A silicone hydrogel soft lens wearer presents with a superior arcuate lesion. What does this indicate?

A superior arcuate lesion in a silicone hydrogel soft lens wearer typically suggests epithelial splitting, also known as an epithelial defect or corneal abrasion. This condition can occur as a result of mechanical trauma or excessive pressure on the corneal epithelium, often exacerbated by the use of contact lenses. Silicone hydrogel lenses are designed to allow more oxygen to reach the cornea, which can help maintain corneal health; however, improper fit or excessive lens wear can lead to complications.

The superior arcuate shape specifically refers to the location and outline of the lesion, which is commonly associated with the pressure distribution caused by the lens. If the lens is too tight or not fitting properly, it can create friction or pressure points on the cornea, leading to the formation of such lesions.

Understanding this association helps address the underlying factors contributing to corneal health issues in contact lens wearers and the importance of proper lens fitting and patient education on lens wear habits. In this case, recognizing a superior arcuate lesion as indicative of epithelial splitting can lead to appropriate management decisions, such as lens adjustment or more frequent follow-ups to monitor the corneal health of the patient.