Pigmentation of the Cornea Secondary to Tinted Soft Contact Lens Wear

Purpose. To report a case of pigmented corneal iron lines following use of tinted soft contact lenses (CL). Methods. A retrospective case report. Results. A 16-year-old girl was referred with suspected CL-related keratopathy OU, having recently switched to tinted soft monthly disposable CLs (8.4/14.0 -3.00 OD, -3.25 OS Aquamarine SofLens Natural Colours, Bausch and Lomb, New York, USA). Both corneas exhibited symmetric superficial corneal pigmented iron lines, which gradually disappeared following discontinuation of CL wear. Conclusions. Pigmented corneal rings have been reported in normal ageing corneas, in certain pathological conditions, and in association with altered corneal topography following LASIK and orthokeratology. We suspect a poorly fitting CL resulted in localised tear pooling between the CL and cornea, and subsequent iron pigment deposition, similar to that seen with orthokeratology. Cosmetic CLs bought via the Internet can be used in an unsupervised manner, with possible impacts on visual function and potential complications.