Painful red eye associated with contact lens wear

Case presentation

A 26-year-old woman, Samantha, presented with a painful, red right eye that she had first noticed on waking that morning. She was photophobic and complained of blurred vision in the eye. Reluctantly, she reported having stayed at a friend’s house the previous night and of forgetting to take her contact lens case and cleaning solution; consequently, she had slept wearing her contact lenses. She said that, although this was not the first time she had worn the lenses during sleep, it was the first time she had woken with such distressing symptoms. The pain had been moderate on waking, but had worsened considerably when the lenses were removed.

Samantha had been wearing disposable soft contact lenses for about 12 hours/day, every day, for myopia. Apart from an episode of giant papillary conjunctivitis three years previously that had caused her to switch from conventional soft contact lenses to the disposable type, her ocular history was unremarkable.