What steps should be taken if a patient reports vision flashes or contact lens-induced corneal staining?

What steps should be taken if a patient reports vision flashes or contact lens-induced corneal staining?

• A. Stop wear, inspect lens for damage, assess cornea, schedule follow-up, consider alternate lens options.
• B. Increase wear time to acclimate to symptoms.
• C. Ignore and continue wear.
• D. Only treat with antibiotic drops without examining lens or cornea.

Answer: (A)

When a patient reports vision flashes or contact lens–induced corneal staining, the first priority is to stop wearing the lenses and evaluate both the lens and the eye. Remove the lenses, inspect the lens for damage, scratches, or deposits, because a compromised lens or misshapen edge can cause mechanical irritation or improper fit. Then assess the cornea—look for epithelial disruption or staining patterns with fluorescein to identify abrasions, hypoxic changes, or early signs of contact lens–related keratitis. A follow-up visit is important to confirm healing and ensure there’s no progression to a more serious issue. After the eye has stabilized, consider alternate lens options to reduce recurrence risk—this might involve a different material with higher oxygen transmission, a different fit, or switching to daily disposable lenses to minimize deposits and irritation. Ignoring symptoms, increasing wear time, or treating without examining the lens and cornea could miss a real problem or worsen it, so a careful, stepwise approach is essential.