Microbial keratitis and the role of rub and rinsing

Area of Science:

• Ophthalmology
• Microbiology
• Contact Lens Science

Background:

• Recent outbreaks of microbial keratitis in contact lens wearers have been linked to various pathogens.
• The specific reasons for the increase in microbial keratitis, especially with unusual pathogens, are not fully understood.

Purpose of the Study:

• To review the literature on the necessity of a digital rubbing step in contact lens cleaning and disinfection.
• To evaluate whether recommending a digital rub component to multipurpose solution lens care systems is warranted.

Main Methods:

• Literature review of studies on microbial keratitis in contact lens wearers.
• Analysis of factors contributing to increased infection rates.
• Examination of the role of multipurpose solutions, lens hygiene, storage case cleanliness, and new contact lens materials.

Main Results:

• Inadequate multipurpose solutions and poor lens care hygiene, including the elimination of digital rubbing, are potential contributors to increased microbial keratitis.
• New soft contact lens materials may enhance pathogen adherence when digital rubbing is omitted.
• Growing evidence supports the reintroduction of a digital rubbing step in lens care systems.

Conclusions:

• The elimination of the digital rubbing step in contact lens cleaning may be a significant factor in the rise of microbial keratitis.
• Recommending a mechanical rub during lens cleaning and disinfection is increasingly supported by evidence and may be crucial for preventing infections.