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SYMPTOMS
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Pain | Photophobia | Blurry vision | Tearing | Contact lens intolerance
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SIGNS
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Injection | Corneal edema | Neovascularization | Epithelial keratopathy | Possible cells/flare in the anterior chamber | Possible infiltrates
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WORK-UP
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Thorough history. Slit lamp examination
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TREATMENT
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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
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FOLLOW-UP
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Every few days during treatment
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ETIOLOGY
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CLARE stems from contact lens wear (extended wear, overnight wear, etc.) | Possible pathogens include: H. influenzae, Pseudomonas aeruginosa and Serratia marcescens, etc.
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DIFFERENTIAL DX
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Microbial keratitis | Infiltrative keratitis | Contact lens peripheral ulcer
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NOTES
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While CLARE is usually self-limited, many providers treat with topical medication to hasten recovery
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