A patient’s long-lost rigid gas permeable (RGP) lens finally showed up after a 28-year absence. It was in her eye the whole time. The incident was recently reported in BMJ Case Reports.¹

The rigid gas permeable lens retrieved from within the cyst. Photo: BMJ Case Reports 2018.

The episode started when the pain became too much for the 42-year-old British woman. She presented to her general practitioner complaining of pain in her upper left eye of six month’s duration, which was also associated with swelling and ptosis. It started as a tender, “pea-sized lump which grew larger and became painful on palpation,” according to the case report published in BMJ. She was referred to an ophthalmologist who used magnetic resonance imaging to identify an ovoid nodule, but since RGP lenses have no radiological features, the doctor wouldn’t be aware of the lens until after a fishing expedition. During the procedure, an encapsulated cyst was found within the soft tissue superior to the superior fornix, the report says. On removal, that cyst ruptured, revealing the lens.

It wasn’t until after the procedure that the puzzled patient’s mother recalled an incident from the patient’s childhood. She explained that the patient had been fit with an RGP lens in the left eye after a trauma and, while wearing the lens, was again hit in the eye with a shuttlecock during a badminton game. The patient, who was 14 years old at the time, presumed the lens fell out during this incident. She never used another RGP lens. The surgeons who finally removed it inferred that it’s likely the lens migrated into her upper eyelid at the time of the impact and had remained their since 1990.

The bizarre case has since been picked up by CNN, USA Today and other major media outlets.

T2-weighted MRI of the head: transverse and sagittal views. Red arrow: high-intensity signal nodular lesion in the left upper eyelid. Image: BMJ Case Reports 2018.