A 32-year-old contact lens wearer presents to the emergency department with eye pain, redness, and photophobia in her right eye. She reports sleeping in her contact lenses for the past week. On examination, you notice a small, grayish-white lesion on her cornea. What is the most likely diagnosis?
The correct answer is bacterial keratitis. This condition is commonly associated with contact lens wear, especially when hygiene practices are poor or lenses are worn for extended periods. The symptoms of eye pain, redness, and photophobia, combined with the presence of a grayish-white lesion on the cornea, are classic signs of bacterial keratitis.
Fungal keratitis, while possible, is less common and typically develops more slowly. Corneal abrasion would not present with a visible lesion, and while it can be caused by contact lens wear, it wouldn't typically result from sleeping in lenses. Herpes simplex keratitis is possible but less likely in this scenario, as it's not typically associated with contact lens wear and often presents with a dendritic (branching) ulcer pattern.
Prompt recognition and treatment of bacterial keratitis is crucial to prevent vision loss. Emergency nurses should be aware of this condition and its association with contact lens wear to ensure appropriate triage and management.
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Maxillofacial and Ocular Emergencies
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