Online Photo Diagnosis

By Gregory W. DeNaeyer, OD

This photograph shows a bandage soft contact lens on the left eye of a patient who has bullous keratopathy. The patient unfortunately experienced an acute angle closure attack as an infant and has never had useful vision with the affected eye. His previously high eye pressure and inflammation damaged his endothelium and he developed mild bullous keratopathy. He had been using Cosopt (Merck & Co.) b.i.d. OS and Muro 128 (Bausch & Lomb) drops OS as needed.

The patient had recently complained of increased pain/irritation in his left eye. Slit lamp examination showed moderate bullous keratopathy OS. He trialed a CIBA Vision Night & Day bandage contact lens with an 8.6mm base curve, −0.75D. He wore the lens on a daily wear basis and used Clear Care (CIBA) as a care system. The patient returned in two weeks reporting significantly improved comfort, so we prescribed the Night & Day lens for monthly replacement as a bandage lens.