The infection resolved with final spectacle-corrected visual acuity of 20/40, requiring rigid contact lenses for correction to 20/20.Ĭase 2. He was treated with topical polyhexamethylene biguanide and chlorhexidine hourly that was tapered over 6 months.
3 AN EYE FOR AN EYE 2018 SERIAL
He was evaluated at an academic medical center, where confocal microscopy, a technique that provides serial images of sections through the cornea, * revealed findings suggestive of Acanthamoeba keratitis. He was treated for bacterial and fungal microbial keratitis for 2 months without improvement. He reported sleeping in his contact lenses 3–4 nights per week and swimming with contact lenses. A man aged 34 years with a 17-year history of soft contact lens use was evaluated for left eye redness and blurry vision. Clinical presentation, risk factors, treatment, and outcomes were reviewed.Ĭase 1. Patients were evaluated and treated by practicing ophthalmologists in four major academic medical centers. In collaboration with the Eye and Contact Lens Association (formerly known as the Contact Lens Association of Ophthalmologists), six cases of contact lens–related corneal infections were identified that were diagnosed in the last 2 years in which sleeping in lenses was reported as a risk factor. Sleeping in lenses, whether inadvertently, occasionally, or as part of a prescribed wearing schedule (i.e., extended wear lenses), increases the risk for contact lens–related eye infections six- to eightfold ( 4). Approximately one third of contact lens wearers report sleeping or napping in their lenses. Among the many behaviors that increase the risk for a contact lens–related corneal infection, sleeping in lenses is one of the riskiest and one of the most commonly reported behaviors among adolescent and adult contact lens wearers ( 3). Despite this high estimated annual prevalence, over an 11-year period, only 1,075 reports of contact lens–related corneal infections were reported to FDA’s MedWatch database ( 2). Outside of MedWatch, no formal surveillance for contact lens–related corneal infections exists in the United States in 2010, an estimated 1 million outpatient and emergency department visits were reported for keratitis of all types ( 1). Additional measures are needed to educate eye care professionals about the need to report contact lens–related corneal infections to MedWatch, the FDA Safety Information and Adverse Event Reporting program ( ). Health education measures directed toward contact lens wearers should emphasize raising awareness of the risks of sleeping in contact lenses as well as adherence to all recommendations for the wear and care of contact lenses. Consequences of infection reported among the identified cases included the need for frequent administration of antibiotic eye drops, multiple follow-up medical appointments, and permanent eye damage. To illustrate their serious health implications, six cases of contact lens–related corneal infection, in which sleeping in lenses was reported as the main risk factor, are presented. Because contact lenses are regulated by the Food and Drug Administration (FDA) as medical devices, contact lens–related corneal infections should be reported to FDA as an adverse event. These infections, affecting the cornea and known as microbial keratitis ( Figure), can lead to serious adverse health outcomes. However, contact lens wearers are at risk for contact lens–related eye infections, especially when wearers do not practice proper contact lens wear and care habits. Contact lenses, when worn and cared for properly, are a safe and effective form of vision correction used by an estimated 45 million Americans.
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