Diagnostic dilemma: Doctors find 27 contact lenses in woman’s eye ahead of routine surgery

The patient: A 67-year-old woman in the U.K.

The symptoms: The woman was scheduled for routine cataract surgery on her right eye. Although her vision in her right eye was poorer than that of her left, historically, she had had “no previous ocular complaints.” Before the procedure, she told doctors she was feeling some minor eye discomfort, which she assumed stemmed from dry eye and old age.

What happened next: As doctors were administering an anesthetic into the woman’s eye, they saw a large, bluish mass under her upper eyelid. It turned out to be a clump of 17 disposable contact lenses bound together by mucus. A surgeon then recovered 10 more lenses during a closer examination under a microscope.

The diagnosis: Together, these 27 lenses would be what doctors call “retained foreign bodies.”

The treatment: Most of the contact lenses fell out on their own as doctors administered anesthesia in the eye socket. After removing the remainder, the doctors postponed the woman’s cataract surgery for two weeks due to the potential bacterial buildup in her eye that could have caused an infection

What makes the case unique: Failing to remove contact lenses from the eye can lead to serious infections — but in this case, the patient had no history of major issues with her vision or excessive eye irritation.

The woman had been wearing monthly disposable contact lenses for 35 years, but she’d rarely gone to the eye doctor during that time. (Monthly contact lenses can be worn for about 30 days but are intended to be removed before bed each night.)

The woman’s doctors, who published a report of the case in the journal The BMJ, suspected that her “deep set eyes” may have made her more prone to retaining such a large number of lenses. They also said the case highlights the importance of properly monitoring contact users to ensure they’re using the lenses correctly. The report authors suggested that clinicians flip over a patient’s eyelids and apply a fluorescein stain — a fluorescent dye that changes color when seen under a special light — to help reveal contact lenses hiding in and around the eye.

News reports about the case noted that it was unclear how long the clumped contacts had been under the patient’s eyelid. Sometimes, the woman said, she would attempt to remove a lens from her right eye but would fail to find it. She simply assumed she had dropped the lens somewhere.

This article is for informational purposes only and is not meant to offer medical advice.

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