The "O" sign presentation of a lost rigid contact lens

Srinivasan Subramaniam FRCOphth ,Naresh Joshi FRCOphth and Luke W Membrey FRCOphth
Reproduced with kind permission of Contact Lens and Anterior Eye

A 47-year-old lady was seen with a swelling of the right upper lid of 4 months duration. She was a rigid gas permeable contact lens user. Examination revealed a smooth lump in the right upper lid. Eversion of the lid revealed a small opening in the conjunctiva; nothing could be seen within the opening (Figure 1).
Under anaesthesia, the right upper lid was everted and the conjunctival opening extended. A contact lens was expressed along with mucopurulent material (Figure 2).
No organisms were cultured from either the mucopurulent material or the contact lens. The patient made an uneventful recovery.

Periocular migration of hard contact lenses is well recognised.1-4 The finding of a hole in the conjunctiva, the '0' sign over an embedded contact lens has also been described.5 Patients presenting with an upper lid lump and a conjunctival defect '0' sign should be questioned regarding contact lens wear.

REFERENCES

  1. Roherts-Hany, T.j., Davey, C.C. and Jagger, J.D. Periocular migration of hard contact lenses. Br. J Ophthalmol., 76, 95-97 (1992).
  2. Benger. R.S. and Froeh, B.R. An upper eyelid cyst from migration of a hard contact lens. Ophthalmic Surg., 17,292-294 (1986).
  3. Homblass. A. and Kass, L.G. Contact lenses in the upper eyelid masquerading as lid masses. Ophthalmic Surg.,18, 438-440 (1987).
  4. Beyer-Machule, C.K. and Shapiro, A. Eyelid penetration of a hard contact lens, simulating a neoplasm. Ophthalmic Surg.,17, 101-102 (1986).
  5. Bellan, L. anrl Buffam, F. The ."0" sign clue to a lost contact lens. Can. J Ophthalmol., 25,348-350 (1990).