Punctate keratitis may be related to poor contact lens fit, toxic reaction to contact lens solutions, or dry eye.
Conjunctival injection, epithelial staining, punctate epithelial keratopathy, erosions, microcysts, and limbal stem cell deficiency are all potential findings of conjunctival or corneal toxicity arising from contact lens solutions. Any of the proteolytic enzymes or chemicals used for cleaning contact lenses, or the preservative-containing soaking solution, may be the culprit. Cleaning and disinfecting agents can cause an immediate, painful epitheliopathy.
Excerpted from BCSC 2020-2021 series : Section 3 - Clinical Optics. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.