Conjunctival Hyperemia and Corneal Infiltrates with Chemically Disinfected Soft Contact Lenses

For three cosmetic soft contact lens wearers who chemically disinfected their lenses, conjunctival hyperemia and anterior stromal infiltrates of the cornea developed. When the conjunctival hyperemia and corneal infiltrates resolved, two of the three patients were challenged with their chemically disinfected soft contact lenses, with reappearance of the conjunctival and corneal reactions. Bacterial cultures of the conjunctiva, lids, lens cases, lens solutions, and eye cosmetics were not helpful. Conjunctival cultures for adenovirus and chlamytdial titers were negative. Giemsa stain of conjunctival scrapings showed a few mononuclear cells, polymorphonuclear leukocytes, and rare eosinophils but no inclusion bodies. Occlusive patch tests and intradermal tests showed positive delayed hypersensitivity reactions to the chemical disinfectants in all three patients. Occlusive patch tests with thimerosal suggested that this preservative was responsible for the reactions. Delayed hypersensitivity to thimerosal may play a role in the development of the conjunctival hyperemia and corneal infiltrates described in these patients.