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Figure 6 This fi gure shows a solution toxicity keratitis (Bruce 2008), Copyright
Color image of this figure appears in the color plate section at the end of the topic.
Symptomatic (IK) and Asymptomatic Infi ltrative Keratitis (AIK)
“Contact Lens Acute Red Eye (CLARE), Contact Lens Induced Peripheral
Ulcer (CPLU), Infi ltrative Keratitis (IK) and Asymptomatic Infi ltrative
Keratitis (AIK) are probable infl ammatory responses of the cornea and
conjunctiva caused by the presence of bacteria colonizing the CL and are
not considered to be infections of the cornea or conjunctiva surface” (Wilcox
2000). Microbial Keratitis (MK) is the only event that is considered infectious,
i.e. showing rapid bacteria growth in tissues. Other corneal infi ltrative
events that are not classifi ed as MK are IK and AIK, CLARE and CLPU.
Contrary to CLARE, there is no association of sleeping with CL with IK.
Its onset is usually later in the day (Sankaridurg 1999a). Watery discharge
and mild to moderate limbal and bulbar conjunctival hyperaemia can be
observed. IK may be found to be related to corneal trauma/corneal erosions,
possibly combined with foreign body traces or matter under the CL. The
infi ltrative response is usually under these erosions or traces. Another
type is a diffuse, dim infi ltration in the mid-periphery to periphery. These
infi ltrations are in the anterior stroma and come from the limbus. Neither the
posterior stroma, nor the endothelium is involved. Non trauma cases often
have bacteria involvement (on the CL and in the CL case). The epithelium
above the infi ltrate can show punctate or strong defects. The most common
accompanying symptoms are redness, irritation and excessive tear fl ow
(watering) (Holden 2000). There is normally no effect on vision.
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