|Title||WHITISH SOLID LESIONS WITHIN THE PIGMENTED CORNEAL ARCS ASSOCIATED WITH ORTHOKERATOLOGY LENS WEARER|
|Author, Co-Author||Wan Sang Chui, Benny Bing-tin Tam|
|Abstract|| BACKGROUND: It has been found that 90% of patients undergoing orthokeratology (ortho-k) treatment would develop Brown corneal pigmented arc (BCPA) within 12 months of lens wear (Cho et al. in press). The BCPA usually become denser and more profound with time upon ortho-k lens wear and may sometime become a complete ring which resembles the Fleischer’s ring and Hudson-Stahli line. Cheung and her co-workers (2005) had reported a few cases in which white solid lesions were observed at the region of the BCPA. Regressions of these solid lesions were not clearly reported although a shift in location of the solid lesion was observed in one of the cases. The etiology and its impact on the corneal health were still remained unclear.
CASE REPORT(S): In this case report, BCPA were observed on both eyes in an eight years old girl after six months of ortho-k treatment. In the mid of the second year of lens wear, light whitish solid lesions were observed on both eyes within the regions of the BCPA and the solid lesions became more profound after another half year of lens wear. The solid lesions were found to be vanished after 4 months cessation of ortho-k lens wear and leaving a light BCPA on each eye. Upon resumption of lens wear, the solid lesions recurred in nine months. In view of the likelihood of recurrence and deterioration in the future and the unpredictable impact on the corneal integrity, the patient was advised to terminate the treatment.
CONCLUSIONS: The currently reported case agreed with previous case report that the whitish solid lesion could be formed at the region of the BCPA in ortho-k lens wearer after teens of months of lens wear but its development was lag behind the formation of the BCPA. This case demonstrated that the solid lesion could regress after cessation but recurred upon resumption of lens wear. Although it caused no symptom and did not affect vision, its long term impact on corneal health was unclear and therefore cessation of treatment is advised and further investigation in this area is necessary.
|Affiliation of Co-Authors||The Hong Kong Polytechnic University, School of Optometry|