KOH smear (c); post-corneal tattooing (d). CCL = cosmetic contact lens
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| Discussion | |  |
Fungal infiltration of contact lenses has been reported previously[2],[3] and it has been attributed to lack of hygiene, excessive eye rubbing, steroid use, or inadequate disinfection. In the current case, fungal infiltration occurred locally in a CCL, mimicking a corneal ulcer without invasion of the cornea, which is similar to the cases reported in the past with the use of bandage soft contact lenses.[1],[4]
The current case highlights the importance of patient education regarding CCL hygiene, the need for regular replacement, and considering alternative options like corneal tattooing in noncompliant patients.
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
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Radhakrishnan N, Panigrahi AK, Balasubramanium A, Das M, Prajna NV. Colonization of therapeutic contact lens by dematiaceous fungi. Cont Lens Anterior Eye 2019;42:470-2.  |
| 2. | Lalitha CS, Nayak B, Hallur V, Kharolia A. Invasion of the therapeutic contact lens by a rare fungal species presenting as the acute red eye: A case report. Indian J Ophthalmol 2020;68:2548-50. [ PUBMED] [Full text] |
| 3. | Bernstein HN. Fungal growth into a bionite hydrophilic contact lenses. Ann Ophthalmol 1973;5:317-22. |
| 4. | Hurtado I, Magran BL. Invasion of a soft contact lens by Exophiala jeanselmei. Mycopathologia 1989;105:171-3. |
[Figure 1]
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