A “blueish mass” in a cataract surgery patient is the largest number of mislaid contact lenses the surgical team has seen

A “blueish mass” of 17 contact lenses has been discovered in the eye of a patient who was scheduled for cataract surgery.

The 67-year-old patient was unaware that the contact lenses were missing, and later told surgeons that she thought her discomfort was due to dry eye and old age.

Specialist trainee ophthalmologist, Rupal Morjaria, told OT that another 10 individual contact lenses were discovered in the woman’s eye following further examination at Solihull Hospital.

The operating team, which included an ophthalmologist with more than 20 years of experience, were startled by the discovery, Ms Morjaria explained.

“None of us have ever seen this before,” she added.

“It was such a large mass. All the 17 contact lenses were stuck together. We were really surprised that the patient didn’t notice it because it would cause quite a lot of irritation while it was sitting there,” Ms Morjaria elaborated.

The cataract surgery was postponed following the discovery due to an increased risk of endophthalmitis.

“Because she had harboured these contact lenses in her eye for an unknown length of time, if we had operated she would have had a lot of bacteria around her conjunctiva,” Ms Morjaria

The patient had been wearing monthly disposable contact lenses for the past 35 years but did not attend regular optometrist appointments.

Ms Morjaria said the patient did not report any symptoms linked to the missing lenses in her pre-operative assessment.

“She was quite shocked. When she was seen two weeks after I removed the lenses she said her eyes felt a lot more comfortable. She thought her previous discomfort was just part of old age and dry eye,” Ms Morjaria shared.

The case, which occurred in November last year, is reported in The BMJ.

Ms Morjaria told OT that the decision was made to publish the case because the clinicians involved had previously not believed it was possible to retain so many contact lenses without being symptomatic.

Reporting on the surgery is also about public awareness, Ms Morjaria emphasised.

“In this day and age, when it is so easy to purchase contact lenses online, people become lax about having regular check ups,” she added.

“Contact lenses are used all the time, but if they are not appropriately monitored we see people with serious eye infections that can cause them to lose their sight,” Ms Morjaria stressed.

Association of Optometrists clinical and regulatory officer, Henry Leonard, told OT that the case illustrates the importance of contact lens wearers having regular professional after care.

“Patients do sometimes present with a contact lens stuck under their upper eyelid, particularly if they are new to contact lens wear, or have problems with dexterity, but finding this many lenses stuck in someone’s eye is exceedingly rare,” Mr Leonard shared.

He added: “Most patients would experience significant discomfort and redness, and be at risk of eye infections.”

The AOP has a series of resources that provide practical advice for contact lens wearers, including a 60 second top tips video.

Image credit: Rupal Morjaria