Synopsis
Recognise infection in a contact-lens wearer, arrange urgent corneal assessment, preserve useful microbiology material, and reduce recurrence through a specific lens-care and return-to-wear plan.
- Ask explicitly about contact lenses in every red-eye assessment, including cosmetic lenses and occasional overnight use.
- Remove lenses promptly when redness or irritation develops and use glasses while the cause is assessed.
- Microbial keratitis and a sterile inflammatory infiltrate can overlap; peripheral position or mild pain alone cannot safely exclude infection.
Key red flags
Pain, light sensitivity, reduced vision or a white corneal spot in a lens wearer requires same-day specialist assessment.
Investigation priorities
Assess functional change and identify an epithelial or stromal lesion.
Management branches
A contact-lens wearer develops redness with pain, light sensitivity, visual symptoms or a corneal lesion.
- Remove the lens, assess vision and seek same-day ophthalmic advice or emergency eye assessment according to the findings.
- Retain the lenses and storage case for possible culture, and tell the service about water exposure and current eye medicines.
Key medicines
Ciprofloxacin 0.3% for an ophthalmologist-selected bacterial ulcerCiloxan's licensed ulcer schedule uses two drops per dose: every 15 minutes for the first six hours, then half-hourly to complete day one; hourly on day two; and four-hourly on days three through fourteen. Include overnight administration at each stage. Extension after day fourteen is physician-directed, with a maximum recommended 21 days in the SmPC.