Here you can see a subepithelial infiltrate which is a collection of white blood cells in response to inflammation. This is in a contact lens wearer who slept in non-extended wear contact lenses overnight. Most contact lens wearers with these problems do not have eyeglasses that are suitable for their lifestyle, therefore they depend on their contact lenses almost entirely. Patients tend to overwear their contact lenses when they don’t have nice glasses that match their lifestyle.
In this case, it was the beginning of peripheral ulceration with multiple subepithelial infiltrates, therefore it was deemed inflammatory in nature. A combination antibiotic/anti-inflammatory was prescribed along with contact lens discontinuation during the healing period and close follow-up.