Bilateral corneal erosion due to retail purchase of unfitted prescription contact lenses

Purpose: We report a case demonstrating the importance of trial fitting before the dispensing of prescription contact lenses. Methods: The patient was an 18-year-old computer-using experienced hydrogel lens wearer who ran out of contact lens supply. The patient purchased a brand new box of daily disposable lenses from a retail store having known his back vertex power. No trial fitting of the lenses was performed at the point of sale. Results: After a day of wear of the lenses with significant computer use, the patient removed them and went to bed, but the next morning, presented on an emergency basis with severe pain and blurry vision in both eyes. Slit lamp examination showed significant bilateral corneal erosions that were treated with prophylactic antibiotics, steroids, and lubricants. A bandage contact lens was further given to his right eye. The characteristics of the daily disposable lenses and his computer overuse were viewed as contributing factors to the complication. Conclusions: The dispensing and wear of prescription contact lenses without a proper selection and fit led to bilateral corneal erosions in this patient. Though our case occurred in Taiwan, a jurisdiction where prescription contact lens sale is not regulated, the authors note that such a scenario could occur in jurisdictions where contact lens sale is regulated if, after confirmation of back vertex power, no effort is made to ensure that a purchased lens is safe or appropriate for a patient, such as when lenses are purchased through internet suppliers or in certain commercial retail settings.