Eye problems in contact lens wearers

### What you need to know More than 140 million people worldwide wear contact lenses.1 Contact lens wearers are more prone to ocular surface problems, particularly those who use extended wear contact lenses.23 Patients may present to the general practitioner, pharmacist, or optometrist in approximately 42% of cases.4 Clinicians in acute care need to be able to identify sight threatening conditions such as microbial keratitis, and advise on more common problems such as a retained contact lens or contact lens discomfort. This article outlines the common eye conditions associated with contact lens wear and an approach that non-specialists can use to identify and manage them. Accurate diagnosis and treatment of contact lens related problems in the non-specialist setting is challenging. Firstly, in the case of someone presenting with a red eye, the wide differential diagnosis of the red eye has to be considered in addition to the specific contact lens related complications described in this article.5 Secondly, a slit lamp is required to confirm the diagnosis in most cases. As such, in primary care an assessment may be limited to identifying a likely cause, and making a judgment about the risk of a serious or sight threatening complications and need for urgent eye specialist assessment. Forming this judgment is summarised in figure 1. We recommend that if a clinician is uncertain about the diagnosis, they should seek further advice from an eye specialist. Advise patients to abstain from using contact lenses while awaiting specialist …