Which term describes the arcuate superficial corneal staining near the limbus linked to tight extended-wear hydrogel lenses?

• A. Guttata
• B. Keratoconus
• C. Superficial Epithelial Arcuate Lesion (SEAL)
• D. Salzmann nodular degeneration

Answer: (C)

Arcuate superficial epithelial lesions describe a pattern of staining in the superficial corneal epithelium that occurs near the limbus from a tight extended-wear hydrogel contact lens. The lens edge presses against the peripheral cornea, causing microtrauma to the epithelium, which shows up as an arc-shaped staining pattern when fluorescein is used. This lesion stays in the outer epithelial layer and follows the arc where the lens makes contact, distinguishing it from deeper or different corneal pathologies. It is not related to guttata (Descemet’s membrane changes), keratoconus (cone-shaped cornea), or Salzmann nodular degeneration (anterior stromal nodules from chronic irritation).