Clinical Scorecard: Navigating Corneal Staining in Ortho-k Wearers

At a Glance

Key Highlights

• Mild superficial punctate keratitis (SPK) is common but should be monitored in ortho-k wearers.
• Corneal staining patterns can indicate lens binding or improper lens application.
• Periodic corneal health assessments are essential in ortho-k programs.
• Switching lens care systems can mitigate corneal staining issues.
• Educating patients on proper lens care and lubrication is crucial for successful lens wear.

Guideline-Based Recommendations

Diagnosis

• Assess corneal staining during initial visits and periodic evaluations.

Management

• Change lens care systems if corneal staining is noted after fitting.
• Evaluate lenses for biofilms and deposits under slit lamp examination.

Monitoring & Follow-up

• Conduct regular corneal health assessments as part of the ortho-k program.

Risks

• Overnight lens wear can pose risks, but benefits often outweigh them.

Patient & Prescribing Data

Ortho-k lens wearers, particularly children

Use preservative-free lubricants instead of multipurpose solutions to reduce corneal exposure to disinfectants.

Clinical Best Practices

• Educate patients on proper lens application techniques to avoid corneal staining.
• Reassess lens parameters if central corneal staining is observed.
• Encourage strong cleaning of lens cases and use of protein-removing solutions.

References

• Brooke Messer, OD, FAAO, FSLS