Corneal iron ring induced by overnight orthokeratology lens wear

Visible iron deposits in the cornea in the form of rings and lines have been observed in patients with corneal pathologies such as keratoconus and pterygium, and other contour-altering procedures such as LASIK and filtering bleb surgery. We report a case of a 14-year-old female overnight orthokeratology patient who was fit with reverse geometry lenses, who after several weeks of lens wear, presented with bilateral shiny brown arcs in the mid-peripheral inferior quadrant of both eyes. Vision was unaffected, and the eyes were otherwise unremarkable. The presumed-to-be iron deposits were deemed the non-pathological orthokeratologic-variant of the keratoconus-associated Fleisher's ring. The location of the deposits, coinciding with the fitting curve of the rigid lens, suggests tear-pooling may have been involved in their development.