If vision symptoms of corneal staining are reported by a lens wearer, what steps should be taken?

• A. Stop wear; inspect lens for damage; assess the cornea; schedule follow-up; consider alternate lens options.
• B. Continue wearing and ignore.
• C. Increase power to hide staining.
• D. Switch to hard lenses immediately.

Answer: (B)

When vision symptoms accompany corneal staining, the priority is to protect the cornea and identify the cause, not to continue wearing the lens. The proper course is to stop wearing the lenses immediately and remove them from the eyes. Then inspect the lenses for damage, deposits, or edges that could irritate the cornea. Next, assess the cornea with fluorescein staining to see where the epithelium is affected and to check for any epithelial defects. Schedule a follow-up promptly, typically within 24 to 48 hours, or sooner if symptoms worsen (increasing pain, redness, light sensitivity, or vision changes). In the meantime, avoid using that lens and consider alternate options to prevent recurrence, such as a different lens material with higher oxygen permeability, a different fit to reduce mechanical irritation, or a switch to daily disposables or a shorter wear schedule. If staining is extensive or symptoms are severe, urgent ophthalmic evaluation is warranted. The goal is to halt further irritation, allow healing, and adjust the lens regimen to prevent future corneal compromise.