Corneal damage wearing contacts to correct astigmatism

[Danise]

I'm 41  years old and have been wearing contacts since I was 17.  I've always worn soft contact lens and have never had problems.  When I would go for a check up, I always wanted to see more bold, but my dr said that my astigmatism wasn't bad enough to correct.  Anyway, about 3 months ago at my last visit, my dr gave me a trial pair of contact lens that correct astigmatism.  Right away I started having problems...the first being the contacts would get a film on them after only about 1/2 hour.  We tried another brand, but these just made my eyes itch.  When the dr checked my eyes again, he said that my corneas were damaged.  He drew a circle and put dots all over it and said that is what my corneas looked like.  I stopped wearing contacts and he tried steroids and eye drops and after a month, he said the damage was just on the lower part of my cornea, kind of like a crescent moon.  Funny though...that is where the weight is in the astigmatism contacts.  He sent me to a corneal specialist who said I have dry eyes, which is doing the damage to my cornea.  Mind you, I've been wearing contacts for 24 years and have never had a problem until my dr started me on the astigmatism contacts.  The specialist has me on Restasis and a few other drops...treating me for dry eyes.  I'm going back on 6/16.  I called my dr and asked if those astigmatism contacts could have caused the cornea damage.  He said "NO," and it would have cleared up by now if it was the contact lens.  I asked about permanent cornea damage from those contacts and he said there is no permanant damage.

Sorry to write so much, but in summary, I want to know if the astigmatism contacts could have caused this damage with my cornea.  Why after 24 years of wearing contacts all of a sudden turn into this problem right after trying the astigmatism contacts?  I've been wearing my glasses now for almost 3 months, and I have massive headaches because I cannot see clearly through them.  The dr said I can't see clearly because the corneas are scratched.  HELP!!!!  

Any advice you could provide would be awesome!!  Thank you!!

[John C Hagan III, MD, FACS]

You can do your own literature search on irregular astigmatism caused by contacts and you will find hundreds of papers. All types of contacts can cause warping of the cornea, in rare cases it can damage the structure and cause keratoconus.  The problem would be more common with a toric CTL than a spherical CTL.

In the cases I've managed leaving the contacts out the cornea has slowly resumed its old shape and the vision has returned to normal. This has taken up to 6 months in some cases. During this time contacts of any kind should not be worn.

There are cases where the warped cornea is permanent but those are unusual.

If you are still flummoxed then get a second corneal Eye MD opinion from one you pick. Find one at www.aao.org

In the future consider getting all your eye care from an eye MD ophthalmologist.

JCH IIMD