Contact Lens-Associated Red Eye (CLARE)

Contact Lens-Associated Red Eye (CLARE)
SYMPTOMS Pain | Photophobia | Blurry vision | Tearing | Contact lens intolerance
SIGNS Injection | Corneal edema | Neovascularization | Epithelial keratopathy | Possible cells/flare in the anterior chamber | Possible infiltrates
WORK-UP Thorough history. Slit lamp examination
TREATMENT Discontinue CL wear | Preservative-free artificial tears | Topical antibiotics and steroids may be used to hasten resolution: Polytrim 1 gtt qid, Pred Forte 1% 1 gtt qid | Topical cycloplegics are rarely used | Consider switching to daily disposable contact lenses
FOLLOW-UP Every few days during treatment
ETIOLOGY CLARE stems from contact lens wear (extended wear, overnight wear, etc.) | Possible pathogens include: H. influenzae, Pseudomonas aeruginosa and Serratia marcescens, etc.
DIFFERENTIAL DX Microbial keratitis | Infiltrative keratitis | Contact lens peripheral ulcer
NOTES While CLARE is usually self-limited, many providers treat with topical medication to hasten recovery