Which term best describes the arcuate pattern of corneal staining near the limbus most commonly associated with tight extended-wear hydrogel lenses?

• A. Superficial Epithelial Arcuate Lesion (SEAL)
• B. Filamentary keratitis
• C. Guttate keratopathy
• D. Keratoconus

Answer: (A)

When a contact lens is too tight for extended wear, the edge of the lens can press on the corneal periphery and create mild, superficial disruption of the epithelium near the limbus. This produces a distinct arc-shaped band of staining that sits just inside the limbal area. That peripheral, arcuate staining is described as a Superficial Epithelial Arcuate Lesion (SEAL). It reflects mechanical compression and relative hypoxia from the tight lens fit, rather than a primary disease process.

Filamentary keratitis involves thread-like filaments on the corneal surface, typically from severe dry eye or ocular surface disease, not an arcuate staining pattern near the limbus. Guttate keratopathy presents as dot-like deposits in the corneal epithelium or Bowman's layer, not a limbal arcuate pattern. Keratoconus is a thinning disorder that changes corneal shape, not a staining pattern from lens wear.