An unusual eyelid lump: unsuspected embedded contact lens for up to 40 years. Two cases and literature review

Abstract

The purpose of this study is to report two patients with retained rigid gas-permeable contact lenses (RCLs) that had become integrated into the upper eyelid tissues, to provide a brief literature review and to discuss possible aetiologies. The methods used in this study are as follows: retrospective review of clinical records and review of the literature. Two contact lens wearers presented with an upper eyelid mass, one after previous loss of a lens and the other 40 years after a failed trial of RCL wear; this latter case appears to be the longest delay in diagnosis reported in the ophthalmic literature. Although extremely rare, the presence of an upper tarsal lump in a RCL wearer should raise possibility of an embedded contact lens, particularly where the contour is suggestive in size or shape. Ultrasonography or magnetic resonance imaging may show characteristic changes. It is probable that RCL migration into periocular tissues occurs by entrapment above the upper tarsal border and integration, by local tissue necrosis, into the tarsus or pretarsal space.