A rigid gas permeable contact lens discovered embedded in the upper eyelid 7 years after trauma: A case report. (July 2022)

• Record Type: Journal Article
• Authors: Ishikawa, Sho; Chino, Minami; Shinoda, Kei
• Is Part Of: International journal of surgery case reports. Volume 96(2022)
• Publication Date: 2022-07
• Subjects: Case report -- Rigid gas permeable contact lens -- Foreign body -- Rheumatoid arthritis; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.107316
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction: Rigid gas permeable (RGP) contact lenses implanted in the upper eyelid may remain asymptomatic. It is important to evert the upper eyelid even in the absence of definite pain. Presentation of case: A 74-year-old woman with a history of rheumatoid arthritis visited a local clinic because of right eye discomfort that had persisted for 5 months. Eversion of the upper eyelid revealed an embedded foreign body, and she was referred to our hospital. A transparent and smooth-surfaced foreign body was found embedded at the center of the upper eyelid conjunctiva. Additionally, fatty tissues were found behind the foreign body. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a foreign body rich in water at the same site. The foreign body was a spherical object with a diameter of 9 mm reaching as deep as the tarsus. On removal, the foreign body was identified as an RGP contact lens. On further questioning, it was discovered that the patient had lost an RGP contact lens 7 years earlier. The symptoms disappeared after removal of the foreign body. Discussion: RGP contact lenses are not detected on MRI scans, but cysts around the lenses are detected, which may result in multiple detections. CT cannot differentiate a foreign body from granulation tissue. The foreign body itself or a reactive granuloma can be seen when the eyelid is everted. Conclusion: A contact lens embedded in the eyelid without symptoms is rare but can be detected via a detailed interview, visual examination, and diagnostic imaging. Highlights: Rigid gas permeable (RGP) contact lenses can become embedded in the eyelid asymptomatically. Upper eyelid eversion and palpation are important to detect foreign bodies. CT could not differentiate RGP contact lenses from granulation tissue. RGP contact lenses themselves are not depicted on MRI scans. Swelling of surrounding tissues is shown by high-intensity signaling on MRI scans.