What is a contact lens induced peripheral ulcer?
A Contact Lens Induced Peripheral Ulcer (CLPU) is a small, round, whitish-yellow spot in the outer part of the cornea, observed in contact lenses wearers. Here we explain in more detail
- What is a Contact Lens Induced Peripheral Ulcer?
- What causes a Contact Lens Induced Peripheral Ulcer?
- What increases the risk of Contact Lens Induced Peripheral Ulcer?
- Signs and Symptoms of a Contact Lens Induced Peripheral Ulcer?
- How to Treat a Contact Lens Induced Peripheral Ulcer?
- How to prevent a Contact Lens Induced Peripheral Ulcer?
What is a Contact Lens Induced Peripheral Ulcer?
As mentioned, a Contact Lens Induced Peripheral Ulcer (CLPU) is a small, round, whitish-yellow spot located in the periphery of the cornea, it occurs in contact lens wearers - hence the name.
It is normally occurs in one eye and is caused by a bacteria such as Staphylococcus exotoxins introduced to the eye via a contact lens or eyelids.
CLPU is not actually a true infection, but a sterile inflammatory reaction often associated with contact lens wear, it is more common in people who wear their lenses over night, and normally occurs in one eye.
What causes a Contact Lens Induced Peripheral Ulcer?
A Contact Lens Induced Peripheral Ulcer (CLPU) is caused by an immune or inflammatory response to :-
- Bacterial toxins - especially staphylococcus Aureus, that are introduced to the eye via a contact lens or the eyelids
- A tight fitting contact lens
- Poor lens hygiene
- Wearing contact lenses overnight
It is interesting to note that CLPU is not a true infection, but an inflammatory reaction in the eye often associated with contact lens wear.
What increases the risk of Contact Lens Induced Peripheral Ulcer
- People with higher refractive prescriptions - typically higher than -5.00, which may reduce oxygen transmission
- People reusing daily disposable contact lenses
- Adolescents and young adults.
- Poor contact lens hygiene
- Environmental changes such as, hot and humid, dry and dusty environments, water exposure
- Dirty or contaminated contact lens cases
There are some risk factors that make a contact lens wearer more susceptible to a Contact Lens Peripheral Ulcer, unfortunately some of these things are out of your control, but others such as poor contact lens hygiene are definitely worth being aware of, as a simple change to your contact lens, insertion, removal and cleaning routine can make a big difference in helping to keep your eyes healthy.
Signs and Symptoms of a Contact Lens Induced Peripheral Ulcer?
The signs and symptoms listed below may indicate a contact lens induced peripheral ulcer
- Watery eyes - Tearing up
- Minimal Discharge
- Peripheral, well circumcised lesion
- Symptoms often less severe than clinical signs
- Red eyes
- Photophobia - Light sensitivity
- Mild to moderate eye pain
- Eye discomfort
These signs and symptoms can be confused with other eye conditions, so such as Early Microbial Keratitis, Corneal Abrasion, Contact Lens-Associated Red Eye (CLARE) etc.
What to do if you suspect you have a Contact Lens Induced Peripheral Ulcer
If you suspect you have a Contact Lens Induced Peripheral Ulcer, it is important that you remove your lenses immediately, if the symptom continue seek medical advice from your optometrist or eye casualty department as soon as possible.
The sooner treatment begins the more positive the outcome.
How to Treat a Contact Lens Induced Peripheral Ulcer?
- Immediately removal and discontinue wearing contact lenses
- Lubricating drops
- Antibiotic eye drops may be prescribed if a bacterial infection is suspected or as prophylactic
Immediately remove your contact lenses and stop wearing them until your optometrist gives the all clear.
Symptoms of a contact lens induced peripheral ulcer often show signs of improvement within 24 to 48 hours of non contact lens wear.
Antibiotics may be prescribed if a bacterial infection is suspected or as a prophylactic, to prevent a secondary infection. The use of hydrating eye drops can help ease discomfort and lubricate the eye.
If left misdiagnosed or there is an underlying infection then if left untreated a CLPU can lead to serious eye problems. Always consult an eye care professional if you suspect you have a contact lens induced peripheral ulcer.
How to prevent Contact Lens Induced Peripheral Ulcer?
- Only wear your contact lenses as prescribed by your optometrist
- Practice excellent contact lens hygiene
- Wash and dry hands before handling lenses
- Rub and rinse lenses (even with “no-rub” solutions)
- Never top off solution — always use fresh solution
- Clean, air-dry, and replace the lens case every 1–3 months
- Avoid wearing lenses overnight
- Maintain healthy eyelids - seek treatment for blephritis if present
- Avoid contact lenses coming into contact with water, tap, swimming pool, sea
- Reduce contact lens wear time if your eyes feel irritated or scratchy
- Wearing daily disposables, daily disposable contact lenses are widely recognised as the safest mode of wear for contact lenses, due to having a fresh clean pair every day.
- Attend regular eye exams
- Check out our - Contact lens check up article
You can greatly reduce your risk of Contact Lens Induced Peripheral Ulcer (CLPU) by following the suggestions above, this will help minimise bacterial contamination and associated risks with contact lens wear.
If in doubt, take lenses out and reach out to your optometrist or eye care professional.
