So, you guys are in for a treat today. This is a chance to test your problem solving abilities. Here’s a photo of my eyes right now:


I woke up this morning with a bit of crustiness in both eyes.  I may have rubbed my eyes a little lot.  I have hayfever and a list of contact allergies a mile long.  I only noticed my eye looked abnormal after I had my shower, although I don’t remember looking in the mirror before that.  I’m careful not to get any water in my eyes when I’m bathing.

I’m an extended wear contact lens wearer, as mentioned in my Dry Eye post, I use them as bandage lenses.  I’ve been wearing these particular lenses for a couple of weeks now, they are Alcon Air Optix Day and Night in an 8.6 BC. I’ve still got my contact lenses in.

I don’t use solution or eye drops.  The affected eye is stinging at the moment. There’s no discharge, although I feel my eye is watering a little.

I have severe dry eye and blepharitis (mild staphylococcal and moderate MGD).

Based on all the stuff I’ve told you, can you answer these questions?

1) Which eye is affected?

2) What are the signs?

3) What are the main symptoms?

4) What could the problem be? (There is no right answer for this, I’ll let you know that now.  I don’t have access to a slit lamp or an optom right now) And which questions could you ask to narrow it down? How would you then examine this patient?

5) Management options for each of your possible diagnoses?

6) What would you say to this patient when she refuses to remove her contact lenses because she’s volunteering this afternoon in a food bank and feels it would be insensitive to wear her Ray Bans?

Answers on a postcard.  And no, it’s not acanthamoeba and yes, I have a slight LSOT.