Upon examination, the vascularized area can stain with rose bengal, and will appear thickened. Some papillae of the upper lid are usually seen.

Steroids, lubrication, silver nitrate, and even surgery have been used in treating this condition. Nothing works very well. Silver nitrate often has to be repeated to be successful.

Some literature says contact lenses may cause it, as may some chemicals in solutions. Other sources say contact lenses are a treatment modality. I'll let you decide! I'd personally lubricate like crazy, and try a one-day lens regimen for a while to see if the patient responds. You can go the steroid route if desired, but don't expect great results. If the condition subsides, suspect a spontaneous remission more than effective therapy.

See you next time...