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Corneal ulcers in two children wearing paragon corneal refractive therapy lenses
1Division of Ophthalmology, Evanston Northwestern Healthcare, Chicago, Illinois, USA. mmacsai@enh.org
Insights
Two children developed bacterial corneal ulcers from wearing Paragon Corneal Refractive Therapy (CRT) lenses nightly. Prompt antibiotic treatment preserved vision, but caution is advised when prescribing CRT lenses for pediatric patients.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Corneal Refractive Therapy (CRT) lenses are approved for all ages, including children.
- Nightly wear of CRT lenses is a common treatment for myopia control.
Observation:
- Two pediatric cases of bacterial corneal ulcers developed within six months of nightly CRT lens wear.
- Causative agents identified were Pseudomonas aeruginosa and Haemophilus influenza.
Findings:
- Both patients experienced rapid resolution of corneal ulcers with intensive antibiotic therapy.
- Vision was preserved in both cases without the need for surgical intervention.
Implications:
- Pediatric use of CRT lenses may pose unique risks, including sight-threatening corneal ulcers.
- Ophthalmologists should exercise caution and ensure informed consent regarding potential complications before prescribing CRT lenses for children.
Objectives:
To report the development of corneal ulcers in two children wearing Paragon Corneal Refractive Therapy (CRT) lenses.
Methods:
Two case reports of children who developed corneal ulcers when fit with Paragon CRT contact lenses, which were worn nightly, are discussed. Each patient presented with a bacterial corneal ulcer after wearing CRT contact lenses for less than 6 months. In the first patient, Pseudomonas aeruginosa was identified as the causative organism. In the second patient, Haemophilus influenza was cultured from the ulcer.
Results:
Both patients were treated with intensive, fortified antibiotics with rapid resolution of the corneal ulcers and preservation of vision. No surgical intervention was required.
Conclusions:
Paragon CRT lenses have been approved for use in patients of all ages. When used in children, these lenses may present unique problems. The absolute incidence of bacterial corneal ulcers in patients with CRT lenses are unknown. Severe caution should be used before prescribing CRT lenses for children and informed consent should include potential sight-threatening corneal ulcers.
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