눈꺼풀판 결막 아래 이물로 발견된 RGP 콘텍트렌즈 1예
A Case of a Rigid Gas Permeable (RGP) Contact Lens Found as a Foreign Body under the Upper Tarsal Conjunctiva
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목적: 위 눈꺼풀판 결막 아래에 5년 이상 박혀 있던 RGP 콘텍트렌즈를 발견하여 제거한 증례를 경험하였기에 이를 보고하고자 한다. 증례요약: 60세 여자가 2주 전부터 간헐적으로 느껴지는 우안의 이물감을 주소로 내원하였다. 환자는 8년 전부터 RGP 콘텍트렌즈를사용하고 있었으며, 5년 전 타인의 주먹에 우안을 수상하면서 콘텍트렌즈를 분실한 경험이 있었다. 수상 당시 우안 각막 미란 외에특이소견이 없다고 들었으며, 그 후에도 일년에 2-3차례 안과 진료를 받아왔으나 별다른 문제는 발견되지 않았다. 초진 시 최대교정시력은 우안 0.8, 좌안 0.8이었고, 안압은 우안 27, 좌안 21이었다. 우안 상안검에 경도의 발적 및 부종이 있었고, 우안 눈꺼풀을 뒤집었을 때, 눈꺼풀판 결막에 4×4 mm 크기의 투명하고 중심부가 움푹 파인 타원형의 이물이 발견되었다. 결막 아래 이물 제거술을시행하여 5년 전 외상에 의해 결막 아래에 들어가 있던 RGP 렌즈를 제거하였다. 환자는 제거술 이후 특별한 불편감을 호소하지 않았으며, 6개월 경과 관찰에서 특별한 문제는 보이지 않았다.
Abstract
Purpose: To report a case of removing a rigid gas permeable (RGP) contact lens that was found under the upper tarsal conjunctivaafter five or more years. Case summary: A 60-year-old female patient visited our Department of Ophthalmology due to the irritation of a foreign body sensationin her right eye that had been present for approximately two weeks. The patient started wearing RGP contact lenses 8years previously. Five years prior, somebody struck her in her right eye, and the patient thought that she lost the RGP lens for herright eye. At that time, she visited the clinic and was diagnosed with corneal erosion, but nothing else in particular. Afterward shecontinued to visit the clinic 2 to 3 times per year for regular checkup, but nothing notable was found. The best corrected visualacuity and IOP at the initial visit were 0.8 and 27 mm Hg in the right eye and 0.8 and 23 mm Hg in the left eye, respectively. Mildswelling and erythema along the right upper eyelid were identified. As we everted the upper eyelid, a 4 × 4 mm sized, transparent,oval-shaped foreign body with a concave dented center was found. Under the local anesthesia, the foreign body underthe upper tarsal conjunctiva was removed and we presumed that the foreign body was the RGP contact lens that had stuck underthe conjunctiva due to the incident 5 years prior. After removal, the patient did not express any discomfort and nothing extraordinarywas found during the 6 months of follow- up.
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