An Odd diagnosis

**chip anderson** · 04-09-2008, 08:22 PM

Over the past decade or so I have seen about a dozen patients a year with a strange fiber which looked like a cotten fiber except about 1/10th the diameter of cotten and up to 14" inches long in the eyes of some of my contact lens patients. I even had such a fiber in my own eye once. I had until today thought it to be some sort of pollen.
For the last few weeks I have a particular patient who has been in one soft aphakic lens and one minus soft lens for years come in about once a week complaining that her eyes hurt and she didn't think her lenses fit anymore. Each time when I examined her, I found one of these fibers in her eye.
She complained that she had been wearing them for years and never had any problems, so something must have changed. As the conversation wore on, I think I have isolated the problem. She has a pekinese with long hair. She never had this problem all those years because she never had the dog.
I began to think that possible the other patients, except myself had pekinese.

Anybody else had similar problems.

**IndianaOD** · 04-09-2008, 08:47 PM

Are you talking about filamentary keratitis?

**chip anderson** · 04-09-2008, 09:07 PM

I think I am talking about dog hair. But I could be wrong?

When It was in my own eye, my opthalmologist (one of the best) asked me: "What do you think that was Chip?" I am sure he would have known if it were fillamentary keratitus.

Chip

**JCHollaway** · 04-09-2008, 10:28 PM

Our pomeranians have extremely tiny, fine hairs that always seem to find a way into our eyes. Very annoying.

**tonyl** · 04-09-2008, 11:21 PM

I have seen this also, not in contact lens patients but in people with inflammed eyes. I could pull it out by twisting it around a cotton bud. Quite long, very thin. Product of inflammation or foreign body?

Could not possibly be a pet hair.

No I'm not seeing UFOs as well.

**Rebecca Petris** · 04-10-2008, 09:44 AM

Originally Posted by tonyl

I have seen this also, not in contact lens patients but in people with inflammed eyes. I could pull it out by twisting it around a cotton bud. Quite long, very thin. Product of inflammation or foreign body?

Filamentary keratitis... We have several dry eye patients on our board who have this... some of them are "mucous fishers" always pulling the strings out of their eyes which I'm told makes it worse/chronic...

**ziggy** · 04-10-2008, 10:17 AM

There was something on one of the news shows( like 20/20) about patients who have fibers all over there body. The program aired about a month ago. It might be linked.

**OHPNTZ** · 04-10-2008, 11:44 AM

Filamentary keratitis is usually found with severe dry eye. The filaments themselves are attached to the cornea, and are removed with forceps or debridement. This would not be what you are experiencing.

"Mucous Fishing Syndrome" is a condition where patients psychologically feel that something is in their eye or eyes, and attempt to remove something, usually affecting the conjunctiva. This can sometimes be associated with dry eye. Usually artificial tears help, but I have even read that these patients should be referred for psychological evaluation.

You could very well be finding a hair, and it should be rather easy to see with slit lamp evaluation. It could also be any foreign body, which has affixed a mucuous strand...I have seen this with eyelashes, hair, even insects...

**chip anderson** · 04-10-2008, 12:29 PM

Actually I have seen these curled up under, around and on top of contacts in the slit-lamp. As well as in various places on the surface and under the lids. Some of the longer ones were from side to side and wraped/curled, etc. on themselves.

Chip

**IndianaOD** · 04-10-2008, 06:47 PM

Originally Posted by chip anderson

I think I am talking about dog hair. But I could be wrong?

When It was in my own eye, my opthalmologist (one of the best) asked me: "What do you think that was Chip?" I am sure he would have known if it were fillamentary keratitus.

Chip

Are your sure, they are usually just looking for a reason to do surgery. :D

**chip anderson** · 04-10-2008, 06:56 PM

Yeah, I'm sure, he's the one that John's Hopkins sends patients back to telling them that he's better than they at pediatric ophthalmology.

Chip

**Judy Canty** · 04-10-2008, 07:59 PM

Years ago my husband bought flokkati rugs and pillows for his living room. Not my choice of decor, but we weren't married yet. One of those fibers made its way into my eye. Very uncomfortable. We still have the rugs and pillows, but they're in boxes in the garage...inching their way to the thrift store.

**ziggy** · 04-11-2008, 08:17 AM

I was telling the folks in the office about this thread, one of the ladies told me that she bought some "cheep" cotton balls from a discount store to take off her make-up. The balls would unravel an she would get a fiber in her eye on a regular basis. It took her a while to figuar out what was going on. When she switched products it never happened again.

**renee1111** · 04-11-2008, 02:20 PM

Back in highschool, I used to use Visine alot. (insert comment here!_____________, lol!) Anywho...I used to get these long filament/mucus strands all the time. (Very uncomfortable) I stopped depending on the drops and voilà, I no longer have that problem.:p

**AdmiralKnight** · 04-11-2008, 02:58 PM

Originally Posted by chip anderson

up to 14" inches long

Am I the only one surprised at how long these things are? I mean, if we're talking pet hair, or some sort of forign body... how do you not notice something over a foot long, no matter how thin, coming at you?