Back on July 19, 2017, a news article came out from CNN about an ophthalmologist, from the United Kingdom who removed 27 contact lenses fused together by mucus from a 67-year-old woman’s right eye. The woman was getting ready to undergo cataract surgery when the doctor found a “blue mass” underneath the top eyelid. Dr. Thomas L. Steinemann, a clinical spokesman for the American Academy of Ophthalmology, said he has seen patients have one lens stuck, but never 27! The woman thought it was just dry eye and old age that was causing her discomfort.

Back on July 19, 2017, a news article came out from CNN about an ophthalmologist, from the United Kingdom who removed 27 contact lenses fused together by mucus from a 67-year-old woman’s right eye. The woman was getting ready to undergo cataract surgery when the doctor found a “blue mass” underneath the top eyelid. Dr. Thomas L. Steinemann, a clinical spokesman for the American Academy of Ophthalmology, said he has seen patients have one lens stuck, but never 27! The woman thought it was just dry eye and old age that was causing her discomfort.

On July 2, 2019, a similar incident occurred, but nothing to the extent of 27 contact lenses stuck in the eye. A 68-year-old male came into my office complaining of sudden vision loss left eye and dryness that started about a week ago. He underwent cataract surgery back in December in both eyes and explained that he has diabetes and had previous retinal surgeries to the left eye. He claimed that his hemoglobin A1C and fasting blood sugar was all under control. He had previously seen an ophthalmologist as well as a retina specialist before he came in to see me with the same chief complaint. He also mentioned that he was a contact lens wearer, daily disposables and that he threw them away every night. I asked him if he had any contact lenses on currently, which he replied “nothing”.

After I finished with my history, I took an auto-refraction, which oddly showed nothing on the screen. I took him into the exam room where I checked his visual acuity and his left eye unaided was 20/400. I then decided to check his anterior/posterior segment and noticed a blob-like appearance on the front of his cornea, which I never have seen or experienced before. I decide to stain the lower palpebral conjunctiva with sodium fluorescein and then asked, “are you sure you are not wearing any contact lenses because I am pretty sure you are.” He replied, “I believe I took them all off, but now I am not sure.” I proceed to wash my hands to remove the contact lens from his eye only to find another one stuck there as well! I take off the next one and low and behold another lens is beneath! I finally removed four contact lenses from the man’s left eye and check his visual acuity to be 20/25! He replied, “WOW! How could the MD’s not figure this out, but you were able to?”

Diabetic eye disease can cause many issues which include diabetic retinopathy, diabetic macular edema, glaucoma, early onset cataracts, change in refractive error and dry eye disease. “In a study of 254 patients with diabetes and 254 without, the group with diabetes only had a 1.8% increased risk of complications with soft daily contact lenses.”1 “The higher the hemoglobin A1C values, the higher the rate of dry eye syndrome.”2The association may be linked to automatic neuropathy, which decreases corneal sensitivity and affects feedback mechanisms and lacrimal gland secretion.”3 With my patient, his cornea had to be desensitized where he could not feel the contact lenses on his eye, which can cause some issues for our diabetic patients.

Some warning signs that a contact lens may be trapped in the eye are redness, itchiness, sharp pain, light sensitivity, dry eye issues, and blurred or reduced vision. The FDA has three classifications for medical devices and contact lenses fall under class II and need to be dispensed by an eye care practitioner. Class I presents the least risk where class III presents the most risk of illness or injury to a patient. Class II devices “typically require pre-market notification by submission and FDA review of a 510(k) clearance to market submission.”4 Also, remember to replace your contact lens case at least every three months to minimize the risk of bacteria buildup and possible infection. “Lens cases are contaminated with bacteria, fungi or protozoa about 19% to 81% of the time.”5 It is very important to get a comprehensive eye exam once a year especially if you are a contact lens wearer and have health issues like diabetes or high blood pressure. You only get a pair of eyes for the rest of your life so keep them healthy and seeing the best they possibly can!


References:

  1. March, W et al. Safety of Contact lenses in patients with diabetes. Diabetes Tech Ther. 2004 Feb;6(1):49-52
  2. Seifart U, Strempel I. The dry eye and diabetes mellitus. Ophthalmologe. 1994 Apr;91(2):235-9.
  3. Optometry Times. How Diabetes Affects Contact Lens Wear. April 19, 2016.
  4. United States Food & Drug Administration. Available at: www.fda.gov (accessed February 2012). 
  5. Szczotka-Flynn L, Pearlman E, Ghannoum M. Microbial contamination of contact lenses, lens care solutions, and their accessories: a literature review. Eye Contact Lens. 2010 Mar;36(2):116-29.