The College of Optometrists

What course of management is recommended for this common stain with SH wear.

I saw one in a px on a friday who'd only last wore his lenses the previous sunday, aren't they supposed to clear in 48 hrs?

this is interesting. THings don't always get better quickly , and who knows - he may have worn his lenses more recently. He may have known from previous aftercare that he has dry eye (which is a common cause of seal) - so he may have put the date back to please you. Certainly, he needs monitoring (1 week)until it clears and then I would suggest a lens which is less likely to give this, either a daily or Si lens. If this reoccurs then maybe its time to be told that the risks outweigh the benefits, and to pack in wear, as it could easily lead to infections.

Palfi,

Do you have any evidence to support your assertion that SEALs are a specific risk factor for infection?

As long as you refit patient with lens that doesnt create seals(SiHydrogel not great as stiffer and seals is thought to be mechanical pressure which is a combination of lid/lens design/material interaction) and monitor as usual for further complications.

These pxs usually can be good wearers.

I agree with John-never had px with infection after seals but make sure epith healed. It can take some time depending on depth and size of break.

- I was thinking it is a significant fl stain - and such a damage would increase the risk of MK, rather than crying Wolf. Fl stain is an indirect indicator of increased risk of MK - see effron c/l complications ch 14.