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Orthokeratology associated microbial keratitis.

R Shehadeh-Masha'our1, F Segev, I S Barequet

  • 1Bnai Zion Medical Center, Faculty of Medicine Technion, Haifa, Israel.

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|January 6, 2009
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Summary

Overnight orthokeratology can lead to microbial keratitis, a serious eye infection. Prompt treatment is crucial, but corneal scarring can impair vision long-term.

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Area of Science:

  • Ophthalmology
  • Microbiology
  • Corneal Disease

Background:

  • Overnight orthokeratology (ortho-k) is a vision correction method using rigid gas permeable lenses worn during sleep.
  • Microbial keratitis is a significant risk associated with contact lens wear, including ortho-k.

Observation:

  • This study reports on four cases of microbial keratitis in patients undergoing overnight orthokeratology.
  • Patients presented with central or paracentral corneal ulcers and varying visual acuity, from 20/30 to hand motion.

Findings:

  • Pseudomonas aeruginosa was identified in all cases, cultured from corneal scrapings or lens storage solutions.
  • All infections resolved with intensive topical antimicrobial therapy.
  • Despite successful treatment, all patients developed corneal scarring, impacting final best-corrected visual acuity (ranging from 20/25 to 20/200).

Implications:

  • Infectious keratitis is a sight-threatening complication of overnight orthokeratology.
  • Ophthalmologists and eye care practitioners must recognize this risk and counsel patients on rigorous lens hygiene.
  • Early detection and prompt medical intervention are essential to manage ortho-k-associated microbial keratitis and minimize visual sequelae.