British doctors find mass (27 in total) of contact lenses under patient's eyelid

[Voyageur]

Kind of bizarre, and I don't know exactly what the patients situation truly is (age, mental health etc.) i.e. how does a person not know and how is a recommendation for cataract surgery not pick this up until the 11th hour?

Having never had to wear these lenses, I'm just not sure of the reality of how this could happen - here is what it says:

Woman thought contacts had fallen out and would simply insert a new lens, doctor says

CBC News Posted: Jul 18, 2017 1:07 PM ET http://www.cbc.ca/news/health/27-contact-lenses-british-patient-1.4210266

When the anesthesiologist injected a topical anesthetic, he noticed a "blue shadow" under the patient's top lid.

Doctors examined further, and found a blue mass of lenses under the eyelid.

"It was 17 contact lenses compacted together," said Morjaria, in an interview with As it Happens' Helen Mann. "It was like a blue solidified mass of mucus around it."

After further examination, Morjaria removed an additional 10 lenses — 27 in total — from the patient's eye.

[...]

"After I removed all the lenses … I had to think about whether it was safe to perform cataract surgery, because that's what she'd come in for," said Morjaria. "I think she was just relieved that there was a reason for her discomfort."

[...]

Assumed lens had fallen out

Morjaria said that the patient isn't sure how she got so many contact lenses stuck in her eye.

"The only thing she said to me was they were mostly disposable lenses, but whenever she was to change her lenses, if she couldn't find it, she'd just put another one in," said Morjaria. "She just assumed it had fallen out."

Morjari said that the patient also had deep set eyes.

"So maybe just the way they were sitting, she couldn't feel it as much," said Morjaria. "I can only imagine that the reason she was only having mild symptoms is because it was not near the front of the eye, it was quite far back."

[...]

At the patient's followup examination two weeks later, she reportedly said that she felt great.

"She's been doing really well from what I hear," said Morjaria....

At the very least, the patient is assumed to have been recommended by her optometrist to have surgery one would think - pretty horrible situation.

 

[Arwenn]

Well I am an optometrist, and I don't understand why the patient was booked in for cataract surgery because of the discomfort she had been feeling. Cataracts are a visual impediment due to a progressive clouding of the lens inside the eye, but they don't cause physical discomfort. Also I don't know how she didn't end up with an eye infection -27 lenses compacted under an upper lid is no joke (irrespective of how deep set the eyes are)! I would assume that they werre daily or fortnightly lenses, and that therefore the discomfort was present for about 1-3 months.

[quote author=voyageur]
Kind of bizarre, and I don't know exactly what the patients situation truly is (age, mental health etc.) i.e. how does a person not know and how is a recommendation for cataract surgery not pick this up until the 11th hour? [/quote]

I agree, it is a very strange situation that doesn't quite make sense from a medical perspective, without having more background information.

 

[Voyageur]

Also I don't know how she didn't end up with an eye infection -27 lenses compacted under an upper lid is no joke (irrespective of how deep set the eyes are)!

Yes, that's a good point too. All very odd on the surface without much more understanding of the exact situation. Here is a "brief" write up that I don't have access to in the British Medical Journal http://www.bmj.com/content/358/bmj.j2783

This similar article adds more from WP - https://www.washingtonpost.com/news/morning-mix/wp/2017/07/17/doctor-finds-27-contact-lenses-lost-in-womans-eye-british-medical-journal-reports/?utm_term=.0e45330165e4

...“None of us have ever seen this before,” Morjaria said. In fact, she chose to publish the case because most doctors didn’t think it was possible for someone to lose so many contact lenses in their eyes without suffering from severe symptoms.

The patient had worn monthly contact lenses for 35 years, and she rarely visited the eye doctor during those years. But she had cataracts, so last November doctors were injecting anesthesia into her eyes for surgery when they paused, surprised by the bizarre discovery.

“It was such a large mass,” Morjaria said. “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.”

“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,” Association of Optometrists clinical and regulatory officer Henry Leonard told Optometry Today. “Most patients would experience significant discomfort and redness, and be at risk of eye infections.”

They were also confused by how they got there. Perhaps it’s because she had “deep set eyes, which might have contributed to the unusually large number of retained foreign bodies,” the paper in BMJ stated.

Immediately, they postponed the pending surgery.

“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” in her eye, Morjaria said.

Morjaria hopes that contact lens wearers who see the story will take a little more caution.

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

Some, though, have questioned the story.

“How is this even possible? How did she not feel the lenses?” tweeted one user.

“How does that happen? I wear my dailies for an HOUR too long and my eyes start the rejection process: goop, itching, hide-n-seek,” tweeted a second.