Treatment of refractory vernal ulcers with large-diameter bandage contact lenses.

Purpose: To report two cases of refractory vernal ulcers in which the fitting of a large-diameter (22 mm) hydrogel (Contaflex T75) bandage contact lens (BCL) ameliorated the signs and symptoms of the condition.

Methods: Two patients with refractory vernal ulcers are described. Mechanisms of the effect of a large-diameter lens across the ocular surface are discussed in this condition.

Results: The first patient is a 10-year-old boy who had been treated unsuccessfully for a left vernal corneal ulcer with topical prednisolone 0.5% and olopatadine. The vernal ulcer resolved 2 weeks after the fitting of a large-diameter BCL. The second patient is a 4-year-old boy who had been intolerant of all his previous topical medications partly because of his ocular discomfort in association with the right vernal ulcer. A large-diameter BCL was fitted in his right eye. The BCL was removed 2 weeks later with complete healing of the corneal vernal ulcer. Owing to his improved comfort, the patient was able to tolerate topical prednisolone 0.5% drops.

Conclusions: Large-diameter BCLs may be a useful treatment option in the management of refractory vernal ulcers.