Contact lens is valuable optical device used in the presence of severe refractive error and treatment of certain chronic diseases. Contact lens can be used for many years without problems only if they are made of well-chosen material, correctly shaped, and properly fitted. The ocular complications range from harmless irritation to sight-threatening corneal ulceration and even loss of eye.

Many patients have associated dry eyes or blepharitis, which further compromise the conjunctival and corneal surface, increasing the chances of complications. With advances in manufacturing techniques, advances in lens materials, and improved hygienic measures, frequency of complications has decreased.

Corneal staining

Corneal staining is probably the most familiar of all potential contact lens complications. The prevalence is as high as 60% and is generally clinically insignificant.

Epithelial microcysts

Epithelial microcysts are an important indicator of chronic metabolic stress and can be readily observed with the slit-lamp biomicroscope. It is usually seen in the central and paracentral cornea. They appear as minute scattered gray opaque dots with focal illumination and as transparent refractile inclusions with indirect retroillumination. Visual acuity is generally unaffected by microcysts. They are usually seen with soft contact lens, especially with extended wear lens. The presence of a small number of microcysts is not dangerous, but a large number of microcysts represent epithelial metabolic distress. It can be treated by decreasing the frequency of overnight wear, changing to daily wear, or increasing the frequency of lens replacement.

Epithelial edema

A small number of vacuoles and bullae can be seen in the corneas of contact lens wearers. They are clinically innocuous but can be confused with other small epithelial inclusions which are clinically more serious. It is the most common and earliest corneal change due to hypoxia.

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