{"id":6,"url":"https://cclm.media-doc.io/conditions/6/","name":"Contact Lens Peripheral Ulcer (CLPU)","category":"Cornea","detail":"<p>Contact lens peripheral ulcer, culture negative peripheral ulcer, sterile corneal ulcer, sterile infiltrate</p>\n\n<h2>Symptoms</h2>\n\n<ul>\n\t<li>Moderate foreign body sensation. None in some cases</li>\n\t<li>Redness</li>\n\t<li>Mild photophobia</li>\n\t<li>Symptoms reduce on lens removal</li>\n</ul>\n\n<h2>Signs</h2>\n\n<ul>\n\t<li>Distinctive, circular infiltrate towards periphery of the cornea</li>\n\t<li>Infiltrate has clearly defined margins, size 0.2 to 1.0mm</li>\n\t<li>Overlying epithelial staining occurs early in the condition</li>\n\t<li>Generally leaves a small scar which fades over time</li>\n</ul>\n\n<h2>Etiology</h2>\n\n<ul>\n\t<li>Non-infectious, infiltrative response to gram positive bacterial exotoxins</li>\n</ul>\n\n<h2>Prevalence</h2>\n\n<ul>\n\t<li>Rare in DW, infrequent in EW</li>\n</ul>\n\n<h2>Differential Diagnosis</h2>\n\n<ul>\n\t<li><a href=\"/condition/24\">Ulcerative (microbial) keratitis</a> .&nbsp;This is the vital differential diagnosis. If in doubt, treat as microbial keratitis</li>\n\t<li><a href=\"/condition/20\">Infiltrates</a> , marginal keratitis and&nbsp;<a href=\"/condition/18\">CLARE</a>.&nbsp;<a href=\"/condition/6\">CLPU</a>&nbsp;is a variation of these other sterile, infiltrative conditions due to different exotoxins and/or endotoxins being involved</li>\n\t<li>Herpes Simplex, corneal dystrophies, stromal scar</li>\n\t<li><a href=\"/condition/66\">See: Infiltrates and Opacities &ndash; Differential Diagnosis</a></li>\n</ul>\n\n<h2>Management</h2>\n\n<ul>\n\t<li>Cease lens wear immediately</li>\n\t<li>If doubt as to whether infectious or sterile, treat as infectious. Start topical antibiotic</li>\n\t<li>Ocular lubricants, steroid/antibiotic combination topical treatment</li>\n\t<li>Review within 24 hours</li>\n\t<li>Recurrence is likely, limit EW to 6N</li>\n\t<li>Consider DD, and lid hygiene</li>\n</ul>","images":[{"name":"Contact Lens Peripheral Ulcer (CLPU)","file":"https://cclm-static.s3.amazonaws.com/images/clpu-01_zoom.jpg"},{"name":"Contact Lens Peripheral Ulcer (CLPU)","file":"https://cclm-static.s3.amazonaws.com/images/clpu-02_zoom.jpg"}],"type":1,"videos":[{"name":"Contact Lens Peripheral Ulcer (CLPU) - White Light","videoSrc":"248362010"},{"name":"Old CLPU Scars - Central Cornea","videoSrc":"248362178"}],"wear":false,"ceaseWear":true,"changeLens":false,"changeSolutions":false,"changeCare":false,"counseling":false,"dd":true,"dw":true,"gp":false,"replace":false,"review":true,"rewettingDrops":false,"rx":true,"SiHy":false,"toric":false,"tags":[]}