Game 9
Solve
in
1
Your patient Ankith walks in. He appears with his contact lens case in his hands.
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You observe his general appearance and don't recognise anything wrong with his eye. You aren't sure if it is just the glare of the room, but there appears to be a small white circular dot in the periphery of his cornea. He hasn't brought any sunglasses, or umbrella.
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"Hello, I feel a bit uncomfortable wearing my contacts. And my eye feels sore sometimes."
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You welcome him in.
solve
in
2
You confirm your suspicions, and a small 0.2mm sized lesion is in the inferior region of the periphal corrnea.
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But no flare, no photophobia, no changes in vision.
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Maybe it's the contact lens case.
last
chance
You try to sample and stain the contact lenses, yet nothing appears. It seems it is well disinfected, and well maintained. Being a long time wearer of contact lenses, Ankith must know how to handle contacts, and how to disinfect.
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But you notice something. The contact lenses have designs on them.
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"Oh yeah, I bought them off Temu."
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Of course he did.
The Answer
Sterile Keratitis
- Less severe than microbial
- Almost no photophobia, or changes in visual acuity since no obstruction of central cornea
- Lesions are fairly small, and typically do not have immune responses, hence the lack of flare and AC reaction.
- Cosmetic contact lenses may be rough, and could damage the corneal epithelium.
- Such trauma can lead to sterile keratitis, or if it gets infected, microbial keratitis.