- Dr. Katerina Kurteeva is an ophthalmologist in Newport Beach, California.
- A patient came in complaining of pain, but Kurteeva couldn't see anything in the initial exam
This as-told-to essay is based on a conversation with Dr. Katerina Kurteeva. It has been edited for length and clarity.
It had been a manic Monday at the clinic with eye emergencies that had come up over the weekend, in addition to our routine appointments. Toward the end of the day, a patient in her mid-70s who wore daily contact lenses came in saying she felt she had something in her eye that she couldn't get out.
Even though we ask seniors to come in once a year for checkups, this woman had skipped appointments and hadn't been to the office in two years. Although her vision was blurry, it was the pain that bothered her most.
My mind jumped to the possibilities of what it could be: a piece of broken contact lens, a scratch on the cornea, an infection, an eyelash, or debris from makeup. I'd only know for sure once I did the examination.
I checked for scratches or foreign objects
To start, I used an anesthetic and a yellow stain to identify any scratches or foreign bodies. I couldn't see anything on the cornea from the initial examination, so I proceeded to manually pull on the lower and upper lids to see if there was anything in the upper or lower fornix. These are the deep corners of the eye, like little pockets of the eyelid, where things occasionally get stuck.
I didn't see much — just a little bit of mucous, which could be a natural response to irritation. I was puzzled.
To continue my investigation, I used an instrument called an eyelid speculum that would keep both the upper and lower lid open at the same time for a longer period of time, so I could freely use my hands to find out what was going on.
When I asked her to look down, I could see the edges of a couple of contacts stuck to each other. Pulling them out, I felt like I could still see more and asked my assistant to get my phone to record the removal.
Asking the patient to look down again, I could see a huge, dark-purple blob of contact lenses stuck to her eye. It almost looked like a second pupil. I gently started using a Q-tip to peel the lenses apart one by one, like you would deal a deck of cards. They were coming out in a chain, drooping down her lid. There were a lot of contact lenses — I thought this could be my Guinness Book of World Record moment.
In nearly 20 years of practice, I had never seen anything like it.
She felt better almost immediately
The patient couldn't believe it either and asked if I was sure about the number I was counting.
After we had removed the biggest blob, we retrieved a few more from the corners, carefully flushed her eye out with distilled, sterile water, removed some of the mucous, and sent her home with anti-inflammatory drops. She said she felt much better already.
Laying out the contacts on a tissue, I separated each one with fine-tip forceps and counted 23 contact lenses. Some of them were yellow and some light blue, because while the natural color of a contact lens is light blue, the stain I put in her eyes to examine had colored some of the lenses yellow.
I posted the video of the examination, and it went viral straight away. Optometrists from South America, Mexico, and Europe were using the video to educate people about making sure they take their daily contact lenses out of their eyes every single night. These are light, flimsy lenses and should not be used for more than 24 hours.
This can be really dangerous for the patient
This patient was very fortunate — she could have lost her vision, scratched her cornea, or gotten an infection. I begged her not to wear contact lenses again and give her eyes a break, but she's gone straight back to wearing them. I saw her a month after the examination and she was doing really well, feeling much more comfortable and seeing clearly.
Although I can't be certain of how she managed to forget to remove all those lenses, it could because she had been wearing contact lenses for 30 years. When a person wears contact lenses over a long period of time, it can cause desensitization of the corneal nerve endings. She wouldn't have felt something like 23 contact lenses as sharply. It also could have been her age. Older people's eyelid fornix, the least sensitive space, is much deeper, and the contact lenses just sat there for a while not bothering her.
I feel really lucky to have captured this on video to remind people to remove their contact lenses every single night. This was a happy ending, but it could have gone sour really quickly.