January 2015 Online Photo Diagnosis

By Gregory W. DeNaeyer, OD, FAAO

Figure 1 shows extensive corneal neovascularization of a 76-year-old female patient’s right eye. The eye has longstanding band keratopathy and no light perception.

Three months prior, she had started wearing a hand-painted soft prosthetic lens for cosmesis. Figure 2 shows her right cornea before contact lens wear. She wore the lens on a 30-day continuous wear basis because she had difficulty with lens handling. The prosthetic lens was 20mm in diameter with an offset pupil to mask severe exotropia.

The patient was ecstatic with the cosmetic results that the lens provided. Corneal neovascularization from continuous wear of a hand-painted prosthetic lens that offers little to no oxygen transmissibility is to be expected. The neovascularization has not resulted in any secondary complications and has not worsened in the last three years. The patient is monitored every six months.